C反应蛋白在乐伐替尼治疗不可切除肝细胞癌中的预后意义：一项多机构研究
Prognostic Significance of C-Reactive Protein in Lenvatinib-Treated Unresectable Hepatocellular Carcinoma: A Multi-Institutional Study.
作者信息
Okumura Taiki, Kimura Takefumi, Iwadare Takanobu, Wakabayashi Shun-Ichi, Kobayashi Hiroyuki, Yamashita Yuki, Sugiura Ayumi, Joshita Satoru, Fujimori Naoyuki, Kunimoto Hideo, Komatsu Michiharu, Fukushima Hideki, Mori Hiromitsu, Umemura Takeji
机构信息
Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto 390-8621, Japan.
Department of Advanced Endoscopic Therapy, Shinshu University School of Medicine, Matsumoto 390-8621, Japan.
出版信息
Cancers (Basel). 2023 Nov 9;15(22):5343. doi: 10.3390/cancers15225343.
BACKGROUND
Serum C-reactive protein (CRP) is an established biomarker for acute inflammation and has been identified as a prognostic indicator for hepatocellular carcinoma (HCC). However, the significance of the serum CRP level, specifically in HCC patients treated with lenvatinib, remains unclear.
METHODS
We retrospectively analyzed 125 HCC patients who received lenvatinib treatment at six centers. Clinical characteristics were assessed to identify clinical associations between serum CRP and HCC prognosis.
RESULTS
The median overall serum CRP level was 0.29 mg/dL. The cohort was divided into two groups: the low-CRP group with a serum CRP < 0.5 mg/dL and the high-CRP group with a serum CRP ≥ 0.5 mg/dL. The low-CRP group exhibited significantly longer overall survival (OS) than the high-CRP group (22.9 vs. 7.8 months, < 0.001). No significant difference was observed for progression-free survival (PFS) between the high- and low-CRP groups (9.8 vs. 8.4 months, = 0.411), while time-to-treatment failure (TTF) was significantly longer in the low-CRP group (8.5 vs. 4.4 months, = 0.007). The discontinuation rate due to poor performance status was significantly higher in the high-CRP group ( < 0.001).
CONCLUSION
A baseline serum CRP level exceeding 0.5 mg/dL was identified as an unfavorable prognostic factor in HCC patients receiving lenvatinib treatment.
背景
血清C反应蛋白（CRP）是一种公认的急性炎症生物标志物，已被确定为肝细胞癌（HCC）的预后指标。然而，血清CRP水平的意义，特别是在接受乐伐替尼治疗的HCC患者中，仍不明确。
方法
我们回顾性分析了在六个中心接受乐伐替尼治疗的125例HCC患者。评估临床特征以确定血清CRP与HCC预后之间的临床关联。
结果
血清CRP总体中位水平为0.29mg/dL。该队列分为两组：血清CRP<0.5mg/dL的低CRP组和血清CRP≥0.5mg/dL的高CRP组。低CRP组的总生存期（OS）明显长于高CRP组（22.9个月对7.8个月，<0.001）。高CRP组与低CRP组之间的无进展生存期（PFS）未观察到显著差异（9.8个月对8.4个月，=0.411），而低CRP组的治疗失败时间（TTF）明显更长（8.5个月对4.4个月，=0.007）。高CRP组因身体状况不佳导致的停药率明显更高（<0.001）。
结论
基线血清CRP水平超过0.5mg/dL被确定为接受乐伐替尼治疗的HCC患者的不良预后因素。
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