Department of Orthopedic Surgery, Mie University Graduate School of Medicine, Tsu City, Japan.
Cancer. 2012 Feb 15;118(4):1055-61. doi: 10.1002/cncr.26353. Epub 2011 Jul 14.
The aim of this study was to determine whether circulating C-reactive protein (CRP) levels before treatment predict the overall survival and disease-free survival in soft tissue sarcoma patients.
A total of 102 primary soft tissue sarcoma patients from 2003 to 2009 were retrospectively reviewed. The CRP levels were obtained before treatment for all patients. The patients who presented with metastases at diagnosis were excluded from this study.
Elevated CRP levels were seen in 18 patients. The tumor histological grade and American Joint Committee on Cancer stage in the patients with elevated CRP levels were significantly higher than those in patients with normal CRP levels. Patients with elevated CRP levels before initial treatment had a poorer overall survival than patients with normal CRP levels (P = .01). The overall survival estimates at 3 and 5 years were 75.3% and 53.8%, respectively, versus 90.3% and 81.3%, respectively. Patients with elevated CRP levels before initial treatment had poorer event-free survival after initial treatment than patients with normal CRP levels (P < .001). The event-free survival estimates at 2 and 5 years were 53.2% and 33.2%, respectively, versus 83.2% and 81.3%, respectively. A multivariate analysis also showed the preoperative CRP level to be an independent predictor of events.
The pretreatment serum CRP level may be a marker of aggressive tumor characteristics. Pretreatment elevated CRP levels were found to be a poor prognostic factor for overall survival in a univariate analysis, and for disease-free survival in a multivariate analysis, for soft tissue sarcoma patients.
本研究旨在确定治疗前循环 C 反应蛋白 (CRP) 水平是否可预测软组织肉瘤患者的总生存率和无病生存率。
回顾性分析了 2003 年至 2009 年期间的 102 例原发性软组织肉瘤患者。所有患者在治疗前均获得 CRP 水平。本研究排除了初诊时即有转移的患者。
18 例患者 CRP 水平升高。CRP 水平升高患者的肿瘤组织学分级和美国癌症联合委员会分期明显高于 CRP 水平正常的患者。初始治疗前 CRP 水平升高的患者总生存率低于 CRP 水平正常的患者（P =.01）。3 年和 5 年的总生存率估计值分别为 75.3%和 53.8%，而 CRP 水平正常的患者分别为 90.3%和 81.3%。初始治疗前 CRP 水平升高的患者初始治疗后无事件生存率低于 CRP 水平正常的患者（P <.001）。2 年和 5 年的无事件生存率估计值分别为 53.2%和 33.2%，而 CRP 水平正常的患者分别为 83.2%和 81.3%。多变量分析还显示术前 CRP 水平是事件的独立预测因子。
治疗前血清 CRP 水平可能是侵袭性肿瘤特征的标志物。单变量分析显示，治疗前 CRP 水平升高是软组织肉瘤患者总生存率的不良预后因素，多变量分析显示，CRP 水平升高是无病生存率的不良预后因素。
