Pretreatment C-Reactive Protein/Albumin Ratio is Associated With Poor Survival in Patients With 2018 FIGO Stage IB-IIA HPV-Positive Cervical Cancer.
Pretreatment C-Reactive Protein/Albumin Ratio is Associated With Poor Survival in Patients With 2018 FIGO Stage IB-IIA HPV-Positive Cervical Cancer.
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治疗前 C 反应蛋白/白蛋白比率与 2018 年 FIFA IB-IIA 期 HPV 阳性宫颈癌患者的较差生存率相关
DOI：
10.3389/pore.2021.1609946
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Zheng M
中科院分区：
文献类型：
--
作者：
Jiang Y;Gu H;Zheng X;Pan B;Liu P;Zheng M
目的：本研究旨在确定根据人乳头状瘤病毒（HPV）感染状态分层的炎症指标对FIGO 2018 IB期和IIA期宫颈癌女性的预测价值。探讨HPV感染状况对宫颈癌患者生存的影响。 方法：我们收集了2009年至2017年中山大学肿瘤防治中心583例IB期和IIA期宫颈癌患者的数据。采用t检验、χ 2检验和Fisher精确检验比较HPV阳性组与阴性组间炎症指标和临床病理特征的差异。单因素和多因素分析用于确定与宫颈癌患者预后相关的临床病理因素。 结果：HPV阳性组和阴性组的总生存期（OS）和无进展生存期（PFS）无差异。在HPV阳性组中，最大肿瘤大小、新辅助化疗和体重指数（BMI）与C反应蛋白/白蛋白比值（CAR）显著相关。最大肿瘤大小和预后营养指数（PNI）与血小板淋巴细胞比率（PLR）显著相关。PNI与最大肿瘤大小、新辅助化疗和PLR显著相关。单因素和多因素分析显示，肿瘤浸润深度（HR：3.651，95% CI：1.464-9.103，p = 0.005; HR：2.478，95% CI：1.218-5.043，p = 0.012）和CAR（HR：5.201，95% CI：2.080-13.004，p < 0.0001; HR：2.769，95% CI：1.406-5.455，p = 0.003）是OS和PFS较差的独立预测因素。PNI是OS的独立保护因素（HR：0.341，95%CI：0.156-0.745，p = 0.007）。PLR是PFS的独立因素（HR：1.991，95% CI：1.018-3.894，p = 0.044）。在HPV阴性组中，BMI与CAR显著相关。只有浸润深度（HR：9.192，95% CI：1.016-83.173，p = 0.048）是OS差的独立预测因子，没有炎症指标是预后的独立预测因子。 结论：在HPV阳性宫颈癌患者中，浸润深度、PNI和CAR是OS的独立因素，浸润深度、PLR和CAR是PFS的独立因素。对于HPV阴性的患者，没有炎症指标对预后有预测价值。HPV阳性宫颈癌患者炎症指标对预后的预测价值更显著。HPV感染状态分层促进炎症指标临床应用更加精确，从而提高其准确性和可行性。
Objectives: The present study aimed to identify the predictive value of inflammatory indexes stratified according to human papillomavirus (HPV) infection status in women with FIGO 2018 stage IB∼IIA cervical cancer. We also explored the influences of HPV infection status on the survival of cervical cancer patients. Methods: We collected data for 583 women with stage IB∼IIA cervical cancer in Sun Yat-sen University Cancer Center between 2009 and 2017. The t-test, chi-squared (χ2) test and Fisher’s exact test were applied to compare the differences of inflammatory indexes and clinicopathological features between HPV-positive and HPV-negative groups. Univariate and multivariate analyses were used to identify clinicopathological factors that were associated with the prognosis of cervical cancer patients. Results: There were no differences in overall survival (OS) and progression-free survival (PFS) between HPV-positive and HPV-negative groups. In HPV-positive group, the maximum tumor size, neoadjuvant chemotherapy and the body mass index (BMI) correlated significantly with C-reactive protein/albumin ratio (CAR). The maximum tumor size and the prognostic nutritional index (PNI) correlated significantly with the platelet-lymphocyte ratio (PLR). The maximum tumor size, neoadjuvant chemotherapy and PLR correlated significantly with PNI. Univariate and multivariate analyses showed that the depth of tumor invasion (HR: 3.651, 95% CI: 1.464–9.103, p = 0.005; HR: 2.478, 95% CI: 1.218–5.043, p = 0.012) and CAR (HR: 5.201, 95% CI: 2.080–13.004, p < 0.0001; HR: 2.769, 95% CI: 1.406–5.455, p = 0.003) were independent predictors of poor OS and PFS. PNI was an independent protective factor of OS (HR: 0.341, 95% CI: 0.156–0.745, p = 0.007). PLR was an independent factor of PFS (HR: 1.991, 95% CI: 1.018–3.894, p = 0.044). In HPV-negative group, BMI correlated significantly with CAR. Only depth of invasion (HR: 9.192, 95% CI: 1.016–83.173, p = 0.048) was the independent predictor of poor OS, and no inflammation indexes were independent predictors of prognosis. Conclusion: In patients with HPV-positive cervical cancer, depth of invasion, PNI and CAR are independent factors of OS, and depth of invasion, PLR and CAR are independent factors for PFS. For patients with HPV-negative disease, no inflammation indexes had predictive value for prognosis. The predictive value of inflammation indexes on prognosis is more significant in patients with HPV-positive cervical cancer. Stratification of HPV infection status promotes a more precise clinical application of inflammation indexes, thus improving their accuracy and feasibility.
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78.8
作者：
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通讯作者：
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影响因子：
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作者：
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影响因子：
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作者：
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影响因子：
3.7
作者：
Migita, Kazuhiro;Takayama, Tomoyoshi;Nakajima, Yoshiyuki
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Nakajima, Yoshiyuki