非小细胞肺癌患者化疗前后的C反应蛋白和血清白蛋白水平变化

Changes of C-reactive protein and serum albumin level in inoperable NSCLC with chemotherapy

目的非小细胞肺癌(NSCLC)是癌症引起死亡的最常见原因,多数晚期NSCLC患者预后差,并出现化疗毒性反应。为了更好地在常规化疗的基础上,改善晚期患者的预后,笔者关注晚期NSCLC患者化疗前后的C反应蛋白和血清白蛋白水平变化。方法 22例晚期NSCLC(Ⅲb和Ⅳ期)无法手术患者,组织病理学诊断确诊,在化疗前后分别测定C反应蛋白和血清白蛋白水平的变化并对其进行评价。结果 22例患者,年龄(58.5±6.4)岁,化疗前4例患者血清白蛋白水平≤35 g/L;2轮化疗结束后15例患者血清白蛋白水平≤35 g/L,化疗前、后患者的血清白蛋白水平显著降低(P<0.05);化疗前C反应蛋白的水平(25.4±4.9)μg/mL,化疗结束后(35.2±5.6)μg/mL,化疗后C反应蛋白的水平较化疗前显著升高(P<0.05);伴有低白蛋白血症的患者化疗诱导的毒性反应更强烈,主要的毒性反应是脱发、恶心、胃肠道反应和贫血。结论 C反应蛋白的水平和血清白蛋白水平改变,是提示NSCLC患者化疗毒性有意义的指标,早期关注这些指标对改善化疗患者预后、减轻化疗毒性有重要意义。

[Objective ] Non-small-cell lung cancer（NSCLC） is the major cause of cancer-related deaths. In order to improve the prognosis in chemotherapy-treated NSCLC, we investigated the changes of C reactive protein （CRP） and albumin serum level. [ Methods ] We evaluated 22 stageⅢ b or stage Ⅳ patients with inoperable NSCLC. CRP and serum albumin level were detected before and after chemotherapy. The occurrence of chemotherapy-induced toxicity was evaluated. [ Results] Among the 22 patients, 4 patients had albumin ≤ 35 g/L before chemotherapy, 15 patients had albumin ≤ 35 g/L after chemotherapy. CRP level was significantly increased after chemotherapy. Patients with hypo-albuminemia developed more severe chemotherapy-induced toxicity. [Conclusions] CRP and serum albumin level are promising markers of chemotherapy induced toxicity in inoperable NSCLC patients.