超敏C反应蛋白水平对外周T细胞淋巴瘤患者预后意义的临床研究

Prognostic evaluation of high sensitivity-C reactive protein in peripheral T-cell lymphoma

目的:探讨超敏C反应蛋白(high sensitivity-C reactive protein,Hs-CRP)水平在外周T细胞淋巴瘤(peripheral T-cell lymphoma,PTCL)患者预后中的意义。方法:回顾性分析2005年1月1日至2016年12月31日浙江大学医学院附属第一医院就诊的初治PTCL患者247例,其中在随访过程中失访13例,实际入组234例,患者中位年龄48岁;治疗前检测Hs-CRP水平,同时完善相关检查以明确肿瘤分期及国际预后指数(international prognostic index,IPI),中位随访时间23个月,观察Hs-CRP水平与患者总生存期(overall survival,OS)的关系。结果:Hs-CRP水平与IPI评分(r=0.132,P<0.01)、Ann Arbor分期(r=0.183,P=0.005)、B症状(r=0.225,P=0.001)、乳酸脱氢酶(lactate dehydrogenase,LDH)(r=0.169,P=0.009)呈正相关(P<0.05);与血浆白蛋白水平(r=-0.343,P<0.001)、血红蛋白浓度(r=-0.239,P<0.001)、血小板计数(r=0.131,P=0.045)呈负相关(P<0.05);与年龄、性别、体能(ECOG)评分、白细胞计数无显著相关性(P>0.05),血清Hs-CRP≤10 mg/L较Hs-CRP>10 mg/L患者具有更好的OS(P<0.05)。单因素分析及多因素Cox回归模型显示血小板计数、Hs-CRP、白蛋白水平、IPI评分是OS的独立预后不良因素(P<0.05)。结论:PTCL患者治疗前血清Hs-CRP水平可以和IPI评分一样作为PTCL预后的指标。

Objective： To investigate the prognostic significance of high sensitivity-C reactive protein（Hs-CRP） in patients with peripheral T-cell lymphoma（PTCL）. Methods： A total of 234 newly diagnosed PTCL patients with a median age of 48 years were analyzed retrospectively. Serum Hs-CRP levels and other factors, including tumor stage and international prognostic index（IPI）, were determined. After a median follow-up of 23 months, the relationship between Hs-CRP and overall survival（OS） was observed. Results： Serum Hs-CRP level positively correlated with IPI score（r=0.132, P0.001）, tumor stage（r=0.183, P=0.005）, B symptoms（r=0.225, P=0.001）, and lactic dehydrogenase（r=0.169, P=0.009）, but negatively correlated with plasma albumin levels（r=-0.343, P0.001）, hemoglobin concentration（r=-0.239, P0.001）, and platelet count（r=0.131, P=0.045）, and is uncorrelated with age（P0.05）, gender（P0.05）, fitness score（P0.05）, and leukocyte count（P0.05）. Patients with serum Hs-CRP levels ≤10 mg/L had better OS than patients with serum Hs-CRP levels10 mg/L. Univariate and multivariate Cox regression models showed that platelet count, Hs-CRP, albumin levels, and IPI score were independent adverse prognostic factors. Conclusion： The baseline Hs-CRP level can serve as a major indicator of prognosis in PTCL patients.