a Department of Medical Oncology , Fujian Cancer Hospital, Fujian Medical University Cancer Hospital , Fuzhou , Fujian , China.
b Department of Nutrition , Daping Hospital & Research Institute of Surgery, Third Military Medical University , Chongqing , China.
Nutr Cancer. 2019;71(2):240-245. doi: 10.1080/01635581.2018.1524019. Epub 2018 Nov 17.
The level of the systemic inflammatory marker C-reactive protein (CRP) is elevated in many patients with malignant disease and may be related to nutritional status.
To analyze the association between serum CRP levels in patients with malignant tumors and their nutritional status.
A total of 3,692 cases were analyzed and the serum CRP levels were determined using an immunometric assay. Nutritional status was assessed by using patient-generated subjective global assessment (PG-SGA). The biochemical evaluation of prealbumin (PA), albumin (ALB), cholesterol (CHOL), and triglycerides (TG) were assayed within 48 h admission to the hospital. The association between serum CRP concentration and the nutritional status, the stage of the tumor and other factors was analyzed by univariate and multivariate logistic regression analysis.
Elevated serum CRP was observed in 47.6% (1,548/3,269) of patients compared with the reference value, and the median CRP concentration was 18.29 mg/l. Patient serum CRP concentrations in the malnourished group (PG-SGA B + C) were higher than in the well-nourished (PG-SGA A) patients (P < 0.05). The serum CRP level was related to the patients' age, gender, tumor stage, and was affected by hepatitis, liver cirrhosis, diabetes, but it has no effect on hypertension. The CRP high patients had lower PA and ALB levels, lower Karnofsky performance status scores, and higher PG-SGA scores (P < 0.05), and there was no relationship with CHOL and TG levels. Weight loss in the previous 1 mo was seen with CRP positive patients (P < 0.05).
Almost 50% of malignant tumor patients had elevated serum CRP levels indicating a systemic inflammatory state. The nutritional status was worse in cancer patients with higher concentrations of serum CRP. The level of CRP was associated with the tumor stage, and, as stage is a prognostic factor, so can CRP be used as a prognostic maker in malignant tumors patients.
许多恶性疾病患者的全身炎症标志物 C 反应蛋白（CRP）水平升高，且其可能与营养状况有关。
分析恶性肿瘤患者血清 CRP 水平与营养状况的关系。
共分析了 3692 例患者，采用免疫比浊法测定血清 CRP 水平，采用患者自评主观整体评估（PG-SGA）评估营养状况。入院 48 h 内检测前白蛋白（PA）、白蛋白（ALB）、胆固醇（CHOL）和甘油三酯（TG）的生化评估。采用单因素和多因素 logistic 回归分析 CRP 浓度与营养状况、肿瘤分期等因素的关系。
与参考值相比，3269 例患者中有 47.6%（1548 例）血清 CRP 升高，中位数为 18.29mg/L。营养不良组（PG-SGA B+C）患者血清 CRP 浓度高于营养良好组（PG-SGA A）（P<0.05）。血清 CRP 水平与患者年龄、性别、肿瘤分期有关，受肝炎、肝硬化、糖尿病的影响，但与高血压无关。CRP 升高患者的 PA 和 ALB 水平较低，卡诺夫斯基表现状态评分较低，PG-SGA 评分较高（P<0.05），与 CHOL 和 TG 水平无关。CRP 阳性患者在过去 1 个月内体重减轻（P<0.05）。
近 50%的恶性肿瘤患者血清 CRP 水平升高，表明存在全身炎症状态。血清 CRP 浓度较高的癌症患者营养状况较差。CRP 水平与肿瘤分期有关，而分期是预后因素，因此 CRP 可作为恶性肿瘤患者的预后标志物。
