García-Marchiñena Patricio, Billordo-Perés Nicolas, Tobía-González Ignacio, Jurado Alberto, Damia Oscar, Gueglio Guillermo
Urology Department, Hospital Italiano de Buenos Aires, Argentina.
Arch Esp Urol. 2012 Jul-Aug;65(6):601-7.
To determine if elevated levels of high-sensitivity C-reactive protein (CRP) in plasma are associated with locally advanced renal cell carcinoma (LARCC) after surgery.
Retrospective cross-sectional study conducted from May 2009 to January 2011. Altogether, 192 patients with non-disseminated disease and with preoperative quantitative determination of the CRP were evaluated. We evaluated the relation between age, gender, history of smoking, symptoms and CRP higher than 10 mg/L, with LARCC. The chi-square and Fisher's tests were used to compare categorical variables. For the multivariate analysis, we used logistic regression methods.
The median age was 62 years (r=23-85), 72.4% were males. The median CRP was 2.40 mg/L (r=0.1-173). Of all the patients, 43.2% had a history of smoking and 81.8% were asymptomatic. As for the tumors, 77.1%were clear cell carcinoma, 14.6% chromophobe, 4.7% papillary, 2.6% oncocytomas, and 1% other varieties of renal cell carcinoma. As for the TNM classification, 45.8% corresponded to stage pT1a, 27.6% pT1b, 13% pT2, and 13.5% pT3, pT4 was not found. In the multivariate analysis, the presence of symptoms (p=0.002, OR=3.1) and the presence of CRP higher than 10 mg/L (p=0.006, OR=4) remained as the only prognostic variables of LARCC.
Values of CRP higher than 10 mg/L increase 4 times the possibilities of finding LARCC in the pathological study of the surgical specimen. This variable should be taken into account when deciding what is the best surgical option.
确定血浆中高敏C反应蛋白（CRP）水平升高是否与术后局部进展性肾细胞癌（LARCC）相关。
2009年5月至2011年1月进行的回顾性横断面研究。共评估了192例无播散性疾病且术前进行了CRP定量测定的患者。我们评估了年龄、性别、吸烟史、症状以及CRP高于10mg/L与LARCC之间的关系。采用卡方检验和Fisher检验比较分类变量。对于多变量分析，我们使用逻辑回归方法。
中位年龄为62岁（范围=23-85岁），72.4%为男性。CRP中位数为2.40mg/L（范围=0.1-173）。所有患者中，43.2%有吸烟史，81.8%无症状。至于肿瘤，77.1%为透明细胞癌，14.6%为嫌色细胞癌，4.7%为乳头状癌，2.6%为嗜酸细胞瘤，1%为其他类型的肾细胞癌。至于TNM分类，45.8%对应pT1a期，27.6%对应pT1b期，13%对应pT2期，13.5%对应pT3期，未发现pT4期。在多变量分析中，症状的存在（p=0.002，OR=3.1）和CRP高于10mg/L的存在（p=0.006，OR=4）仍然是LARCC的唯一预后变量。
CRP高于10mg/L的值使在手术标本病理研究中发现LARCC的可能性增加4倍。在决定最佳手术方案时应考虑这一变量。
