Leukocyte telomere length associates with nasopharyngeal carcinoma risk and survival in Hong Kong Chinese

Abstract

Telomere shortening occurs as an early event in tumorigenesis. The TERT-CLPTM1L locus associates with nasopharyngeal carcinoma (NPC) risk. It remains unknown if leukocyte telomere length (LTL) associates with NPC risk and survival. The relative LTL (rLTL) was measured by quantitative-PCR in 2,996 individuals comprised of 1,284 NPC cases and 1712 matched controls. The odds ratio (OR) and 95% confidence intervals (CI) were calculated by logistic regression. The hazard ratio (HR) and 95% CI were calculated by Cox regression for survival analysis with rLTL and other clinical parameters in 1,243 NPC with a minimum follow-up period of 25 months. NPC patients had significantly shorter telomere length than controls. Shorter rLTL significantly associated with increased NPC risk, when the individuals were dichotomized into long and short telomeres based on median-split rLTL in the control group (OR = 2.317; 95% CI = 1.989-2.700, p = 4.10 × 10 ). We observed a significant dose-response association (p = 3.26 × 10 ) between rLTL and NPC risk with OR being 3.555 (95% CI = 2.853-4.429) for the individuals in the first quartile (shortest) compared with normal individuals in the fourth quartile (longest). A multivariate Cox regression analysis adjusted by age demonstrated an independent effect of rLTL on NPC survival for late-stage NPC patients, when the individuals were categorized into suboptimal rLTL versus the medium rLTL based on a threshold set from normal (HR = 1.471, 95% CI = 1.056-2.048, p = 0.022). Shorter blood telomeres may be markers for higher susceptibility for NPC risk. Suboptimal rLTL may be a poor prognostic factor for advanced NPC patients, as it associates independently with poor survival.

Platelet to Lymphocytes Ratio to Predict Nasopharyngeal Carcinoma Progressivity

“…Telomere length in NPC patients is 3.2 times shorter than in normal tissue; this indicates that telomere shortening is involved in tumor progression. Ko et al studies suggest that telomere shortening is associated with old age and males [21].…”

Leukocyte telomere length is associated with aggressive prostate cancer in localized prostate cancer patients

“…A number of studies have evaluated the association of LTL with the prognosis of other cancers and most showed that shorter LTL was associated with increased risks of death in cancer patients, including bladder cancer [46], stage I and II cutaneous melanoma [47], gastric cancer [48], colorectal cancer [49], renal cell carcinoma [50], pancreatic cancer [51], and lung adenocarcinoma [52]. Interestingly, a recent large study of nasopharyngeal carcinoma in Hong Kong found that suboptimal LTL (both too short and too long) was associated with poor survival compared to patients with normal range LTL [53]. Only a couple of studies reported that shorter LTL increased risk of relapse [48,49].…”

Platelet to Lymphocytes Ratio in the Clinical Stage of Nasopharyngeal Carcinoma

“…According to Gihbid et al, EBV DNA plasma levels in patients above 30 years old are 4 times higher than in patients under 30 years. [17][18][19][20][21][22][23] The genetic factors of the patient are important in the development of NPC. The ends of DNA chains that contain proteins that protect DNA from damage are known as telomeres.…”

“…Telomere shortening is caused by the aging process and is associated with male gender. 22 Lymphocytes play an important role in the immune system because they influence the immune response to infectious microorganisms and other foreign substances. The specific lymphocyte response functions to attack microorganisms, protect against tumors, and cause tissue rejection after organ transplantation.…”