血清C反应蛋白对晚期非小细胞肺癌患者预后作用的研究
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摘要
目的观察晚期非小细胞肺癌(NSCLC)患者血清C反应蛋白与其近远期预后的关系,分析血清CRP是否可以预测晚期NSCLC患者预后。方法回顾性分析2013年1月1日～2017年12月31日于潍坊市人民医院呼吸内科初诊的187例晚期NSCLC患者的临床资料,根据化疗前血清CRP水平分为高CRP组和正常CRP组。所有患者均于入院后接受2周期化疗,分析化疗前后血清CRP变化与化疗疗效评价的关系,并分析不同分组患者预后情况。结果 2周期化疗后,疗效评价为PR的患者,化疗后血清CRP水平降低(P<0.05),疗效评价为PD的患者,化疗后血清CRP显著上升(P<0.05)。高CRP组的治疗有效率、疾病控制率、无进展生存期及中位生存期均显著低于正常组(P<0.05)。结论化疗后CRP水平与晚期NSCLC患者化疗后近期疗效较好有关,化疗前CRP升高的NSCLC患者远期预后较差。故血清CRP水平可以作为预测晚期NSCLC患者预后指标之一。
Objective Comparing serum CRP with short-term and long-term prognosis in patients with advanced non-small cell lung cancer,investigate the clinical significance of the changes of serum CRP on the prognosis of non-small cell lung cancer(NSCLC).Methods The case data of lung cancer from the Respiratory Medicine Department of Weifang People's Hospital in 2013.1.1～2017.12.31 were collected by computer search.There were 187 cases of patients with advanced NSCLC.All of cases were received the first time systemic chemothempy.According to the level of serum CRP before chemotherapy,there were divided into high-CRP group and normal-CRP group.The data was statistically analysed,which was between the changes of serum CRP before and after chemotherapy.At the same time,compare prognosis of patients in different groups.Results After 2 periods chemotherapy,the level of serum CRP of patients in PR group reduced significantly and the level of serum CRP of patients in PD group improved obviously.The differences were statistically significant(P<0.05).The ORR%,DCR%,PFS and OS in normal-CRP group after chemotherapy was significantly elevated compared with high-CRP group(P<0.05).Conclusion The normalization of serum CRP level after chemotherapy is related to the short-term curative effect of advanced NSCLC patients.And the high serum CRP before chemotherapy is related to the poor prognosis of the patients with advanced nsclc.So the level of serum CRP can act as predictive factors of the evolution of progressive disease with prognosis of non-small cell lung cancer.
Objective Comparing serum CRP with short-term and long-term prognosis in patients with advanced non-small cell lung cancer,investigate the clinical significance of the changes of serum CRP on the prognosis of non-small cell lung cancer(NSCLC).Methods The case data of lung cancer from the Respiratory Medicine Department of Weifang People's Hospital in 2013.1.1～2017.12.31 were collected by computer search.There were 187 cases of patients with advanced NSCLC.All of cases were received the first time systemic chemothempy.According to the level of serum CRP before chemotherapy,there were divided into high-CRP group and normal-CRP group.The data was statistically analysed,which was between the changes of serum CRP before and after chemotherapy.At the same time,compare prognosis of patients in different groups.Results After 2 periods chemotherapy,the level of serum CRP of patients in PR group reduced significantly and the level of serum CRP of patients in PD group improved obviously.The differences were statistically significant(P<0.05).The ORR%,DCR%,PFS and OS in normal-CRP group after chemotherapy was significantly elevated compared with high-CRP group(P<0.05).Conclusion The normalization of serum CRP level after chemotherapy is related to the short-term curative effect of advanced NSCLC patients.And the high serum CRP before chemotherapy is related to the poor prognosis of the patients with advanced nsclc.So the level of serum CRP can act as predictive factors of the evolution of progressive disease with prognosis of non-small cell lung cancer.
引文
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[7] Li C,Xu Q,Chen L,et al.C-reactive protein(CRP) as a prognostic factor for colorectal cancer after surgical resection of pulmonary metastases[J].Bull Cancer,2017,104(3):232～236.
[8] Fujiwara Y,Haruki K,Shiba H,et al.C-reactive protein-based prognostic measures are superior at predicting survival compared with peripheral blood cell count-based ones in patients after curative resection for pancreatic cancer[J].Anticancer Res,2018,38(11):6491～6499.
[9] Nakayama T,Saito K,Kumagai J,et al.Higher serum C-reactive protein level represents the immunosuppressive tumor microenvironment in patients with clear cell renal cell carcinoma[J].Clin Genitourin Cancer,2018,16(6):1151～1158.
[10] Ondrej F,Milos P,Jindrich F,et al.High serum level of C-reactive protein is associated with worse outcome of patients with advanced-stage NSCLC treated with erlotinib[J].Tumour Biol,2015,36(12):9215～9222.
[11] Saoussen B,Améni S,Sonia H,et al.Combined c-reactive protein and neutrophil to lymphocyte ratio use predic,survival in non-small-cell lung cancer[J].Tunis Med,2017,95(12):229～235.
[12] Fiala O,Hosek P,Pesek M,et al.Prognostic role of serum C-reactive protein in patients with advanced-stage NSCLC treated with pemetrexed[J].Neoplasma,2017,64(4):605～610.
[13] Mari K,Tomiko S,Shoko N,et al.Prognostic index for survival in patients with advanced non-small-cell lung cancer treated with third-generation agents[J].Chemotherapy,2017,62(4):239～245.
[14] Giovanni L,Carlota G,Mara G,et al.Baseline C-reactve protein level predicts survival of early-stage lung cancer:evidence from a systematc review and meta-analysis[J].Tumori,2016,102(5):441～449.
[2] 姜远瞩.术前血液学指标与淋巴结转移阴性非小细胞肺癌患者预后关系的研究[D].济南:山东大学,2015年.
[3] Young WK,Hyun WL.Prognostic impact of C-reactive protein/albumin ratio on the overall survival of patients with advanced nonsmall cell lung cancers receiving palliative chemotherapy[J].Medicine,2017,96(19):e6848.
[4] Katsurahara K,Shiozaki A,Fujiwara H,et al.Relationship between postoperative crp and prognosis in thoracic esophageal squamous cell carcinoma[J].Anticancer Res,2018,38(11):6513～6518.
[5] Feng JF,Chen S,Yang X.Combination of c-reactive protein and squamous cell carcinoma antigen in predicting postoperative prognosis for patients with squamous cell carcinoma of the esophagus[J].Oncotarget,2017,8(38):63 132～63 139.
[6] Shimura T,Kitagawa M,Yamada T,et al.C-reactive protein is a potential prognostic factor for metastatic gastric cancer[J].Anticancer Res,2012,32(2):491～496.
[7] Li C,Xu Q,Chen L,et al.C-reactive protein(CRP) as a prognostic factor for colorectal cancer after surgical resection of pulmonary metastases[J].Bull Cancer,2017,104(3):232～236.
[8] Fujiwara Y,Haruki K,Shiba H,et al.C-reactive protein-based prognostic measures are superior at predicting survival compared with peripheral blood cell count-based ones in patients after curative resection for pancreatic cancer[J].Anticancer Res,2018,38(11):6491～6499.
[9] Nakayama T,Saito K,Kumagai J,et al.Higher serum C-reactive protein level represents the immunosuppressive tumor microenvironment in patients with clear cell renal cell carcinoma[J].Clin Genitourin Cancer,2018,16(6):1151～1158.
[10] Ondrej F,Milos P,Jindrich F,et al.High serum level of C-reactive protein is associated with worse outcome of patients with advanced-stage NSCLC treated with erlotinib[J].Tumour Biol,2015,36(12):9215～9222.
[11] Saoussen B,Améni S,Sonia H,et al.Combined c-reactive protein and neutrophil to lymphocyte ratio use predic,survival in non-small-cell lung cancer[J].Tunis Med,2017,95(12):229～235.
[12] Fiala O,Hosek P,Pesek M,et al.Prognostic role of serum C-reactive protein in patients with advanced-stage NSCLC treated with pemetrexed[J].Neoplasma,2017,64(4):605～610.
[13] Mari K,Tomiko S,Shoko N,et al.Prognostic index for survival in patients with advanced non-small-cell lung cancer treated with third-generation agents[J].Chemotherapy,2017,62(4):239～245.
[14] Giovanni L,Carlota G,Mara G,et al.Baseline C-reactve protein level predicts survival of early-stage lung cancer:evidence from a systematc review and meta-analysis[J].Tumori,2016,102(5):441～449.
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