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系统炎症生物标志物对 II/III 期结肠癌患者预后价值的综合比较分析。

Comprehensive Comparative Analysis of Prognostic Value of Systemic Inflammatory Biomarkers for Patients with Stage II/III Colon Cancer.

机构信息

Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.

Department of Biostatistics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.

出版信息

Ann Surg Oncol. 2020 Mar;27(3):844-852. doi: 10.1245/s10434-019-07904-9. Epub 2019 Nov 12.

DOI:10.1245/s10434-019-07904-9

PMID:31720937

Abstract

BACKGROUND

Among numerous systemic inflammatory biomarkers, it remains unclear which is the most prognostic for patients with stage II/III colon cancer. We aimed to compare the prognostic significance of systemic inflammatory biomarkers among patients with stage II/III colon cancer.

METHODS

We included 1303 patients with stage II/III colon cancer who underwent potentially curative resection from July 2004 to December 2013. Sixteen systemic inflammatory biomarkers-derived from combinations of neutrophils, lymphocytes, monocytes, platelets, C-reactive protein (CRP), and albumin-were compared to identify the biomarker most associated with overall survival (OS) and disease-free survival (DFS) using receiver operating characteristic (ROC) curve analysis.

RESULTS

Nine inflammatory biomarkers were predictive for OS, among which lymphocyte-to-CRP ratio (LCR), CRP-to-albumin ratio (CAR), neutrophil × CRP, monocyte × CRP, and platelet × CRP were also predictive for DFS. Among these five inflammatory biomarkers, the area under the curve (AUC) value was highest (0.630) for LCR, being significantly higher than that for neutrophil × CRP (P = 0.010), monocyte × CRP (P = 0.007), or platelet × CRP (P = 0.010) for OS. When the prognostic impact of LCR and CAR were analyzed by multivariate analysis, only LCR was an independent predictor of both OS [hazard ratio (HR), 1.77; 95% confidence interval (CI), 1.23-2.60; P = 0.002] and DFS (HR, 1.29; 95% CI, 1.00-1.66; P = 0.048).

CONCLUSIONS

LCR may be the most useful predictive factor for OS and DFS in patients with stage II or III colon cancer.

摘要

背景

在众多全身性炎症生物标志物中，对于 II 期/III 期结肠癌患者，哪种标志物的预后价值最高仍不明确。本研究旨在比较 II 期/III 期结肠癌患者的全身性炎症生物标志物的预后意义。

方法

本研究纳入了 2004 年 7 月至 2013 年 12 月接受潜在治愈性切除术的 1303 例 II 期/III 期结肠癌患者。通过受试者工作特征（ROC）曲线分析，比较了由中性粒细胞、淋巴细胞、单核细胞、血小板、C 反应蛋白（CRP）和白蛋白组合衍生的 16 种全身性炎症生物标志物，以确定与总生存（OS）和无病生存（DFS）最相关的生物标志物。

结果

9 种炎症生物标志物与 OS 相关，其中淋巴细胞与 CRP 比值（LCR）、CRP 与白蛋白比值（CAR）、中性粒细胞×CRP、单核细胞×CRP 和血小板×CRP 也与 DFS 相关。在这 5 种炎症生物标志物中，LCR 的曲线下面积（AUC）值最高（0.630），显著高于中性粒细胞×CRP（P=0.010）、单核细胞×CRP（P=0.007）或血小板×CRP（P=0.010），用于 OS。当通过多变量分析分析 LCR 和 CAR 的预后影响时，只有 LCR 是 OS [风险比（HR），1.77；95%置信区间（CI），1.23-2.60；P=0.002]和 DFS（HR，1.29；95%CI，1.00-1.66；P=0.048）的独立预测因子。