术前C反应蛋白/白蛋白比值在卵巢癌中的预后价值

The prognostic value of the preoperative c-reactive protein/albumin ratio in ovarian cancer.

作者信息

Liu Yubo, Chen Shengfu, Zheng Chengyu, Ding Miao, Zhang Lan, Wang Liangan, Xie Meiqing, Zhou Jianhua

机构信息

Department of Ultrasound, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dong feng Road East, Guangzhou, 510060, People's Republic of China.

Department of Obstetrics and Gynecology, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetic and Gene Regulation , 107 Yan Jiang Road West, Guangzhou, 510120, People's Republic of China.

出版信息

BMC Cancer. 2017 Apr 21;17(1):285. doi: 10.1186/s12885-017-3220-x.

DOI:10.1186/s12885-017-3220-x

PMID:28431566

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5399817/

Abstract

BACKGROUND

Inflammation plays an important role in the pathogenesis of ovarian cancer. This study sought to investigate the association between the preoperative c-reactive protein/albumin ratio (CRP/Alb) and oncological outcomes in ovarian cancer patients.

METHODS

Two hundred patients with histologically verified ovarian cancer between June 2006 and July 2012 were retrospectively reviewed. Overall survival was evaluated by the Kaplan-Meier method and log-rank test. The significance of risk factors for overall survival was evaluated with the Cox proportional hazards model. Additionally, area under the receiver operating characteristic curve (AUC) was used to compare the predictive ability of CRP/Alb, Glasgow Prognostic Score (GPS), modified GPS (mGPS), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), prognostic index (PI) and prognostic nutritional index (PNI).

RESULTS

The optimal cutoff value of CRP/Alb was 0.68. Increased CRP/Alb (≥0.68) was associated with advanced stage, residual tumor, ascites, elevated serum carbohydrate antigen(CA)-125 level, GPS, and mGPS (all p < 0.05). Patients with high CRP/Alb had poor overall survival compared to those with low CRP/Alb (p < 0.001). Multivariable analysis showed that CRP/Alb (Hazard Ratio (HR) 1.330, 95% confidence interval (CI) 1.131-1.564, p = 0.001), tumor stage (HR 1.577, 95% CI 1.189-2.091, p = 0.002), residual tumor (HR 2.337, 95% CI 1.518-3.597, p < 0.001) and age (HR 1.017, 95% CI 1.000-1.035, p = 0.046) were independent prognostic factors for overall survival. Additionally, the CRP/Alb showed greater AUC values at 1 year (0.692), 3 years (0.659), and 5 years (0.682) than GPS, mGPS and PNI.

CONCLUSIONS

The CRP/Alb is a novel independent marker of poor prognosis among ovarian cancer patients and shows superior prognostic ability compared to the established inflammation-based prognostic indices.

摘要

背景

炎症在卵巢癌发病机制中起重要作用。本研究旨在探讨术前C反应蛋白/白蛋白比值（CRP/Alb）与卵巢癌患者肿瘤学结局之间的关联。

方法

回顾性分析2006年6月至2012年7月间200例经组织学证实的卵巢癌患者。采用Kaplan-Meier法和对数秩检验评估总生存期。用Cox比例风险模型评估总生存期危险因素的显著性。此外，采用受试者工作特征曲线下面积（AUC）比较CRP/Alb、格拉斯哥预后评分（GPS）、改良GPS（mGPS）、中性粒细胞淋巴细胞比值（NLR）、血小板淋巴细胞比值（PLR）、预后指数（PI）和预后营养指数（PNI）的预测能力。

结果

CRP/Alb的最佳临界值为0.68。CRP/Alb升高（≥0.68）与晚期、残留肿瘤、腹水、血清糖类抗原（CA）-125水平升高、GPS及mGPS相关（均P<0.05）。与CRP/Alb低的患者相比，CRP/Alb高的患者总生存期较差（P<0.001）。多变量分析显示，CRP/Alb（风险比（HR）1.330，95%置信区间（CI）1.131-1.564，P=0.001）、肿瘤分期（HR 1.577，95%CI 1.189-2.091，P=0.002）、残留肿瘤（HR 2.337，95%CI 1.518-3.597，P<0.001）和年龄（HR 1.017，95%CI 1.000-1.035，P=0.046）是总生存期的独立预后因素。此外，CRP/Alb在1年（0.692）、3年（0.659）和5年（0.682）时的AUC值高于GPS、mGPS和PNI。