Blood Cadmium Level Is Associated with Short Progression-Free Survival in Nasopharyngeal Carcinoma
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subjects
2.2. Collection of General and Clinical Data
2.3. Collection of Survival Time Data
2.4. Analysis of Blood Cd Level
2.5. Statistical Analysis
3. Results
3.1. Association between Clinical Characteristics and NPC Progression
3.2. Association between Clinical Characteristics of NPC Patients and Blood Cd Level
3.3. Prognostic Factors Associated with PFS and NPC Progression
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Clinicopathologic Characteristics | NPC Progression n = 49 | No NPC Progression n = 85 | p-Value |
---|---|---|---|
Age (years), mean ± SD | 54.00 ± 11.61 | 56.47 ± 12.08 | 0.250 a |
Cd level (μg/L), median, IQR | 7.62 (3.37–9.43) | 3.09 (1.77–4.80) | <0.001 * |
EA+ | 4.53 (0.73–10.08) | 5.99 (2.51–10.36) | 0.270 a |
VCA+ | 0.37 (0.03–2.05) | 1.15 (0.21–3.09) | 0.092 a |
Sex | |||
Female | 8 (16.3) | 23 (27.1) | 0.156 b |
Male | 41 (83.7) | 62 (72.9) | |
Family history of cancer | |||
Yes | 8 (16.3) | 15 (17.6) | 0.845 b |
No | 41 (83.7) | 70 (82.4) | |
History of disease | |||
Yes | 12 (24.5) | 33 (38.8) | 0.091 b |
No | 37 (75.5) | 52 (61.2) | |
Smoking pack-years | |||
No smoking | 14 (28.6) | 42 (49.4) | 0.118 b |
<30 | 12 (24.5) | 17 (20.0) | |
30–40 | 8 (16.3) | 10 (11.8) | |
≥40 | 15 (30.6) | 16 (18.8) | |
Smoking history | |||
Yes | 35 (71.4) | 43 (50.6) | 0.018 b |
No | 14 (28.6) | 42 (49.4) | |
Alcohol drinking | |||
Yes | 8 (16.3) | 10 (11.8) | 0.456 b |
No | 41 (83.7) | 75 (88.2) | |
T classification | |||
T1 | 5 (10.4) | 1 (1.2) | 0.080 b |
T2 | 14 (29.2) | 32 (37.6) | |
T3 | 13 (27.1) | 20 (23.5) | |
T4 | 16 (33.3) | 32 (37.6) | |
Clinical stages | |||
Early | 1 (2.0) | 8 (9.4) | 0.101 b |
Advanced | 48 (98.0) | 77 (90.6) | |
N classification | |||
N0 | 2 (4.2) | 3 (3.5) | 0.573 b |
N1 | 5 (10.4) | 14 (16.5) | |
N2 | 34 (70.8) | 61 (71.8) | |
N3 | 7 (14.6) | 7 (8.2) | |
M classification | |||
M0 | 44 (91.7) | 77 (90.6) | 0.835 b |
M1 | 4 (8.3) | 8 (9.4) | |
Pathological types | |||
Undifferentiated | 36 (73.5) | 50 (58.8) | 0.234 b |
Differentiated | 12 (24.5) | 32 (37.6) | |
Squamous | 1 (2.0) | 3 (3.5) |
Clinicopathologic Characteristics | No. of Patients | Blood Cd Level | p-Value | |
---|---|---|---|---|
<3.84 μg/L (n = 67) | ≥3.84 μg/L (n = 67) | |||
Age (years), mean ± SD | 134 | 55.40 ± 11.66 | 55.73 ± 12.28 | 0.631 a |
EA+ | 106 | 5.13 (1.73–9.97) | 7.10 (2.49–10.71) | 0.185 a |
VCA+ | 107 | 0.81 (0.12–2.40) | 0.89 (0.21–3.35) | 0.432 a |
Sex | ||||
Female | 103 | 49 (73.1) | 54 (80.6) | 0.306b |
Male | 31 | 18 (26.9) | 13 (19.4) | |
Family history of cancer | ||||
Yes | 23 | 8 (11.9) | 15 (22.4) | 0.109 b |
No | 111 | 59 (88.1) | 52 (77.6) | |
Disease history | ||||
Yes | 45 | 29 (43.3) | 16 (23.9) | 0.017 b |
No | 89 | 38 (56.7) | 51 (76.1) | |
Smoking pack-years | ||||
No smoking | 56 | 35 (52.2) | 21 (31.3) | 0.003 b |
<30 | 29 | 17 (25.4) | 12 (17.9) | |
30–40 | 18 | 8 (11.9) | 10 (14.9) | |
≥40 | 31 | 7 (10.4) | 24 (35.8) | |
Smoking history | ||||
Yes | 78 | 32 (47.8) | 46 (68.7) | 0.014 b |
No | 56 | 35 (52.2) | 21 (31.3) | |
Alcohol drinking | ||||
Yes | 18 | 7 (10.4) | 11 (16.4) | 0.311 b |
No | 116 | 60 (89.6) | 56 (83.6) | |
Clinical stage | ||||
Early | 9 | 8 (11.9) | 1 (1.5) | 0.016 b |
Advanced | 125 | 59 (88.1) | 66 (98.5) | |
T classification | ||||
T1 | 6 | 2 (3.0) | 4 (6.1) | 0.356 b |
T2 | 46 | 25 (37.3) | 21 (31.8) | |
T3 | 33 | 13 (19.4) | 20 (30.3) | |
T4 | 48 | 27 (40.3) | 21 (31.8) | |
N classification | ||||
N0 | 5 | 3 (4.5) | 2 (3.0) | 0.345 b |
N1 | 19 | 13 (19.4) | 6 (9.1) | |
N2 | 95 | 45 (67.2) | 50 (75.8) | |
N3 | 14 | 6 (9.0) | 8 (12.1) | |
M classification | ||||
M0 | 121 | 62 (92.5) | 59 (89.4) | 0.527 b |
M1 | 12 | 5 (7.5) | 7 (10.6) | |
Pathological types | ||||
Undifferentiated | 86 | 40 (59.7) | 46 (68.7) | 0.410 b |
Differentiated | 44 | 24 (35.8) | 20 (29.9) | |
Squamous | 4 | 3 (4.5) | 1 (1.5) |
Variables | Blood Cd Level | OR (95%CI) | p-Value | |
---|---|---|---|---|
<3.84 μg/L n = 67 | ≥3.84 μg/L n = 67 | |||
Family History of Cancer | ||||
No | 59 (88.1) | 52 (77.6) | Reference | |
Yes | 8 (11.9) | 15 (22.4) | 1.52 (0.53–4.40) | 0.437 |
Smoking pack-years | ||||
No smoking | 35 (52.2) | 21 (28.8) | Reference | |
<30 | 17 (25.4) | 12 (16.4) | 1.14 (0.44–2.96) | 0.790 |
30–40 | 8 (11.9) | 16 (21.9) | 2.01 (0.64–6.32) | 0.228 |
≥40 | 7 (10.4) | 24 (32.9) | 4.83 (1.68–13.91) | 0.004 |
History of disease | ||||
No | 38 (56.7) | 51 (76.1) | Reference | |
Yes | 29 (43.3) | 16 (23.9) | 0.39 (0.17–0.89) | 0.025 |
Clinical stage | ||||
Early | 8 (11.9) | 1 (1.5) | Reference | |
Advanced | 59 (88.1) | 66 (98.5) | 5.50 (0.62–48.54) | 0.125 |
Investigated Factors | SPY | Age | Sex | FHC | DH | AD | CS | PT | SH | BCL | VCA+ |
---|---|---|---|---|---|---|---|---|---|---|---|
EA+ | −0.025 | 0.204 * | −0.108 | −0.045 | −0.129 | −0.268 ** | 0.032 | 0.207 * | −0.080 | 0.167 | 0.476 ** |
VCA+ | -0.082 | 0.149 | 0.179 | −0.039 | −0.014 | −0.066 | −0.095 | −0.105 | −0.100 | 0.065 | |
BCL | 0.314 ** | −0.006 | −0.056 | 0.146 | −0.202 * | −0.088 | 0.192 * | −0.155 | 0.224 ** | ||
SH | 0.899 ** | 0.064 | −0.612 ** | 0.145 | −0.006 | 0.289 ** | 0.135 | 0.017 | |||
PT | 0.031 | 0.017 | −0.074 | 0.020 | −0.051 | −0.100 | −0.003 | ||||
CS | 0.143 | −0.064 | −0.065 | 0.122 | −0.125 | 0.018 | |||||
AD | 0.269 ** | 0.048 | −0.216 * | 0.111 | 0.183* | ||||||
DH | −0.023 | 0.056 | −0.053 | 0.137 | |||||||
FHC | 0.241 ** | 0.107 | −0.109 | ||||||||
Sex | −0.539 ** | −0.039 | |||||||||
Age | 0.204 * |
Variables | PFS | ||
---|---|---|---|
HR | 95% CI | p-Value | |
Sex (male vs. female) | 1.25 | 0.45–3.42 | 0.671 |
Residence | |||
Chaozhou | Reference | ||
Shantou | 0.70 | 0.28–1.74 | 0.443 |
Jieyang | 0.99 | 0.39–2.48 | 0.976 |
Other area | 0 | 0 | 0.976 |
Family history of cancer (yes vs. no) | 1.11 | 0.49–2.53 | 0.800 |
History of disease (yes vs. no) | 0.65 | 0.31–1.34 | 0.240 |
Alcohol drinking (yes vs. no) | 1.11 | 0.46–2.71 | 0.817 |
Smoking pack-years | |||
No smoking | Reference | ||
<30 | 2.32 | 0.87–6.22 | 0.093 |
30–40 | 1.47 | 0.52–4.18 | 0.468 |
≥40 | 1.76 | 0.70–4.42 | 0.230 |
Clinical stage (advanced vs early) | 3.03 | 0.37–24.65 | 0.301 |
Blood Cd level (≥3.84 vs. <3.84 μg/L) | 4.11 | 1.92–8.81 | <0.001 |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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Du, T.; Huang, W.; Zheng, S.; Bao, M.; Huang, Y.; Li, A.; He, M.; Wu, K. Blood Cadmium Level Is Associated with Short Progression-Free Survival in Nasopharyngeal Carcinoma. Int. J. Environ. Res. Public Health 2019, 16, 2952. https://doi.org/10.3390/ijerph16162952
Du T, Huang W, Zheng S, Bao M, Huang Y, Li A, He M, Wu K. Blood Cadmium Level Is Associated with Short Progression-Free Survival in Nasopharyngeal Carcinoma. International Journal of Environmental Research and Public Health. 2019; 16(16):2952. https://doi.org/10.3390/ijerph16162952
Chicago/Turabian StyleDu, Taifeng, Wenlong Huang, Shukai Zheng, Mian Bao, Yuanni Huang, Anna Li, Meirong He, and Kusheng Wu. 2019. "Blood Cadmium Level Is Associated with Short Progression-Free Survival in Nasopharyngeal Carcinoma" International Journal of Environmental Research and Public Health 16, no. 16: 2952. https://doi.org/10.3390/ijerph16162952