Nagaoka Sakae, Yoshida Takafumi, Akiyoshi Junji, Akiba Jun, Torimura Takuji, Adachi Hisashi, Kurogi Junichi, Tajiri Nobuyoshi, Inoue Kinya, Niizeki Takashi, Koga Hironori, Imaizumi Tsutomu, Kojiro Masamichi, Sata Michio
Department of Medicine, Division of Gastroenterology, Kurume University School of Medicine, Kurume, Japan.
Liver Int. 2007 Oct;27(8):1091-7. doi: 10.1111/j.1478-3231.2007.01550.x.
BACKGROUND/AIMS: C-reactive protein (CRP) was recently identified as a prognostic factor for patients with hepatocellular carcinoma (HCC) after surgical resection. We investigated the relationship between the serum levels of high sensitivity CRP (H-CRP) and the prognosis of HCC patients.
We conducted a cohort study of 90 HCC patients enrolled from 1997 to 1998. All patients were treated and followed for a mean period of 3.2 years. Clinical variables were compared between patients positive for H-CRP (serum H-CRP levels >/=3.0 mg/L, n=47) and those negative for H-CRP (serum H-CRP levels <3.0 mg/L, n=43). We also determined the relationship between serum H-CRP and prognosis in HCC patients.
The survival rate of patients of the H-CRP-positive group was lower than that of H-CRP-negative patients. Tumour stage (stages 3 or 4), total bilirubin >/=1.2 mg/dL, albumin (Alb) <3.5 g/dL, des-gamma-carboxy prothrombin >/=40 mAU/mL, positive H-CRP and initial treatment (transcatheter arterial chemoembolization, hepatic arterial infusion chemotherapy or best supportive care) were identified as significant poor prognostic factors by univariate analysis, while positive H-CRP [hazard ratio (HR), 1.58; P=0.048], Alb<3.5 g/dL (HR, 2.10; P=0.004), tumour stage (stages 3 or 4; HR, 3.05; P=0.001) and initial treatment (HR, 1.88; P=0.029) were considered to be significant determinants of poor prognosis by multivariate Cox proportional hazards analysis.
The prognosis of H-CRP-positive patients was poorer compared with H-CRP-negative patients. This study confirmed that H-CRP, like CRP, is a marker of poor prognosis in HCC patients.
背景/目的：C反应蛋白（CRP）最近被确定为肝细胞癌（HCC）患者手术切除后的一个预后因素。我们研究了高敏CRP（H-CRP）血清水平与HCC患者预后之间的关系。
我们对1997年至1998年纳入的90例HCC患者进行了一项队列研究。所有患者均接受治疗并随访，平均随访时间为3.2年。比较H-CRP阳性患者（血清H-CRP水平≥3.0mg/L，n = 47）和H-CRP阴性患者（血清H-CRP水平<3.0mg/L，n = 43）的临床变量。我们还确定了血清H-CRP与HCC患者预后之间的关系。
H-CRP阳性组患者的生存率低于H-CRP阴性患者。肿瘤分期（3期或4期）、总胆红素≥1.2mg/dL、白蛋白（Alb）<3.5g/dL、异常凝血酶原≥40mAU/mL、H-CRP阳性和初始治疗（经动脉化疗栓塞、肝动脉灌注化疗或最佳支持治疗）经单因素分析被确定为显著的不良预后因素，而H-CRP阳性[风险比（HR），1.58；P = 0.048]、Alb<3.5g/dL（HR，2.10；P = 0.004）、肿瘤分期（3期或4期；HR，3.05；P = 0.001）和初始治疗（HR，1.88；P = 0.029）经多因素Cox比例风险分析被认为是不良预后的显著决定因素。
与H-CRP阴性患者相比，H-CRP阳性患者的预后较差。本研究证实，H-CRP与CRP一样，是HCC患者预后不良的一个标志物。
