治疗前炎症标志物在晚期非小细胞肺癌中的预测价值。
The predictive value of pre-treatment inflammatory markers in advanced non-small-cell lung cancer.
机构信息
Division of Pulmonary Diseases, Sir Mortimer B. Davis Jewish General Hospital, Montreal, QC.
出版信息
Curr Oncol. 2010 Aug;17(4):52-8. doi: 10.3747/co.v17i4.567.
BACKGROUND
Accurate prediction of outcome in advanced non-small-cell lung cancer (NSCLC) remains challenging. Even within the same stage and treatment group, survival and response to treatment vary. We set out to determine the predictive value of inflammatory markers C-reactive protein (CRP) and white blood cells (WBCS) in patients with advanced NSCLC.
PATIENTS AND METHODS
Patients were assigned a prognostic index (PI): 0 for crp 10 mg/L or less and WBCS 11x10⁹/L or less, 1 if one of the two markers was elevated, and 2 if both markers were elevated. We then used chest computed tomography (CT) imaging to evaluate response after 2 cycles of chemotherapy treatment.
RESULTS
Of 134 patients, 46 had a PI of 0; 60, a PI of 1; and 28, a PI of 2. Disease progressed in 41 patients. Progression was significantly more frequent among patients with a PI of 2 (p = 0.008). Median survival was 20.0 months for the PI 0 group, 10.4 months for the PI 1 group, and 7.9 months for the PI 2 group (p < 0.001). The PI was the only significant prognostic factor for survival even after adjustment for performance status, smoking, and weight loss (hazard ratio: 1.57; 95% confidence interval: 1.2 to 2.14; p = 0.004).
CONCLUSIONS
Inflammatory state correlates significantly with both chemotherapy response and survival in stage IV NSCLC. The PI may provide additional guidance for therapeutic decision-making.
背景
准确预测晚期非小细胞肺癌（NSCLC）的预后仍然具有挑战性。即使在同一分期和治疗组内，生存和对治疗的反应也存在差异。我们旨在确定炎症标志物 C 反应蛋白（CRP）和白细胞（WBC）在晚期 NSCLC 患者中的预测价值。
患者和方法
患者被分配预后指数（PI）：CRP 10mg/L 或以下且 WBC 11x10⁹/L 或以下为 0，两种标志物之一升高为 1，两种标志物均升高为 2。然后，我们使用胸部计算机断层扫描（CT）评估化疗治疗 2 个周期后的反应。
结果
在 134 名患者中，46 名患者的 PI 为 0；60 名患者的 PI 为 1；28 名患者的 PI 为 2。41 名患者疾病进展。PI 为 2 的患者疾病进展明显更为频繁（p = 0.008）。PI 0 组的中位生存时间为 20.0 个月，PI 1 组为 10.4 个月，PI 2 组为 7.9 个月（p < 0.001）。PI 是生存的唯一显著预后因素，即使在调整了体能状态、吸烟和体重减轻后（风险比：1.57；95%置信区间：1.2 至 2.14；p = 0.004）。
结论
炎症状态与 IV 期 NSCLC 的化疗反应和生存密切相关。PI 可能为治疗决策提供额外的指导。
Zotero 插件