术前血清超敏C反应蛋白测定对评估子宫内膜癌预后的价值

Prognostic value of preoperative serum high sensitivity C-reactive protein in patients with endometrial cancer

目的探讨术前血清超敏C反应蛋白（hs—CRP）水平是否可作为评价子宫内膜癌患者预后的因素。方法对2005年9月至2009年12月在中山大学孙逸仙纪念医院妇科肿瘤专科初始治疗方式为手术治疗的110例子宫内膜癌患者的临床病理资料进行回顾性研究，分析术前血清hs—CRP水平与临床病理参数、无瘤生存期及总生存期的相关性。结果患者术前血清hs-CRP平均水平为5．58mg／L（0．02～140．54mg／L），其与肿瘤分期（P〈0．01）、淋巴结转移（P〈0．05）、患者年龄（P〈0．05）有关，而与肿瘤的分化程度、脉管癌栓及组织学类型均无关（均P〉0．05）。单因素分析显示，肿瘤分期、淋巴结转移、肿瘤分化程度、术后辅助治疗及hs-CRP水平与子宫内膜癌患者的无瘤生存期及总生存期相关；多因素分析显示仅肿瘤分期及hs-CRP水平与无瘤生存期及总生存期有关。秩和相关分析结果显示，术前血清hs—CRP与CA125呈正相关（P〈0．01）。结论术前血清hs—CRP水平有望作为判断子宫内膜癌预后的有价值的指标，但其价值需要进一步评估。

Objective To evaluate whether high sensitivity C-reactive protein （hs-CRP） is a predictive factor in the patients with endometrial cancer. Methods The investigators retrospectively analyzed the clinical records of 110 patient with endometrial carcinoma treated at our institution for their initial serum hs-CRP level at pre-operation. Pearson＇s chi-square was used to evaluate the association of the level of hs-CRP with variables associated with a poor prognosis. COX proportional hazard model was employed to perform univariate and multivariate analyses. Results The median serum level of hs-CRP in the patients with endometrial cancer was 5.58 mg/L（range： 0. 02 -140. 54 rag/L）. The serum level of hs- CRP was significantly associated with advanced tumor stage （P 〈 0. 01 ）, lymph node involvement （ P 〈 0. 05） and patient age （ P 〈 0. 05 ） . Tumor stage, lymph node involvement, histological grade, postoperative adjuvant therapy and the serum level of hs-CRP were correlated with the overall and disease-free survivals. Tumor stage and the serum level of hs-CRP were independent factors. The rank correlation analysis showed that there was a positive correlation between the serum levels of hs-CRP and CA125 （P 〈 0. 01 ）. Conclusion The serum level of hs-CRP may serve as a prognostic parameter in patients with endometrial cancer. Further studies are warranted to validate its value.