Eight-signature classifier for prediction of nasopharyngeal [corrected] carcinoma survival.
OBJECTIVE
Currently, nasopharyngeal carcinoma (NPC) prognosis evaluation is based primarily on the TNM staging system. This study aims to identify prognostic markers for NPC.


METHODS
We detected expression of 18 biomarkers by immunohistochemistry in NPC tumors from 209 patients and evaluated the association between gene expression level and disease-specific survival (DSS). We used support vector machine (SVM)--based methods to develop a prognostic classifier for NPC (NPC-SVM classifier). Further validation of the NPC-SVM classifier was performed in an independent cohort of 1,059 patients.


RESULTS
The NPC-SVM classifier integrated patient sex and the protein expression level of seven genes, including Epstein-Barr virus latency membrane protein 1, CD147, caveolin-1, phospho-P70S6 kinase, matrix metalloproteinase 11, survivin, and secreted protein acidic and rich in cysteine. The NPC-SVM classifier distinguished patients with NPC into low- and high-risk groups with significant differences in 5-year DSS in the evaluated patients (87% v 37.7%; P < .001) in the validation cohort. In multivariate analysis adjusted for age, TNM stage, and histologic subtype, the NPC-SVM classifier was an independent predictor of 5-year DSS in the evaluated patients (hazard ratio, 4.9; 95% CI, 3.0 to 7.9) in the validation cohort.


CONCLUSIONS
As a powerful predictor of 5-year DSS among patients with NPC, the newly developed NPC-SVM classifier based on tumor-associated biomarkers will facilitate patient counseling and individualize management of patients with NPC.
Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, 651 Dongfeng Rd East, Guangzhou 510060, People's Republic of China.
Hai-Yun
HY
Wang
Bing-Yu
BY
Sun
Zhi-Hua
ZH
Zhu
Ellen T
ET
Chang
Ka-Fai
KF
To
Jacqueline S G
JS
Hwang
Hao
H
Jiang
Michael Koon-Ming
MK
Kam
Gang
G
Chen
Shie-Lee
SL
Cheah
Ming
M
Lee
Zhi-Wei
ZW
Liu
Jing
J
Chen
Jia-Xing
JX
Zhang
Hui-Zhong
HZ
Zhang
Jie-Hua
JH
He
Fa-Long
FL
Chen
Xiao-Dong
XD
Zhu
Ma-Yan
MY
Huang
Ding-Zhun
DZ
Liao
Jia
J
Fu
Qiong
Q
Shao
Man-Bo
MB
Cai
Zi-Ming
ZM
Du
Li-Xu
LX
Yan
Chun-Fang
CF
Hu
Ho-Keung
HK
Ng
Joseph T S
JT
Wee
Chao-Nan
CN
Qian
Qing
Q
Liu
Ingemar
I
Ernberg
Weimin
W
Ye
Hans-Olov
HO
Adami
Anthony T
AT
Chan
Yi-Xin
YX
Zeng
Jian-Yong
JY
Shao
D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics* / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D015870:Gene Expression; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000401:mortality*; D011379:Prognosis; D016019:Survival Analysis; D046888:Tissue Array Analysis; D054928:Validation Studies as Topic
D014408:Biomarkers, Tumor