Serum CCL2 and serum TNF-α--two new biomarkers predict bone invasion, post-treatment distant metastasis and poor overall survival in nasopharyngeal carcinoma.
OBJECTIVE
To evaluate the prognostic potential of serum CCL2 (sCCL2) and serum TNF-α (sTNF-α) in nasopharyngeal carcinoma (NPC) before treatment by analysing the expression of these two markers.


METHODS
Both sCCL2 and sTNF-α were prospectively detected in 297 NPC patients with enzyme-linked immunosorbent assay (ELISA) before treatment. The correlations between sCCL2 level or sTNF-α level and patient's survival were evaluated.


RESULTS
For sCCL2, the 5-year overall survival (OS) and 5-year distant metastasis-free survival (DMFS) of high expression group and low expression group were 64% versus 81% and 67% versus 84% (P < 0.05), respectively. For sTNF-α, the 5-year OS and 5-year DMFS of high expression group and low expression group were 62% versus 79% and 66% versus 82% (P < 0.05), respectively. The 5-year OS and 5-year DMFS for both positive patients, one marker positive patient and both negative patients were 53% versus 77% versus 85% and 58% versus 80% versus 86% (P < 0.05), respectively. Concentrations of sCCL2 and sTNF-α in patients with large skull base invasion were higher than those without or with small skull invasion (P < 0.05). Patients who developed bone metastasis alone after radical treatment had higher pre-treatment concentrations of sCCL2 and sTNF-α than those without metastasis (P < 0.001). Multifactorial Cox regression analyses demonstrated that T/N/M classification, chemotherapy, sCCL2 level and sTNF-α level were independent predictors of OS and DMFS of NPC patients.


CONCLUSIONS
High expression levels of sCCL2 and sTNF-α predict bone invasion, post-treatment distant metastasis and poor overall survival in NPC patients.
Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou 510060, PR China.
Xing
X
Lu
Chao-Nan
CN
Qian
Yong-Gao
YG
Mu
Ning-Wei
NW
Li
Su
S
Li
Hai-Bo
HB
Zhang
Si-Wei
SW
Li
Fei-Li
FL
Wang
Xiang
X
Guo
Yan-Qun
YQ
Xiang
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D001859:Bone Neoplasms / Q000378:metabolism* / Q000401:mortality; D002277:Carcinoma; D018932:Chemokine CCL2 / Q000097:blood*; D018572:Disease-Free Survival; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000097:blood / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D055815:Young Adult
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D014409:Tumor Necrosis Factor-alpha