Serum C-reactive protein (CRP) as a simple and independent prognostic factor in extranodal natural killer/T-cell lymphoma, nasal type.
Serum C-reactive protein (CRP) as a simple and independent prognostic factor in extranodal natural killer/T-cell lymphoma, nasal type.
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DOI：
10.1371/journal.pone.0064158
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Jiang WQ
中科院分区：
文献类型：
--
作者：
Li YJ;Li ZM;Xia Y;Huang JJ;Huang HQ;Xia ZJ;Lin TY;Li S;Cai XY;Wu-Xiao ZJ;Jiang WQ
c反应蛋白（CRP）是炎症反应的生物标志物，对几种类型的实体瘤具有重要的预后价值。CRP对淋巴瘤的预后意义尚未得到充分的研究。我们评估了基线血清CRP水平在结外自然杀伤(NK)/ t细胞淋巴瘤（ENKTL）患者中的预后作用。我们回顾性分析了185例新诊断的ENKTL患者。评估低CRP组（CRP≤10 mg/L）与高CRP组（CRP≤10 mg/L）血清CRP水平的预后价值。评价国际预后指数（IPI）和韩国预后指数（KPI）的预测价值，并与新建立的预测模型进行比较。高crp组患者往往表现出更多的不良临床特征，更低的完全缓解率（P<0.001），更低的无进展生存期（PFS, P = 0.001）和更低的总生存期（OS， P<0.001）。多因素分析表明，血清CRP水平升高、年龄在60岁以下、低白蛋白血症和乳酸脱氢酶水平升高是OS的独立不良预测因素。基于这四个独立的预测因素，我们构建了一个新的预后模型，确定了4组不同OS: 1组，无不良因素；第2组，1因子；第3组，2个因子；4、3、4组因素差异有统计学意义（P<0.001）。新预后模型在区分IPI低危组不同结局患者方面优于IPI，在区分低危组和中危组、中危组和高危组、高危组和高危组方面优于KPI。我们的研究结果表明，预处理血清CRP水平是ENKTL患者临床结局的独立预测因子。新预测模型的预测价值优于IPI和KPI。
C-reactive protein (CRP) is a biomarker of the inflammatory response, and it shows significant prognostic value for several types of solid tumors. The prognostic significance of CRP for lymphoma has not been fully examined. We evaluated the prognostic role of baseline serum CRP levels in patients with extranodal natural killer (NK)/T-cell lymphoma (ENKTL). We retrospectively analyzed 185 patients with newly diagnosed ENKTL. The prognostic value of the serum CRP level was evaluated for the low-CRP group (CRP≤10 mg/L) versus the high-CRP group (CRP>10 mg/L). The prognostic value of the International Prognostic Index (IPI) and the Korean Prognostic Index (KPI) were evaluated and compared with the newly developed prognostic model. Patients in the high-CRP group tended to display increased adverse clinical characteristics, lower rates of complete remission (P<0.001), inferior progression-free survival (PFS, P = 0.001), and inferior overall survival (OS, P<0.001). Multivariate analysis demonstrated that elevated serum CRP levels, age >60 years, hypoalbuminemia, and elevated lactate dehydrogenase levels were independent adverse predictors of OS. Based on these four independent predictors, we constructed a new prognostic model that identified 4 groups with varying OS: group 1, no adverse factors; group 2, 1 factor; group 3, 2 factors; and group 4, 3 or 4 factors (P<0.001). The novel prognostic model was found to be superior to both the IPI in discriminating patients with different outcomes in the IPI low-risk group and the KPI in distinguishing between the low- and intermediate-low-risk groups, the intermediate-low- and high-intermediate-risk groups, and the high-intermediate- and high-risk groups. Our results suggest that pretreatment serum CRP levels represent an independent predictor of clinical outcome for patients with ENKTL. The prognostic value of the new prognostic model is superior to both IPI and KPI.
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影响因子：
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通讯作者：
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