Objective       To estimate the clinical significance of tissue expression of Ki-67 and serum levels of cytokeratin 19 fragment Cyfra21-1

squamous cell carcinoma antigen (SCCA)

lactate dehydrogenase (LDH) and alkaline pho

sphatase (ALP) in the prognosis prediction of nasopharyngeal carcinoma.       Methods        A total of 89 patients with pathologically diagnosed nasopharyngeal carcinoma who receiving concurrent radiotherapy and chemotherapy in our center from June to December 2008 were recruited in this retrospective study. The expression of Ki-67 in the cancer tissue was detected by immunohistochemical assay

while the serum levels of Cyfra21-1

SCCA

LDH and ALP were measured by chemiluminescence assay and continuous monitoring after the treatment respectively.       Results      Till the end of follow-up (December 2013)

36 cases were enrolled in recurrence group

while 34 cases and 19 cases were enrolled in distant metastasis group and clinical remission group respectively. The clinical remission group had obviously milder expression level of Ki-67 than the distant metastasis group (

P

=0.011)

and significantly lower level of Cyfra21-1 than the recurrence group and the distant metastasis group respectively (

P

<

0.05). The LDH level was markedly lower in the recurrence group than the distant metastasis group (

P

<

0.05). There was no significant difference in the levels of ALP and SCCA among the 3 groups (

P

>0.05). Cox regression analysis demonstrated that high expression of Ki-67 (

P

<

0.01

HR

=1.973) and high serum level of Cyfra21-1 (

P

<

0.01

HR

=1.537) were adverse prognostic factors for progression-free survival

and Cyfra21-1(

P

<

0.01，

HR

=1.492) was also an adverse prognostic factor for overall survival. Kaplan-Meier survival curves indicated that there were significant differences in progression-free survival and overall survival between the low risk and the high risk groups (

P

<

0.01).       Conclusion        Combining detection of histological Ki-67 and serum Cyfra21-1 is of great value in predicting the poor prognosis of nasopharyngeal carcinoma.