Shibutani Masatsune, Maeda Kiyoshi, Nagahara Hisashi, Ohtani Hiroshi, Sugano Kenji, Ikeya Tetsuro, Kimura Kenjiro, Amano Ryosuke, Kubo Naoshi, Tanaka Hiroaki, Muguruma Kazuya, Ohira Masaichi, Hirakawa Kosei
Hepatogastroenterology. 2014 Nov-Dec;61(136):2236-40.
BACKGROUND/AIMS: Previous studies have reported that elevated preoperative serum C-reactive protein (CRP) levels are associated with a poor prognosis in patients with various types of cancer. The aim of this study was to evaluate the prognostic significance of the preoperative serum CRP levels in patients with colorectal cancer and determine an appropriate cutoff value of the serum CRP level.
We enrolled 855 patients who underwent surgery for stage I-IV colorectal cancer. The median serum CRP level was 0.13 (range: 0.01-22.8). We set 0.6 as the cutoff value of the serum CRP level based on the receiver operating characteristic curve. The patients were classified into two groups according to the serum CRP level. The prognostic significance of an elevated serum CRP level was evaluated using a multivariate analysis.
The cancer-specific survival was significantly worse in the patients with a high serum CRP level. In particular, more significant differences were observed in the patients with stage IV disease. The multivariate analysis indicated that a high serum CRP level was an independent risk factor for poor survival.
The preoperative serum CRP level is a convenient biomarker and predictor of a poor prognosis after surgery for colorectal cancer.
背景/目的：既往研究报道，术前血清C反应蛋白（CRP）水平升高与各类癌症患者的预后不良相关。本研究旨在评估术前血清CRP水平对结直肠癌患者的预后意义，并确定血清CRP水平的合适临界值。
我们纳入了855例行I-IV期结直肠癌手术的患者。血清CRP水平中位数为0.13（范围：0.01-22.8）。基于受试者工作特征曲线，我们将血清CRP水平的临界值设定为0.6。根据血清CRP水平将患者分为两组。采用多因素分析评估血清CRP水平升高的预后意义。
血清CRP水平高的患者癌症特异性生存率显著更差。特别是，IV期疾病患者中观察到更显著的差异。多因素分析表明，血清CRP水平高是生存不良的独立危险因素。
术前血清CRP水平是结直肠癌手术后预后不良的便捷生物标志物和预测指标。
