Kano Hisao, Midorikawa Yutaka, Song Peipei, Nakayama Hisashi, Moriguchi Masamichi, Higaki Tokio, Tsuji Shingo, Takayama Tadatoshi
Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
National Center for Global Health and Medicine, Tokyo, Japan.
Biosci Trends. 2020 Sep 21;14(4):304-309. doi: 10.5582/bst.2020.03167. Epub 2020 Jun 5.
C-reactive protein (CRP)- and albumin (Alb)-based scoring systems are available for predicting the prognosis of patients with diverse forms of gastrointestinal cancer, but their utility for patients with intrahepatic cholangiocarcinoma (ICC) is still unclear. This study aimed to elucidate whether a high CRP/Alb ratio is associated with the surgical outcome of ICC patients. Patients who underwent initial and curative resection for ICC were included in this study, and were divided into the High and Low CRP/Alb groups based on their preoperative CRP and Alb values. The surgical outcomes were compared between the two groups. The median CRP/Alb ratio amongst 88 patients was 0.033 (range, 0.019-3.636); 44 patients with CRP/Alb > 0.033 were allocated to the High CRP/Alb group and 44 patients were allocated to the Low CRP/Alb group. The operative data did not differ between the two groups, while the tumor status was more advanced in the High CRP/Alb group. The median overall survival was 2.4 years (95% CI, 1.4-3.3) and 8.9 years (3.8-NA) in the High and Low CRP/Alb groups, respectively (P < 0.001), and recurrence-free survival was 0.5 years (95% CI, 0.3-0.7) and 7.7 years (1.3-NA), respectively (P < 0.001). In a multivariate analysis, the independent factors for overall survival were High CRP/Alb (P = 0.017) and multiple nodules (P = 0.008). Taken together, the survival of ICC patients in the High CRP/Alb group was reduced compared to that of patients in the Low CRP/Alb group due to the advanced stage of the tumor as well as malnutrition.
基于C反应蛋白（CRP）和白蛋白（Alb）的评分系统可用于预测多种形式胃肠道癌患者的预后，但其对肝内胆管癌（ICC）患者的效用仍不明确。本研究旨在阐明高CRP/Alb比值是否与ICC患者的手术结局相关。本研究纳入了接受ICC初次根治性切除术的患者，并根据术前CRP和Alb值将其分为高CRP/Alb组和低CRP/Alb组。比较两组的手术结局。88例患者的CRP/Alb比值中位数为0.033（范围：0.019 - 3.636）；44例CRP/Alb>0.033的患者被分配至高CRP/Alb组，44例患者被分配至低CRP/Alb组。两组的手术数据无差异，而高CRP/Alb组的肿瘤状态更晚期。高CRP/Alb组和低CRP/Alb组的中位总生存期分别为2.4年（95%CI，1.4 - 3.3）和8.9年（3.8 - NA）（P<0.001），无复发生存期分别为0.5年（95%CI，0.3 - 0.7）和7.7年（1.3 - NA）（P<0.001）。在多因素分析中，总生存期的独立因素为高CRP/Alb（P = 0.017）和多发结节（P = 0.008）。综上所述，由于肿瘤晚期以及营养不良，高CRP/Alb组ICC患者的生存期低于低CRP/Alb组患者。
