Comprehensive Comparative Analysis of Prognostic Value of Systemic Inflammatory Biomarkers for Patients with Stage II/III Colon Cancer
Comprehensive Comparative Analysis of Prognostic Value of Systemic Inflammatory Biomarkers for Patients with Stage II/III Colon Cancer
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DOI：
10.1245/s10434-019-07904-9
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发表时间：
2019-11-12
影响因子：
3.7
通讯作者：
Ueno, Masashi
中科院分区：
文献类型：
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作者：
Suzuki, Shinsuke;Akiyoshi, Takashi;Ueno, Masashi
背景在众多全身炎症生物标志物中，尚不清楚哪一种对II/III期结肠癌患者的预后最好。我们的目的是比较全身炎症生物标志物在II/III期结肠癌患者中的预后意义。方法从2004年7月至2013年12月，1303例II/III期结肠癌患者接受了潜在根治性切除术。通过受试者工作特征(ROC)曲线分析，比较了来自中性粒细胞、淋巴细胞、单核细胞、血小板、C反应蛋白(CRP)和白蛋白的16种全身性炎症生物标志物，以确定与总生存期(OS)和无病生存期(DFS)最相关的生物标志物。结果9种炎症标志物对DFS有预测作用，其中淋巴细胞/C反应蛋白比值(LCR)、C反应蛋白/白蛋白比值(CAR)、中性粒细胞x-C反应蛋白、单核细胞x-C反应蛋白、血小板x-C反应蛋白对DFS有预测作用。在5种炎症标志物中，LCR的曲线下面积(AUC值)最高(0.630)，显著高于OS的中性粒细胞x C反应蛋白(P=0.010)、单核细胞x C反应蛋白(P=0.007)和血小板x C反应蛋白(P=0.010)。多因素分析显示LCR和CAR对预后的影响仅LCR是OS[危险比(HR)1.77，95%可信区间(CI)1.23~2.60；P=0.002]和DFS(HR，1.29；95%CI，1.00~1.66；P=0.048)的独立预测因子。结论LCR可能是预测II、III期结肠癌患者OS和DFS的最有用的指标。
Background Among numerous systemic inflammatory biomarkers, it remains unclear which is the most prognostic for patients with stage II/III colon cancer. We aimed to compare the prognostic significance of systemic inflammatory biomarkers among patients with stage II/III colon cancer. Methods We included 1303 patients with stage II/III colon cancer who underwent potentially curative resection from July 2004 to December 2013. Sixteen systemic inflammatory biomarkers-derived from combinations of neutrophils, lymphocytes, monocytes, platelets, C-reactive protein (CRP), and albumin-were compared to identify the biomarker most associated with overall survival (OS) and disease-free survival (DFS) using receiver operating characteristic (ROC) curve analysis. Results Nine inflammatory biomarkers were predictive for OS, among which lymphocyte-to-CRP ratio (LCR), CRP-to-albumin ratio (CAR), neutrophil x CRP, monocyte x CRP, and platelet x CRP were also predictive for DFS. Among these five inflammatory biomarkers, the area under the curve (AUC) value was highest (0.630) for LCR, being significantly higher than that for neutrophil x CRP (P = 0.010), monocyte x CRP (P = 0.007), or platelet x CRP (P = 0.010) for OS. When the prognostic impact of LCR and CAR were analyzed by multivariate analysis, only LCR was an independent predictor of both OS [hazard ratio (HR), 1.77; 95% confidence interval (CI), 1.23-2.60; P = 0.002] and DFS (HR, 1.29; 95% CI, 1.00-1.66; P = 0.048). Conclusions LCR may be the most useful predictive factor for OS and DFS in patients with stage II or III colon cancer.