CAJ | 학술논문

目的 C反应蛋白(CRP)是一种急性时相反应蛋白,除了在机体急性损伤感染时的作用得到公认外,升高的急性时相反应蛋白与多种组织类型的非小细胞肺癌差的预后相关.本研究旨在调查治疗前血CRP对神经内分泌肿瘤小细胞肺癌预后的影响.方法回顾性分析2007年至2010年间初治的小细胞肺癌125例,随访并对可能影响预后的因素进行分析.结果 125例小细胞肺癌患者中有79例(63.2％)治疗前血CRP正常(＜10 mg/L),46例(36.8％)患者血CRP值升高(≥10 mg/L).治疗前血清CRP值的升高与患者的ECOG PS评分(P=0.037)、肿瘤最大直径(P=0.034)、肿瘤分期(P =0.015)、治疗前血清白蛋白(P=0.024)相关.治疗前血CRP值正常的患者中位生存期为13.470个月,而血CRP值≥10 mg/L的患者中位生存期仅为9.780个月,两者差异有统计学意义(P=0.047).单因素分析显示:治疗前血清CRP值(P=0.047)、ECOG PS评分(P=0.017)、疾病分期(P=0.024)、治疗前白蛋白值(P =0.012)、化疗周期数(P=0.034)与患者的预后相关.应用Logistic回归分析上述多因素,结果发现治疗前血清CRP值升高(HR=1.525,P=0.037)、ECOG PS评分高(HR =1.904,P =0.015)、疾病分期晚(HR =1.798,P=0.004)、治疗前白蛋白水平低下(HR =1.542,P=0.038)是导致患者预后差的独立因子.结论对于小细胞肺癌患者,CRP的存在及强度是独立的预后因素,与患者的功能状态评分、疾病分期、肿瘤大小、低蛋白血症有关.系统性炎症反应越强烈,CRP水平越高,患者的生存预后越差.
목적 C반응단백(CRP)시일충급성시상반응단백,제료재궤체급성손상감염시적작용득도공인외,승고적급성시상반응단백여다충조직류형적비소세포폐암차적예후상관.본연구지재조사치료전혈CRP대신경내분비종류소세포폐암예후적영향.방법 회고성분석2007년지2010년간초치적소세포폐암125례,수방병대가능영향예후적인소진행분석.결과 125례소세포폐암환자중유79례(63.2％)치료전혈CRP정상(＜10 mg/L),46례(36.8％)환자혈CRP치승고(≥10 mg/L).치료전혈청CRP치적승고여환자적ECOG PS평분(P=0.037)、종류최대직경(P=0.034)、종류분기(P =0.015)、치료전혈청백단백(P=0.024)상관.치료전혈CRP치정상적환자중위생존기위13.470개월,이혈CRP치≥10 mg/L적환자중위생존기부위9.780개월,량자차이유통계학의의(P=0.047).단인소분석현시:치료전혈청CRP치(P=0.047)、ECOG PS평분(P=0.017)、질병분기(P=0.024)、치료전백단백치(P =0.012)、화료주기수(P=0.034)여환자적예후상관.응용Logistic회귀분석상술다인소,결과발현치료전혈청CRP치승고(HR=1.525,P=0.037)、ECOG PS평분고(HR =1.904,P =0.015)、질병분기만(HR =1.798,P=0.004)、치료전백단백수평저하(HR =1.542,P=0.038)시도치환자예후차적독립인자.결론 대우소세포폐암환자,CRP적존재급강도시독립적예후인소,여환자적공능상태평분、질병분기、종류대소、저단백혈증유관.계통성염증반응월강렬,CRP수평월고,환자적생존예후월차.
Objective C-reactive protein (CRP),an acute phase protein,is an indicator of underling systemic inflammation.It plays an important role in the processes of acute injury and infection.Meanwhile,it is recognized now be associated with poor prognosis in several histological types of nonsmall cell lung cancer.The purpose of this study was to investigate serum CRP as a prognostic marker in neuroendocrine tumors such as small cell lung cancer (SCLC).Methods The pretreatment serum CRP level was measured in 125 newly diagnosed SCLC patients,and correlation between serum CRP level and other clinical characteristics was analyzed to discuss the prognosis.Results The initial CRP concentration was within the normal range in 79 (63.2％) patients and elevated in 46 (36.8％) patients.There was a correlation between serum CRP level and the performance status (P =0.037),maximum diameter of tumor (P =0.034),stage of disease (P =0.015),and serum albumin (P =0.024).Median overall survival in normal CRP group was longer than that in high CRP group (13.470 months vs 9.780 months,P =0.047).Pretreatment CRP level (P =0.047),performance status (P =0.017),stage of disease (P =0.024),serum albumin (P =0.012),and cycles of chemotherapy(P =0.034) were prognostic factors on univariate analysis.On multivariate analysis,elevated serum CRP level (HR =1.525,P =0.037),high sore of performance status (HR =1.904,P =0.015),regardless of the extent of disease (HR =1.798,P =0.004),and hypoalbuminemia (HR =1.542,P =0.038) were independent prognostic factors for poor survival.Conclusions High level of CRP is an independent poor prognostic serum marker in patients with SCLC.Also,it is associated with the performance status,stage,tumor size and hypoalbuminemia of the patients.