CAJ | 학술논문

目的：建立鼻咽癌新辅助化疗近期疗效的模型，为个体化治疗提供依据。方法对鼻咽癌新辅助化疗的63例患者的临床资料进行回顾性分析，在综合分析影响疗效主要因素的基础上，采用Logistic回归分析构建预测模型。结果新辅助化疗鼻咽部病灶有效率为39．7％，颈部淋巴结转移灶有效率为50．8％。单因素分析显示，无远处转移、颅神经未受侵犯、血浆EBV阴性、Ki67高表达的患者对治疗更敏感。逐步Logistic回归分析显示，远处转移、颅神经受侵、血浆EBV情况影响新辅助化疗疗效。由此建立的预测模型为：Logit＝－0．470－2．863×远处转移＋1．328×颅神经受侵＋3．639×EBV，其预测的灵敏度为79．4％，特异性为82．8％，阳性预测值为84．4％，阴性预测值为77．4％。结论远处转移、颅神经受侵情况和EBV感染是影响晚期鼻咽癌患者新辅助化疗疗效的重要指标，由此建立的预测模型为鼻咽癌患者个体化治疗提供初步的依据。
목적：건립비인암신보조화료근기료효적모형，위개체화치료제공의거。방법대비인암신보조화료적63례환자적림상자료진행회고성분석，재종합분석영향료효주요인소적기출상，채용Logistic회귀분석구건예측모형。결과신보조화료비인부병조유효솔위39．7％，경부림파결전이조유효솔위50．8％。단인소분석현시，무원처전이、로신경미수침범、혈장EBV음성、Ki67고표체적환자대치료경민감。축보Logistic회귀분석현시，원처전이、로신경수침、혈장EBV정황영향신보조화료료효。유차건립적예측모형위：Logit＝－0．470－2．863×원처전이＋1．328×로신경수침＋3．639×EBV，기예측적령민도위79．4％，특이성위82．8％，양성예측치위84．4％，음성예측치위77．4％。결론원처전이、로신경수침정황화EBV감염시영향만기비인암환자신보조화료료효적중요지표，유차건립적예측모형위비인암환자개체화치료제공초보적의거。
Objective To establish a model to predict the clinical response of neoadjuvant chemotherapy for nasopharyngeal car‐cinoma ,and provide basis for the individual treatment .Methods The clinical data of 63 cases of advanced nasopharyngeal carcinoma patients who have received neoadjuvant chemotherapy in the past 2 years were analyzed retrospectively .Univariate and multivariate analyses were performed using the Logistic analyses to identify efficacy factors .Results The response rate in nasopharyngeal tumor and lymph node metastasis were 39 .7% and 50 .8% ,respectively .Single factor analysis showed that patients with no distant metas‐tasis ,cranial nerve inviolated ,EBV negative and high expression of Ki67 were more sensitive to therapy .Logistic analysis showed that the influencing factors for the effect of the new chemotherapy include :distant metastasis ,cranial nerve inviolated and EBV . Thus ,the prediction model would be:Logit= -0 .470 -2 .863 × distant metastasis + 1 .328 × cranial nerve invasion+ 3 .639 × EBV ,its sensitivity ,specificity ,positive predictive value and negative predictive value were 79 .4% ,82 .8% ,84 .4% and 77 .4% . Conclusion The distant metastasis ,cranial nerve invasion and EBV infection were important predictive factors for neoadjuvant chemotherapy of nasopharyngeal carcinoma .This model could be used to predict the response of patients with nasopharyngeal carci‐noma .