The impact of preoperative serum C-reactive protein on the prognosis of patients with hepatocellular carcinoma
The impact of preoperative serum C-reactive protein on the prognosis of patients with hepatocellular carcinoma
复制标题
DOI：
10.1002/cncr.20976
复制
发表时间：
2005-05-01
期刊：
影响因子：
6.2
通讯作者：
Takenaka, K
中科院分区：
文献类型：
--
作者：
Hashimoto, K;Ikeda, Y;Takenaka, K
背景作者评价了术前血清C反应蛋白（CRP）水平作为肝细胞癌（HCC）患者预后指标的意义。回顾性分析了141例接受根治性切除术的HCC患者。比较血清CRP水平>= 1.0 mg/dL的患者（n = 22例; CRP阳性组）和血清CRP水平< 1.0 mg/dL的患者（n = 119例; CRP阴性组）的临床病理学变量。进行单变量和多变量分析，以确定影响生存和疾病复发的因素。术前血清CRP水平与肿瘤大小有显著相关性。CRP阳性组门静脉侵犯明显多于CRP阴性组。即使在接受根治性切除术后，CRP阳性组中75.3%的患者在1年内复发。CRP阳性组的总生存率和无复发生存率明显低于CRP阴性组。在多因素分析中，术前血清CRP水平被选为生存和复发的不利指标之一。当术前CRP水平、白蛋白水平和血小板计数作为一个综合指标进行评分时，总评分对肝切除术后的生存率有很好的分层价值。目前的研究结果表明，术前血清CRP水平是预测肝癌患者预后不良和早期复发的一个独立而重要的指标。新的CRP评分系统为预测生存提供了可靠的信息。(c)2005年美国癌症协会。
BACKGROUND. The authors evaluated the significance of the preoperative serum C-reactive protein (CRP) level as a prognostic indicator in patients with hepatocellular carcinoma (HCC).METHODS. One hundred forty-one patients who underwent curative resection for HCC were reviewed retrospectively. Clinicopathologic variables were compared between patients with serum CRP levels >= 1.0 mg/dL (n = 22 patients; the CRP-positive group) and patients with serum CRP levels < 1.0 mg/dL (n = 119 patients; the CRP-negative group). Univariate and multivariate analyses were conducted to identify factors that affected survival and disease recurrence.RESULTS. There was a significant correlation between the preoperative serum CRP level and tumor size. Invasion to the portal vein in the CRP-positive group was significantly more frequent than that in the CRP-negative group. Even after they underwent curative resection, 75.3% of patients in the CRP-positive group experienced recurrence within 1 year. The overall survival and recurrence-free survival rates in the CRP-positive group were significantly lower compared with the rates in the CRP-negative group. On multivariate analysis, the preoperative serum CRP level was selected as one of the unfavorable indicators regarding survival and recurrence. When CRP levels, albumin levels, and platelet counts that were available before surgery were scored as a combined index, the total score demonstrated a good stratification value for survival after hepatic resection.CONCLUSIONS. The current results showed that the preoperative serum CRP level is an independent and significant indicator predictive of poor prognosis and early recurrence in patients with HCC. The new CRP-based scoring system offers reliable information for predicting survival. (c) 2005 American Cancer Society.