C反应蛋白在肿瘤患者感染的诊断和病情监测中的价值

Significance of C-reactive protein in the diagnosis and disease monitoring among cancer patients with infection

目的评估C反应蛋白(CRP)在肿瘤感染患者中的水平变化,并观察其与中性粒细胞计数及降钙素原(PCT)之间的关系。方法选取206例肿瘤发热患者,测定其CRP水平,并按照中性粒细胞计数及感染情况进行分组研究。从其中选取57例进行跟踪,评估CRP在肿瘤发热过程中的变化及其与感染的关系。结果在206例肿瘤发热患者中,中性粒细胞计数增加组CRP水平[中位数(四分位数)]为119.95(57.22,182.62)mg/L,较中性粒细胞计数正常组[64.55(26.92,119.25)mg/L]及中性粒细胞计数减少组[80.45(42.00,123.35)mg/L]显著升高(P<0.05)。在各类发热的肿瘤患者中,感染组和肿瘤晚期组患者CRP水平高于术后状态组、药物反应组及其他组。在疗效评估方面,治疗无效组CRP水平为101.00(69.50,143.00)mg/L,明显高于治疗有效组[10.00(4.00,27.00)mg/L](P<0.05)。在病情监测方面,CRP的变化趋势与PCT基本一致。结论CRP可以作为肿瘤患者感染时的诊断指标,同时也是治疗过程中一个独立的预后指标。

Objective To evaluate the change of C-reactive protein（CRP） in cancer patients with infection,and to observe the relationships of CRP with neutrophil count and procalcitonin（PCT）. Methods The levels of CRP in 206 cancer patients with fever were determined,and the results of neutrophil count and infection status were analyzed. Among them,57 patients were followed up,and the change of CRP was evaluated,and the relationship with infection was analyzed. Results Among 206 cancer patients with fever,CRP level [median（quartile） ] in increased neutrophil count group was 119.95（57.22,182.62） mg/L,which was higher than that in normal neutrophil count group [64.55（26.92,119.25） mg/L] and decreased neutrophil count group [80.45（42.00,123.35）mg/L]（P〈0.05）. Among cancer patients with various kinds of fever,CRP levels in infection group and late-phase group were significantly higher than those in postoperative group,drug reaction group and other groups. For therapeutic effect assessment,CRP level in invalid treatment group was 101.00（69.50,143.00）mg/L,which was significantly higher than that in valid treatment group [10.00（4.00,27.00）mg/L]（P〈0.05）. For disease monitoring,the change of CRP was similar to that of PCT. Conclusions CRP can be used as a diagnosis parameter for cancer patients with infection,and it is also an independent indicator for prognosis.