Morimoto Masaki, Honjo Soichiro, Sakamoto Teruhisa, Yagyu Takuki, Uchinaka Ei, Hanaki Takehiko, Watanabe Joji, Matsunaga Tomoyuki, Yamamoto Manabu, Fukumoto Yoji, Tokuyasu Naruo, Fujiwara Yoshiyuki
Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
Yonago Acta Med. 2020 Feb 20;63(1):70-78. doi: 10.33160/yam.2020.02.011. eCollection 2020 Feb.
C-reactive protein (CRP) levels reflect ongoing inflammation and/or tissue damage, and studies suggest that platelets play a role in tumor invasion and metastasis. P-CRP is defined as the multiplied product of serum CRP and platelet levels. Here the prognostic value of pre- and post-operative P-CRP levels in pancreatic cancer (PC) patients was assessed.
This retrospective study used data from 107 consecutive PC patients who had undergone either pancreaticoduodenectomy or distal pancreatectomy. Clinicopathological parameters and pre/post-operative laboratory data derived from patient records were used for analyses. P-CRP was defined as the product of peripheral thrombocyte count (/uL) × serum CRP level (mg/dL) divided by 10; the optimal P-CRP cut-off value was defined using receiver operating characteristic curves.
PC patients were classified as either P-CRP (< 1.782; = 49) or P-CRP (≥ 1.782; = 58), based on the cut-off value of 1.782. Univariate analysis revealed that performance status, clinical stage, pathological T and N stages, P-CRP, and carbohydrate antigen 19-9 (CA19-9) significantly affected overall survival (OS). Multivariate analysis revealed that independent risk factors for OS were pathological N stage, P-CRP, and CA19-9. Additionally, 103 PC patients for whom postoperative data were available were classified into four groups (P-CRP, P-CRP, P-CRP and P-CRP), based on preoperative P-CRP and postoperative trend of P-CRP, and we found that prognosis, in terms of OS, was significantly different among these groups ( = 0.012).
Pre- and post-operative P-CRP values are a potential predictor of prognosis in PC patients.
C反应蛋白（CRP）水平反映了持续的炎症和/或组织损伤，并且研究表明血小板在肿瘤侵袭和转移中发挥作用。P-CRP被定义为血清CRP水平与血小板水平的乘积。在此评估了胰腺癌（PC）患者术前和术后P-CRP水平的预后价值。
这项回顾性研究使用了107例连续接受胰十二指肠切除术或胰体尾切除术的PC患者的数据。从患者记录中获取的临床病理参数和术前/术后实验室数据用于分析。P-CRP被定义为外周血小板计数（/μL）×血清CRP水平（mg/dL）除以10的乘积；使用受试者工作特征曲线定义最佳P-CRP临界值。
根据临界值1.782，PC患者被分为P-CRP（<1.782；n = 49）或P-CRP（≥1.782；n = 58）两组。单因素分析显示，体能状态、临床分期、病理T和N分期、P-CRP以及糖类抗原19-9（CA19-9）显著影响总生存期（OS）。多因素分析显示，OS的独立危险因素是病理N分期、P-CRP和CA19-9。此外，根据术前P-CRP和术后P-CRP的变化趋势，将103例有术后数据的PC患者分为四组（P-CRP高术前高术后、P-CRP高术前低术后、P-CRP低术前高术后、P-CRP低术前低术后），我们发现这些组之间的OS预后存在显著差异（P = 0.012）。
术前和术后P-CRP值是PC患者预后的潜在预测指标。
