Pan Qianqian, Wei Mingjing, Lu Mengyi, Xu Yaping, Xie Xing, Li Xiao
Department of Gynecologic Oncology, Women's Hospital, School of Medicine Zhejiang University, Hangzhou, Zhejiang, 310006, People's Republic of China.
Zhejiang Financial College, Hangzhou, Zhejiang, People's Republic of China.
Cancer Manag Res. 2023 Feb 27;15:233-243. doi: 10.2147/CMAR.S385974. eCollection 2023.
Increasing epidemiological evidence supported that chronic inflammatory factors might be involved in the carcinogenesis and progression of various cancers. The present study tried to investigate the prognostic value of perioperative C-reactive protein (CRP) in prognosis of patients with epithelial ovarian carcinoma (EOC) from a tertiary university teaching hospital.
The cutoff value of CRP was calculated according to receiver operating characteristic (ROC) curve. Variables were compared using Chi-square test. Progress-free survival (PFS) and overall survival (OS) time were assessed by Kaplan-Meier (KM) survival analysis and Log rank test based on serum CRP level. Univariate and multivariate Cox regression analyses were applied for assessing the relationship between clinicopathological parameters and survival.
Higher perioperative CRP levels (preoperative ≥5.15 mg/L and postoperative ≥72.45 mg/L) were significantly associated with serous tumor, high-grade, advanced stage, elevated preoperative CA125, suboptimal surgery, chemotherapy resistance, recurrence and death in EOC (P < 0.01). KM analysis suggested patients with elevated preoperative, postoperative and perioperative CRP had shorter survival (P < 0.01). Elevated perioperative CRP was an independent risk factor for PFS (HR 1.510, 95% CI 1.124-2.028; P = 0.006) and OS (HR 1.580, 95% CI 1.109-2.251; P = 0.011). Similar results were obtained for elevated preoperative CRP. Subgroup analysis further suggested that elevated perioperative CRP was also an independent risk factor for prognosis in advanced stage and serous EOC.
Elevated perioperative CRP was an independent risk factor for poorer prognosis of EOC, particularly in advanced stage and serous patients.
越来越多的流行病学证据支持慢性炎症因子可能参与各种癌症的发生和发展。本研究试图从一所三级大学教学医院调查围手术期C反应蛋白（CRP）对上皮性卵巢癌（EOC）患者预后的预测价值。
根据受试者工作特征（ROC）曲线计算CRP的临界值。使用卡方检验比较变量。基于血清CRP水平，通过Kaplan-Meier（KM）生存分析和对数秩检验评估无进展生存期（PFS）和总生存期（OS）。应用单因素和多因素Cox回归分析评估临床病理参数与生存之间的关系。
围手术期较高的CRP水平（术前≥5.15mg/L和术后≥72.45mg/L）与EOC中的浆液性肿瘤、高级别、晚期、术前CA125升高、手术不理想、化疗耐药、复发和死亡显著相关（P<0.01）。KM分析表明，术前、术后和围手术期CRP升高的患者生存期较短（P<0.01）。围手术期CRP升高是PFS（HR 1.510，95%CI 1.124-2.028；P=0.006）和OS（HR 1.580，95%CI 1.109-2.251；P=0.011）的独立危险因素。术前CRP升高也得到了类似结果。亚组分析进一步表明，围手术期CRP升高也是晚期和浆液性EOC患者预后的独立危险因素。
围手术期CRP升高是EOC患者预后较差的独立危险因素，尤其是在晚期和浆液性患者中。
