C反应蛋白与白蛋白比值对P-Gemox方案联合放疗治疗早期结外NK/T细胞淋巴瘤患者预后的影响

Effect of C-reactive protein to albumin ratio on prognosis of P-Gemox regimen combined with radiotherapy in patients with early extranodal NK/T cell lymphoma

目的探讨外周血C反应蛋白与白蛋白比值(C-reactive protein to albumin ratio,CRP/Alb)对P-Gemox方案联合放疗治疗早期结外NK/T细胞淋巴瘤(extranodal NK/T cell lymphoma,ENKTL)患者预后的影响。方法回顾性分析四川省肿瘤医院2012年至2017年收治的83例ENKTL患者的临床资料。采用X-Tile软件计算CRP/Alb的截断值,根据截断值将患者分为低CRP/Alb组(CRP/Alb<0.4,n=64)和高CRP/Alb组(CRP/Alb≥0.4,n=19),采用Cox回归分析CRP/Alb与预后的关系。结果低CRP/Alb组患者的3年无进展生存率高于高CRP/Alb组(77.1%vs 30.7%,χ~2=20.954,P<0.001),3年总生存率亦高于高CRP/Alb组(87.4%vs 36.1%,χ~2=22.559,P<0.001)。多因素Cox回归分析显示,CRP/Alb≥0.4是影响ENKTL患者无进展生存期(HR=4.163,95%CI:1.899~9.128,P<0.001)和总生存期(HR=4.424,95%CI:2.026~9.662,P<0.001)的独立危险因素。低危ENKTL患者和中高危ENKTL患者中,低CRP/Alb组的中位无进展生存期和中位总生存期均高于高CRP/Alb组(P<0.05)。结论高CRP/Alb的早期ENKTL患者接受P-Gemox方案联合放疗治疗预后较差。

Objective To explore the prognostic significance of C-reactive protein to albumin ratio for(CRP/Alb)extranodal NK/T cell lymphoma(ENKTL) treated with P-Gemox chemotherapy regimen combined radiotherapy. Methods The clinical data of 83 ENKTL patients treated in Sichuan Cancer Hospital from 2012 to 2017 were retrospectively analyzed. X-Tile software was used to calculate the cutoff value of CRP/Alb. According to the cutoff value,patients were divided into low CRP/Alb group(CRP/Alb<0.4,n=64) and high CRP/Alb group(CRP/Alb≥ 0.4,n =19). Cox regression was used to analyze the relationship between CRP/Alb and prognosis.Results The 3-year progression-free survival(PFS)rate in the low CRP/Alb group was higher than that in the high CRP/Alb group(77.1% vs 30.7%,χ~2=20.954,P<0.001),and the 3-year overall survival(OS) rate was also higher than in the high CRP/Alb group(87.4% vs 36.1%,χ~2=22.559,P<0.001). Multivariate Cox regression showed that CRP/Alb ≥0.4 was an independent risk factor for PFS(HR=4.163,95%CI:1.899-9.128,P<0.001)and OS(HR=4.424,95%CI:2.026-9.662,P<0.001) in ENKTL patients. Further analysis showed that the median PFS and median OS of the low CRP/Alb group were higher than those of the high CRP/Alb group in both low-risk ENKTL patients and medium-high risk ENKTL patients(P<0.05). Conclusion The prognosis of patients with high CRP/Alb in early ENKTL treated with P-Gemox combined with radiotherapy is poor.