Prognostic and predictive value of serum C-reactive protein levels in patients with metastatic or locally recurrent gastric cancer
Prognostic and predictive value of serum C-reactive protein levels in patients with metastatic or locally recurrent gastric cancer
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DOI：
10.5301/jbm.5000210
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发表时间：
2016-07-01
影响因子：
2
通讯作者：
Zhuang, Zhixiang
中科院分区：
文献类型：
--
作者：
Chen, Zhigang;Sun, Yongchen;Zhuang, Zhixiang
背景和目标：越来越多的证据表明，血清C-反应蛋白（CRP）水平升高与许多恶性肿瘤的生存率低。然而，CRP在进展期胃癌（AGC）中的预后价值仍不确定。本研究旨在探讨血清CRP作为AGC患者长期生存的生物标志物的意义。回顾性收集了2006年10月1日至2013年9月30日期间接受治疗的244例患者的数据。结果：化疗前CRP水平与总生存率显著相关。CRP >= 10 mg/L的患者的中位生存期为351天，CRP < 10 mg/L的患者为370天（p = 0.033）。考克斯分析显示CRP是总生存期的独立预后因素。在基线CRP>= 10 mg/L的93例患者中，基于ROC曲线，CRP下降率的22%的截止点提供了1年生存的最佳灵敏度和特异性。CRP下降率> 22%预测总生存期较长（410天对299天; p = 0.001）。结论：化疗前血清CRP基线水平升高与AGC患者总生存期降低相关。CRP下降率与总生存期相关。化疗前CRP基线浓度和化疗后CRP下降率可作为新的、广泛可用的、实时独立的AGC预后和预测指标。
Background and aims: Increasing evidence suggests that elevated serum levels of C-reactive protein (CRP) are associated with poor survival in many malignant tumors. However, the prognostic value of CRP in advanced gastric cancer (AGC) remains uncertain. This study was undertaken to evaluate the significance of serum CRP as a biomarker of long-term survival in patients with AGC.Methods: The serum CRP levels of AGC patients were analyzed for clinicopathological significance. Data were collected retrospectively for 244 patients treated between October 1, 2006 and September 30, 2013. The prognostic effect of serum CRP levels was evaluated.Results: The baseline CRP level before chemotherapy was significantly associated with overall survival. The median survival was 351 days for patients with CRP >= 10 mg/L and 370 days for patients with CRP < 10 mg/L (p = 0.033). Cox analysis revealed CRP to be an independent prognostic factor for overall survival. In the 93 patients whose baseline CRP was >= 10 mg/L, a cutoff point of 22% for the CRP declining rate provided optimum sensitivity and specificity for 1-year survival based on ROC curves. A CRP declining rate > 22% was found to predict longer overall survival (410 days versus 299 days; p = 0.001).Conclusions: Elevated serum CRP baseline levels before chemotherapy were associated with reduced overall survival in patients with AGC. The CRP declining rate was also associated with overall survival. The CRP baseline concentration before chemotherapy and CRP declining rate after chemotherapy may be used as novel, widely available and real-time independent prognostic and predictive markers of AGC.