Prognostic values of preoperative C-reactive protein, albumin, and neutrophil ratios in patients with malignant pleural mesothelioma who underwent extrapleural pneumonectomy
Prognostic values of preoperative C-reactive protein, albumin, and neutrophil ratios in patients with malignant pleural mesothelioma who underwent extrapleural pneumonectomy
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DOI：
10.1016/j.suronc.2022.101813
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发表时间：
2022-07-08
影响因子：
2.3
通讯作者：
Ikeda, Eiji
中科院分区：
文献类型：
--
作者：
Okita, Riki;Okada, Masanori;Ikeda, Eiji
简介：恶性胸膜间皮瘤（MPM）的胸膜外肺切除术（EPP）是最具侵入性的手术类型之一，因此需要一套预测其临床结果的术前验证系统。最近，一些炎症和营养参数，如c反应蛋白（CRP）和白蛋白，被重新关注为几种类型癌症的有用预后因素；然而，这些报告中很少涉及MPM。方法：回顾性分析连续行EPP的MPM患者的临床病理特征及术前炎症和营养参数。使用Cox回归检验变量的预后价值，并将候选术前参数输入多变量模型以确定其独立效应。结果：在61例符合条件的病例中，CRP/白蛋白比值（CAR）与组织学相关，CRP指数乘以中性粒细胞比值（C-NR指数）与组织学和病理分期相关。CAR - r指数为>0.125的患者生存预后明显差，而C-NR指数为>0.58的患者预后也明显差。多因素分析显示，年龄、组织学、CRP、白蛋白、CAR和C-NR指数是5年总生存率的独立预测因素。结论：我们的研究结果表明，CAR和C-NR指标是MPM患者EPP临床结果的术前预测参数。
Introduction: A preoperative validation system for predicting the clinical outcome of extrapleural pneumonec-tomy (EPP) for malignant pleural mesothelioma (MPM) is required, as EPP for MPM is one of the most invasive operation types. Recently, several inflammatory and nutritional parameters, such as C-reactive protein (CRP) and albumin, have been re-focused on as useful prognostic factors for several types of cancer; however, few of these reports involved MPM.Methods: As a retrospective study, clinicopathological characteristics and preoperative inflammatory and nutritional parameters were calculated in consecutive patients with MPM who underwent EPP. The prognostic value of the variables was examined using Cox regression, and the candidate preoperative parameters were entered into a multivariate model to determine their independent effects. Results: Of the 61 eligible cases, the CRP/albumin ratio (CAR) was associated with histology, and the CRP index multiplied by the neutrophil ratio (C-NR index) was associated with histology and pathological stage. Patients with CAR >0.125 had a significantly poor survival outcome, and patients with a C-NR index >0.58 also had a significantly poor prognosis. Multivariate analysis showed that age, histology, CRP, albumin, CAR, and C-NR index were independent predictors of 5-year overall survival.Conclusion: Our results demonstrated that the CAR and C-NR indices are promising preoperative predictive pa-rameters for the clinical outcomes of EPP in patients with MPM.