Prognostic Correlations between ABO Blood Group and Pre-Treatment Plasma Epstein-Barr Virus DNA in Patients with Nasopharyngeal Carcinoma Receiving Intensity-Modulated Radiotherapy

PLoS One. 2016 Nov 11;11(11):e0166194. doi: 10.1371/journal.pone.0166194. eCollection 2016.

Abstract

Purpose: The objective of this study is to assess the prognostic value of ABO blood group in nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT).

Patients and methods: We retrospectively reviewed the data on 1397 patients with non-metastatic, newly diagnosed NPC treated using IMRT. Patient survival between different ABO blood groups were compared using log-rank test. Cox hazards model was adopted to establish independent prognostic factors.

Results: In our study, the distribution of the A, B, AB and O blood groups was 26.6% (372/1397), 26.2% (366/1397), 5.2% (73/1397) and 42.0% (586/1397), respectively. The cut-off value of pre-treatment Epstein-Barr virus (EBV) DNA based on disease-free survival (DFS) was 1355 copies/ml (area under curve [AUC], 0.649; sensitivity, 0.76; specificity, 0.496) for the whole cohort. Estimated four-year DFS, overall survival (OS), distant metastasis-free survival (DMFS) and locoregional relapse-free survival (LRRFS) rates were 81.7%, 89.2%, 89.4% and 92.3% for blood group A; 82.1%, 89.3%, 89.0% and 92.0% for group B; 83.3%, 88.1%, 86.2% and 95.5% for group AB, 80.9%, 90.7%, 88.4% and 90.2% for group O (P > 0.05 for all rates). Multivariate analysis revealed ABO blood group was not an independent prognostic factor for DFS, OS, DMFS or LRRFS (P > 0.05 for all rates) after adjusting for plasma EBV DNA in either the whole cohort or subgroup analysis by gender.

Conclusions: The prognostic value of ABO blood group may be limited for patients with NPC in the era of IMRT, and no substantial correlation between ABO blood group and plasma EBV DNA was observed.

MeSH terms

  • ABO Blood-Group System*
  • Adolescent
  • Adult
  • Aged
  • Carcinoma / blood
  • Carcinoma / radiotherapy*
  • Carcinoma / virology
  • DNA, Viral / blood*
  • DNA, Viral / genetics
  • Epstein-Barr Virus Infections / blood
  • Epstein-Barr Virus Infections / virology
  • Female
  • Follow-Up Studies
  • Herpesvirus 4, Human / genetics
  • Herpesvirus 4, Human / physiology
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nasopharyngeal Neoplasms / blood
  • Nasopharyngeal Neoplasms / radiotherapy*
  • Nasopharyngeal Neoplasms / virology
  • Prognosis
  • Radiotherapy, Intensity-Modulated / methods*
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • ABO Blood-Group System
  • DNA, Viral

Grants and funding

This work was supported by grants from the Health & Medical Collaborative Innovation Project of Guangzhou City, China (No. 201400000001), the Sun Yat-sen University Clinical Research 5010 Program (No. 2012011), the Science and Technology Project of Guangzhou City, China (No. 14570006), and the Planned Science and Technology Project of Guangdong Province (No. 2013B020400004). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.