CRP/ALB、P-CRP与非小细胞肺癌预后的相关性分析

Correlation analysis of CRP/ALB and P-CRP in the prognosis of non-small cell lung cancer

目的:探讨术前血清C反应蛋白(c-reactive protein,CRP)/白蛋白(albumin,ALB)比值、血小板计数与C反应蛋白的乘积(P-CRP)与非小细胞肺癌(non-small-cell lung cancer,NSCLC)患者临床预后的关系。方法:选取2015年1~12月就诊于蚌埠医学院第一附属医院并接受肺癌手术治疗的284例患者,根据患者3年及5年生存情况分别绘制ROC曲线并确定最佳截断值,依据截断值将患者分成:高CRP/ALB组、低CRP/ALB组及高P-CRP组、低P-CRP组。应用Kaplan-Meier生存曲线、Cox比例风险模型评估术前CRP/ALB、P-CRP水平在预测NSCLC患者预后的意义。结果:生存曲线显示NSCLC患者3年生存率分别在高值CRP/ALB、P-CRP组与低值CRP/ALB、P-CRP组间均未见明显差异(P>0.05);高值CRP/ALB、P-CRP组患者5年生存率分别显著低于低值CRP/ALB、P-CRP组(P<0.05)。Cox比例风险模型提示CRP/ALB、年龄、吸烟史、淋巴结转移、TNM分期是影响患者5年生存率的危险因素(P<0.05)。结论:术前CRP/ALB水平作为基于炎症的预后评判指标,较P-CRP能更好反映患者预后情况。

Objective:To investigate the relationship between preoperative C-reactive protein/albumin ratio(CRP/ALB),platelet count and C-reactive protein product(P-CRP)and clinical prognosis in patients with non-small cell lung cancer.Methods:From January to December 2015,284 patients who underwent surgery for lung cancer in the First Affiliated Hospital of Bengbu Medical College were selected.According to their 3-year and 5-year survival conditions,ROC curves were drawn and the best cut-off value was determined.According to the cut-off value,the patients were divided into the high CRP/ALB group,the low CRP/ALB group,the high P-CRP group and the low P-CRP group.Survival curves were described by Kaplan-Meier method and compared by Log-rank test.The univariate and multivariate analyses were performed with the Cox proportional hazard model to evaluate the prognostic factors.Results:Survival analysis showed that there was no significant difference in 3-year survival rate between the high CRP/ALB and P-CRP groups and the low CRP/ALB and P-CRP groups,while the 5-year survival rate in the high CRP/ALB and P-CRP groups was significantly lower than that in the low CRP/ALB and P-CRP groups.Cox proportional hazard model showed that CRP/ALB,age,smoking history,lymph node metastasis and TNM stage were risk factors for 5-yearsurvival rate.Conclusion:As a prognostic index based on inflammation,preoperative CRP/ALB level can better reflect the prognosis of patients than P-CRP.