Department of Surgery, Catharina Hospital Eindhoven, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
Int J Colorectal Dis. 2011 Aug;26(8):1067-73. doi: 10.1007/s00384-011-1187-7. Epub 2011 Apr 8.
Only a limited number of patients with peritoneal carcinomatosis (PC) of colorectal origin benefit from palliative chemotherapy. Identification of prognostic factors may aid in patient selection. The plasma concentration of C-reactive protein (CRP) is increasingly recognized as prognostic factor in a variety of malignancies. However, its value in peritoneal PC of colorectal origin is currently unknown. The aim of the present study was to investigate the association of plasma CRP concentrations with survival in patients suffering from PC of colorectal origin who receive palliative chemotherapy.
Fifty patients with colorectal PC were identified from the Eindhoven Cancer Registry. Relevant data were retrieved from their clinical records. The most discriminatory CRP concentration was identified and patients were stratified accordingly, resulting in a group with low and a group with high CRP concentrations. Further comparisons were made between these groups.
A CRP concentration <35 mg/L was associated with a better prognosis (median survival 22.4 months) than a CRP concentration ≥35 mg/L (7.9 months) (p = 0.0002). CRP concentrations were inversely related to albumin concentrations which could predict survival at a cut-off value of 35 g/L (median survival 7.2 vs. 12.9 months, p = 0.01). High CRP concentrations were related to a decreased resectability rate of the primary tumor.
Elevated CRP plasma concentrations are associated with decreased survival in patients with colorectal PC. This reflects the importance of inflammation in cancer survival. Further research is warranted to assess the clinical applicability of the current findings.
只有少数结直肠腹膜转移（PC）患者能从姑息性化疗中获益。识别预后因素有助于患者选择。C 反应蛋白（CRP）的血浆浓度在多种恶性肿瘤中被认为是预后因素。然而，其在结直肠来源腹膜 PC 中的价值目前尚不清楚。本研究旨在探讨接受姑息性化疗的结直肠 PC 患者的 CRP 血浆浓度与生存的关系。
从埃因霍温癌症登记处确定了 50 例结直肠 PC 患者。从他们的临床记录中检索相关数据。确定了最具区分能力的 CRP 浓度，并据此对患者进行分层，分为 CRP 浓度低组和 CRP 浓度高组。对这两组进行了进一步比较。
CRP 浓度<35mg/L 的患者预后较好（中位生存期 22.4 个月），而 CRP 浓度≥35mg/L 的患者预后较差（7.9 个月）（p=0.0002）。CRP 浓度与白蛋白浓度呈负相关，白蛋白浓度在 35g/L 时可以预测生存（中位生存期分别为 7.2 个月和 12.9 个月，p=0.01）。高 CRP 浓度与原发肿瘤切除率降低有关。
结直肠 PC 患者 CRP 血浆浓度升高与生存期缩短有关。这反映了炎症对癌症生存的重要性。需要进一步研究来评估当前发现的临床应用价值。
