Koike Yuhki, Miki Chikao, Okugawa Yoshinaga, Yokoe Takeshi, Toiyama Yuji, Tanaka Koji, Inoue Yasuhiro, Kusunoki Masato
Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
J Surg Oncol. 2008 Dec 1;98(7):540-4. doi: 10.1002/jso.21154.
This study aimed to evaluate the significance of preoperative C-reactive protein (CRP) as a prognostic marker for carcinoembryonic antigen (CEA)-independent stage I or II colorectal cancer (CRC) patients.
Preoperative CRP was measured in 300 CRC patients to assess its relationships with clinicopathological factors and long-term survival. Based on the results of the initial study, the relationship between preoperative CRP and long-term survival was evaluated with reference to adjuvant 5-fluorouracil (5-FU)-based chemotherapy in a further 128 stage II patients.
CRP was associated with disease progression and factors reflecting nutritional depletion such as serum albumin, lymphocyte count and body weight loss ratio. In stage I or II patients, CRP could predict early disease recurrence, even when a CEA test could not. Multivariate analyses revealed that CRP was an independent prognostic variable in stage I or II patients. In the additional 128 stage II patients, CRP-positive patients showed a 3-year survival rate of only 55% without adjuvant chemotherapy, but this increased to 90% with adjuvant chemotherapy.
CRP may be a potent prognostic and therapeutic indicator that provides valuable information for determining the need for adjuvant chemotherapy in stage II CRC patients.
本研究旨在评估术前C反应蛋白（CRP）作为癌胚抗原（CEA）独立的Ⅰ期或Ⅱ期结直肠癌（CRC）患者预后标志物的意义。
检测300例CRC患者的术前CRP，以评估其与临床病理因素及长期生存的关系。基于初始研究结果，在另外128例Ⅱ期患者中，参照基于5-氟尿嘧啶（5-FU）的辅助化疗评估术前CRP与长期生存的关系。
CRP与疾病进展以及反映营养消耗的因素相关，如血清白蛋白、淋巴细胞计数和体重减轻率。在Ⅰ期或Ⅱ期患者中，即使CEA检测无法预测，CRP也能够预测疾病早期复发。多因素分析显示，CRP是Ⅰ期或Ⅱ期患者的独立预后变量。在另外128例Ⅱ期患者中，CRP阳性患者在未接受辅助化疗时3年生存率仅为55%，但接受辅助化疗后这一比例增至90%。
CRP可能是一种有效的预后和治疗指标，可为确定Ⅱ期CRC患者是否需要辅助化疗提供有价值的信息。
