Lin Maosong, Huang Junxing, Zhu Jiayi, Shen Hongzhang
Department of Gastroenterology, Taizhou People's Hospital, Taizhou, Jiangsu 225300, P.R. China.
Exp Ther Med. 2013 Dec;6(6):1369-1374. doi: 10.3892/etm.2013.1350. Epub 2013 Oct 16.
Elevated levels of C-reactive protein (CRP) have been described as a prognostic factor in various types of human malignancy. In the present study, the prognostic potency of CRP was validated for patients with colorectal cancer (CRC) in order to guide patient management and define high-risk populations for follow-up or for therapeutic purposes. The association between the high sensitivity-CRP (hs-CRP) levels of a total of 123 patients with CRC and their clinicopathological characteristics was explored. Subsequently, univariate and multivariate analyses were performed to investigate the survival impact of pre-treatment hs-CRP levels in this cohort study. Statistically significant correlations between the serum levels of hs-CRP and lymph node and distant metastasis (P<0.001 and P=0.012, respectively), vascular and perineural invasion (P<0.001 and P<0.001), grades (P=0.022) and clinical stages (P=0.001), but not age and gender (P=0.616 and 0.676, respectively), were found. The five-year survival rate of patients with elevated (>5.0 mg/l) hs-CRP levels was demonstrated to be significantly less than that of those in the normal group (≥5.0 mg/l) by applying the Kaplan-Meier method (13.3 versus 57.0%, log-rank test P<0.001). Furthermore, following identification as a prognostic factor through using univariate analysis, high levels of hs-CRP (P<0.001) were validated as an independent prognosticator in CRC in the present study through using multivariate analysis. Pre-treatment serum CRP levels were associated with advanced and progressed CRC patients, therefore these levels may serve as a potential prognostic marker for CRC patients.
C反应蛋白(CRP)水平升高已被描述为各类人类恶性肿瘤的一个预后因素。在本研究中,对CRP的预后效力在结直肠癌(CRC)患者中进行了验证,以指导患者管理并确定随访或治疗目的的高危人群。探讨了总共123例CRC患者的高敏CRP(hs-CRP)水平与其临床病理特征之间的关联。随后,在本队列研究中进行单因素和多因素分析,以研究治疗前hs-CRP水平对生存的影响。发现hs-CRP血清水平与淋巴结及远处转移(分别为P<0.001和P=0.012)、血管及神经周围侵犯(分别为P<0.001和P<0.001)、分级(P=0.022)和临床分期(P=0.001)之间存在统计学显著相关性,但与年龄和性别(分别为P=0.616和0.676)无关。通过应用Kaplan-Meier方法,hs-CRP水平升高(>5.0mg/l)的患者五年生存率显著低于正常组(≥5.0mg/l)患者(13.3%对57.0%;对数秩检验P<0.001)。此外,在通过单因素分析确定为预后因素后,在本研究中通过多因素分析验证了高水平的hs-CRP(P<0.001)作为CRC的独立预后指标。治疗前血清CRP水平与晚期和进展期CRC患者相关,因此这些水平可能作为CRC患者的潜在预后标志物。