Ni Xue-Feng, Wu Ping, Wu Chang-Ping, Ji Mei, Wu Jun, Gu Xiao-Fang, Jiang Zhen-Xing
Department of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, Jiangsu Province, China.
Department of Pharmacology, The Third Affiliated Hospital, Soochow University, Changzhou, Jiangsu Province, China.
Asia Pac J Clin Oncol. 2015 Dec;11(4):e22-30. doi: 10.1111/ajco.12091. Epub 2014 May 30.
To assess the prognostic value of mediastinal lymph node metastases (N2 disease), carcinoembryonic antigen (CEA) levels and C-reactive protein (CRP) in non-small cell lung cancer (NSCLC), according to the 7th edition of the TNM classification.
Newly diagnosed stage III-IV NSCLC were enrolled, including 75 patients with malignant pleural effusion. The relationship between serum CRP levels and other relevant variables such as sex, Eastern Cooperative Oncology Group status, smoking status, initial staging, N2 disease, serum albumin, white blood cell count, platelet count, CEA, comorbidity and pathology were analyzed. Univariate and multivariate analyses were performed to find prognostic markers using Cox's proportional hazards model.
Of the 127 patients enrolled, 55 (43%) had elevated CRP levels. There was a significant correlation between serum CRP level and platelet count (P = 0.011). Median overall survival (OS) in the normal CRP group was significantly longer than in the high CRP group (15.7 months vs 9.1 months, P = 0.013). Hypoalbuminemia (P = 0.047), higher CEA (P = 0.043) and N2 disease (P = 0.040) were additional prognostic factors on univariate analysis. On multivariate analysis an elevated CRP serum level (HR = 1.796; P = 0.005), higher CEA (HR = 1.563; P = 0.031) and N2 disease (HR = 1.723; P = 0.012) were independent prognostic factors for poor survival.
High levels of serum CRP and CEA, and N2 disease are independent prognostic indicators for the survival of patients with stage III-IV NSCLC.
根据第7版TNM分类法，评估纵隔淋巴结转移（N2期疾病）、癌胚抗原（CEA）水平和C反应蛋白（CRP）在非小细胞肺癌（NSCLC）中的预后价值。
纳入新诊断的Ⅲ-Ⅳ期NSCLC患者，其中75例伴有恶性胸腔积液。分析血清CRP水平与其他相关变量之间的关系，这些变量包括性别、东部肿瘤协作组状态、吸烟状态、初始分期、N2期疾病、血清白蛋白、白细胞计数、血小板计数、CEA、合并症和病理类型。使用Cox比例风险模型进行单因素和多因素分析，以寻找预后标志物。
在纳入的127例患者中，55例（43%）CRP水平升高。血清CRP水平与血小板计数之间存在显著相关性（P = 0.011）。正常CRP组的中位总生存期（OS）显著长于高CRP组（15.7个月对9.1个月，P = 0.013）。单因素分析显示，低白蛋白血症（P = 0.047）、较高的CEA（P = 0.043）和N2期疾病（P = 0.040）是其他预后因素。多因素分析显示，血清CRP水平升高（HR = 1.796；P = 0.00）、较高的CEA（HR = 1.563；P = 0.031）和N2期疾病（HR = 1.723；P = 0.012）是生存不良的独立预后因素。
血清CRP和CEA水平升高以及N2期疾病是Ⅲ-Ⅳ期NSCLC患者生存的独立预后指标。
