Preresection serum C-reactive protein measurement and survival among patients with resectable non-small cell lung cancer
Preresection serum C-reactive protein measurement and survival among patients with resectable non-small cell lung cancer
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DOI：
10.1016/j.jtcvs.2011.07.021
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发表时间：
2011-11-01
影响因子：
6
通讯作者：
Regnard, Jean-Francois
中科院分区：
文献类型：
--
作者：
Alifano, Marco;Falcoz, Pierre E.;Regnard, Jean-Francois
目的：本研究的目的是确定是否切除前血清CRP水平独立预测可切除的非小细胞肺癌患者的生存率。方法：从300例非小细胞肺癌患者在一个单一的机构进行手术的临床，病理和实验室数据进行了研究，在单变量和多变量生存分析。结果：在主要队列中，术前CRP值为3 mg/L或更低的136例患者（45.3%），4和20 mg/L之间的89例（29.7%），64例（21.3%）大于20。CRP水平与慢性支气管炎、低白蛋白血症、病理分期和瘤周血管栓塞显著相关。总体而言，术前CRP ≤ 3 mg/L、4 - 20 mg/L和> 20 mg/L患者的5年生存率分别为55.6%、45.6%和40.0%（P = 0.0571）。在多变量分析中，CRP水平大于20与生存率显著相关，但CRP水平与疾病分期之间存在显著相互作用（P = 0.02）。CRP水平大于20的I期或II期患者的生存率低于CRP检测不到的患者（校正风险比为1.874; 95%置信区间为1.039-3.381）; III期和IV期患者的差异无统计学意义。在验证系列中，CRP水平大于20 mg/L也预测较差的生存率（P = 0.018）。结论：术前CRP水平大于20 mg/L与I期或II期非小细胞肺癌患者的生存率显著相关。（《胸血管外科杂志》2011;142：1161-7）
Objective: This study aimed to determine whether preresection serum CRP level independently predicts survival among patients with resectable non-small cell lung cancer.Methods: Clinical, pathologic, and laboratory data from 300 patients operated on for non-small cell lung cancer in a single institution were studied in univariate and multivariate survival analyses. Validation was sought in another cohort of 68 similar patients from another institution.Results: In the main cohort, preoperative CRP value was 3 mg/L or lower in 136 patients (45.3%), between 4 and 20 mg/L in 89 (29.7%), and greater than 20 in 64 (21.3%). CRP level was significantly associated with chronic bronchitis, hypoalbuminemia, pathologic stage, and peritumoral vascular emboli. Overall, 5-year survivals of patients with preoperative CRP 3 mg/L or lower, between 4 and 20 mg/L, and greater than 20 mg/L were 55.6%, 45.6%, and 40.0%, respectively (P = .0571). In multivariate analysis, CRP level greater than 20 was significantly associated with survival, but with significant interaction between CRP level and disease stage (P = .02). Patients in stage I or II disease with CRP levels greater than 20 had worse survival than did patients with undetectable CRP (adjusted hazard ratio, 1.874; 95% confidence interval, 1.039-3.381); the difference was not significant in stages III and IV. In the validation series, CRP level greater than 20 mg/L also predicted worse survival (P = .018).Conclusions: Preoperative CRP level greater than 20 mg/L is significantly associated with worse survival than undetectable CRP in patients with stage I or II non-small cell lung cancer. (J Thorac Cardiovasc Surg 2011;142:1161-7)