C反应蛋白与胃癌腹腔转移及预后的相关性研究

Study on relationship of C-reactive protein with peritoneal cavity metastasis and prognosis of gastric carcinoma

目的探讨C反应蛋白(CRP)与胃癌腹腔转移及预后的相关性。方法回顾性分析2008年6月至2014年8月于本院接受一线化疗的晚期胃癌患者150例,根据腹腔转移情况分为腹腔转移组(112例)和非腹腔转移组(38例),单因素和多因素分析年龄、性别、腹腔转移、CRP、白蛋白、ECOG评分对预后的影响,并比较腹腔转移组与非腹腔转移组的CRP、白蛋白和ECOG评分。结果单因素生存分析发现CRP、ECOG评分、白蛋白和腹腔转移与患者预后有关,而性别和年龄与预后无关。多因素生存分析发现腹腔转移是影响胃癌预后的独立因素(P<0.001)。与非腹腔转移组比较,腹腔转移组CRP、ECOG评分升高,而血浆白蛋白降低,差异均有统计学意义(P<0.05)。结论与非腹腔转移患者比较,胃癌腹腔转移患者预后较差,系统性炎症明显增强,应从炎症角度为胃癌腹腔转移患者提供治疗策略。

Objective To explore the relationship of Creactive protein （ CRP ） with peritoneal cavity metastasis and prognosis of gastric carcinoma. Methods In a retrospective study, the clinic data of 150 patients with advanced gastric carcinoma treated with firstline chemotherapy, including 112 patients with peritoneal cavity metastasis and 38 patients with nonperitoneal cavity metastasis, was analyzed. Influences of CRP, serum albumin, Eastern Cooperative Oncology Group performance status （ ECOG PS） and peritoneal cavity metastasis on the prognosis were studied by univariate analysis and Cox proportional hazard mode. The difference of CRP, serum albumin and ECOG was analyzed between patients with or without peritoneal cavity metastasis. Results The results of univariate analysis showed that the factors associated with poor prognosis were CRP, serum albumin, ECOG and peritoneal cavity metastasis. According to multivariate analysis, peritoneal cavity metastasis was the only factor independently associated with prognosis. Compared with nonperitoneal cavity metastasis group, CRP （ P=0. 006） and ECOG PS （ P〈0. 001） were significantly increased, while serum albumin group（P〈0. 001） was significantly decreased in peritoneal cavity metastasis group（P〈0. 001）. Conclusion Compared with nonperitoneal cavity metastasis group, response of systemic inflammation was significantly upregulated in peritoneal cavity metastasis group with poorer prognosis, which could provide a treatment strategy for advanced gastric carcinoma patients with peritoneal cavity metastasis from standpoint of inflammation.