Nakanishi Hirofumi, Araki Nobuhito, Kudawara Ikuo, Kuratsu Shigeyuki, Matsumine Akihiko, Mano Masayuki, Naka Norifumi, Myoui Akira, Ueda Takafumi, Yoshikawa Hideki
Department of Orthopedic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Int J Cancer. 2002 May 10;99(2):167-70. doi: 10.1002/ijc.10343.
Paraneoplastic syndromes (PNSs) associated with mesenchymal tumors are uncommon. Previous reports sporadically described inflammatory PNSs with elevated serum C-reactive protein (CRP) levels and leukocytosis in patients with inflammatory malignant fibrous histiocytoma (MFH) of soft tissue; however, the relationship between other subtypes of MFH and PNS has not been extensively investigated. Forty-six patients with primary MFH of soft tissues who underwent radical surgery were retrospectively analyzed. These patients were divided into 2 groups according to preoperative serum CRP level: normal (<1.0 mg/dl) and elevated (> or = 1.0 mg/dl). The correlation between serum CRP level and several clinicopathologic factors was analyzed. Correlation between preoperative serum CRP level and metastasis-free and overall survival was also investigated by univariate and multivariate analyses. Elevated preoperative serum CRP levels were found in 65% of patients with a mean of 3.7 mg/dl. There were statistically significant relationships regarding tumor size, depth, histologic subtypes, grade, stage and metastatic rate among normal and elevated CRP groups (p < 0.001, p < 0.02, p < 0.005, p < 0.001, p < 0.001 and p < 0.05, respectively). When the tumor was removed, the elevated CRP level subsided into the normal range and other abnormal laboratory findings diminished in all cases. In 11/14 relapsed cases that showed elevated CRP preoperatively, the serum CRP level re-elevated with tumor relapse. The normal CRP group showed significantly more favorable prognosis than the elevated CRP group in metastasis-free and overall survival on univariate analysis (p < 0.02, p < 0.05, respectively). Patients with MFH frequently present with an inflammatory PNS, such as elevated serum CRP level, which can be a useful marker of disease activity and a valuable prognostic indicator.
与间充质肿瘤相关的副肿瘤综合征（PNSs）并不常见。既往报告曾零星描述过软组织炎性恶性纤维组织细胞瘤（MFH）患者出现血清C反应蛋白（CRP）水平升高和白细胞增多的炎性PNSs；然而，MFH的其他亚型与PNS之间的关系尚未得到广泛研究。对46例行根治性手术的原发性软组织MFH患者进行了回顾性分析。根据术前血清CRP水平将这些患者分为两组：正常（<1.0mg/dl）和升高（≥1.0mg/dl）。分析了血清CRP水平与若干临床病理因素之间的相关性。还通过单因素和多因素分析研究了术前血清CRP水平与无转移生存期和总生存期之间的相关性。65%的患者术前血清CRP水平升高，平均为3.7mg/dl。正常和CRP升高组在肿瘤大小、深度、组织学亚型、分级、分期和转移率方面存在统计学显著差异（分别为p<0.001、p<0.02、p<0.005、p<0.001、p<0.001和p<0.05）。肿瘤切除后，所有病例中升高的CRP水平均降至正常范围，其他异常实验室检查结果也消失。在术前CRP升高的11/14例复发病例中，血清CRP水平随肿瘤复发而再次升高。单因素分析显示，正常CRP组在无转移生存期和总生存期方面的预后明显优于CRP升高组（分别为p<0.02、p<0.05）。MFH患者常出现炎性PNS，如血清CRP水平升高，这可能是疾病活动的有用标志物和有价值的预后指标。
