Systemic inflammatory response predicts survival following curative resection of colorectal cancer
Systemic inflammatory response predicts survival following curative resection of colorectal cancer
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DOI：
10.1002/bjs.4038
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发表时间：
2003-02-01
影响因子：
9.6
通讯作者：
McArdle, CS
中科院分区：
文献类型：
--
作者：
McMillan, DC;Canna, K;McArdle, CS
背景：一些研究表明，全身炎症反应的存在，如循环中C反应蛋白(CRP)浓度升高所证明的那样，可以预测结直肠癌患者的复发和总生存期。本研究的目的是探讨结直肠癌根治性切除患者的炎症反应与总生存率和肿瘤特异性生存率之间的关系。结果：大多数患者年龄在65岁或以上，有结肠肿瘤和Dukes‘s B期病变。在随访期间，47名患者(27%)复发，59名患者(34%)死亡。在单因素分析中，年龄(P<；0.01)、Dukes‘s分期(P<；0.001)以及手术前(P<；0.01)和术后(P<；0.01)的C反应蛋白水平与总生存率和肿瘤特异性生存率显著相关。多因素分析显示，年龄(P<；0.01)、Dukes‘s分期(P<；0.05)和C-反应蛋白浓度(P<；0.01)与结直肠癌患者的总体生存率和肿瘤特异性生存率独立相关。结论：在接受潜在根治性结直肠癌切除术的患者中，全身炎症反应的存在预示着不良预后。
Background: Some studies have shown that the presence of a systemic inflammatory response, as evidenced by raised circulating concentrations of C-reactive protein (CRP), predicted recurrence and overall survival in patients with colorectal cancer. The aim of this study was to examine the relationship between the inflammatory response and overall and cancer-specific survival in patients undergoing potentially curative resection for colorectal cancer.Methods: A total of 174 patients considered to have undergone curative resection were studied. Circulating CRP concentrations were measured before and/or after operation.Results: The majority of patients were aged 65 years or more, had colonic tumours and Dukes' stage B lesions. During follow-up, 47 patients (27 per cent) developed recurrence and 59 (34 per cent) died. On univariate analysis, age (P < 0.01), Dukes' stage (P < 0.001), and CRP levels before (P < 0.01) and after (P < 0.01) operation were significantly associated with overall and cancer-specific survival. On multivariate analysis of patients in whom preoperative CRP concentration was measured, age (P < 0.01), Dukes' stage (P < 0.05) and CRP concentration (P < 0.01) were independently associated with both overall and cancer-specific survival.Conclusion: In patients who have undergone potentially curative resection for colorectal cancer, the presence of a systemic inflammatory response predicts a poor outcome.