Is C-reactive protein a prognostic factor of colorectal cancer?
Is C-reactive protein a prognostic factor of colorectal cancer?
复制标题
DOI：
10.1007/s10350-007-9133-z
复制
发表时间：
2008-04-01
影响因子：
3.9
通讯作者：
Yang, Shung-Haur
中科院分区：
文献类型：
--
作者：
Shiu, Yu-Chen;Lin, Jen-Kou;Yang, Shung-Haur
目的：C反应蛋白是一种常用的炎症标志物，已被报道为结直肠癌的预后因素。方法：自2001年1月至2005年9月，对212例(140例男性)择期开腹结直肠癌切除术患者进行了术前C反应蛋白检测。高于0.5 mg/dl的水平被定义为阳性。对照临床病理因素进行分析。对158例根治性切除的生存情况进行分析。结果：C反应蛋白中位数为0.54 mg/dl，阳性率为48.6%。阳性率与溃疡类型、肿块较大、分期较高、癌胚抗原阳性(>；5 ng/ml)有关。在单因素对数检验和多因素COX比例风险回归分析中，临床分期(单因素P=0.011，多因素P=0.016；危险比6.23，95%可信区间1.41~27.54)、C反应蛋白(0.5 mg/dl；P=0.005，P=0.016；危险比：6.5 1，95%可信区间：1.41~30.05)和分化程度(P=0.006，P=0.043；危险比，3.5；95%可信区间，1.04~11.98)是有意义的因素。无病间期分析显示，C反应蛋白水平显著(P=0.03)：随着水平的升高，预后恶化。静止性炎症反应组(
PURPOSE: C-reactive protein, a commonly used inflammation marker, has been reported to be a prognostic factor of colorectal cancer. This prospective study was designed to confirm the prognostic value of its preoperative levels and to observe their perioperative change.METHODS: Between January 2001 and September 2005, preoperative C-reactive protein levels were obtained for 212 consecutive patients (140 males) receiving elective open resection of colorectal cancer. A level higher than 0.5 mg/dl was defined as positive. They were analyzed against clinicopathologic factors. The survival of 158 curative resections was analyzed. Postoperative levels (at months 1, 3, and 6) were collected for analysis of changing trend, from the patients receiving curative surgeries.RESULTS: Median value of preoperative C-reactive protein was 0.54 mg/dl (48.6 percent positive). Positive rate was significantly correlated with ulcerative type, larger size, higher stage, and positive carcinoembryonic antigen (> 5 ng/ml). In both univariate log-rank test and multiple Cox proportional hazards regression, stage (univariate P=0.011, and multivariate P=0.016; hazard ratio, 6.23; 95 percent confidence interval, 1.41-27.54), C-reactive protein (0.5 mg/dl; P=0.005, and P=0.016; hazard ratio: 6.51; 95 percent confidence interval: 1.41-30.05), and differentiation (P=0.006, and P=0.043; hazard ratio, 3.53; 95 percent confidence interval, 1.04- 11.98) were significant factors. Analysis of disease-free interval showed C-reactive protein was significant (P=0.03): as level rose, prognosis worsened. The quiescent inflammation-response group (