Consalvo Sarah, Hinterwimmer Florian, Stephan Maximilian, Breden Sebastian, Lenze Ulrich, Peeken Jan, von Eisenhart-Rothe Rüdiger, Knebel Carolin
Department of Orthopaedics and Sport Orthopaedics, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany.
Institute for AI and Informatics in Medicine, Technical University of Munich, 81675 Munich, Germany.
Diagnostics (Basel). 2024 Jul 4;14(13):1428. doi: 10.3390/diagnostics14131428.
An aberrant cellular microenvironment characterized by pathological cells or inflammation represents an added risk factor across various cancer types. While the significance of chronic inflammation in the development of most diffuse tumors has been extensively studied, an exception to this analysis exists in the context of chondrosarcomas. Chondrosarcomas account for 20-30% of all bone sarcomas, with an estimated global incidence of 1 in 100,000. The average age at diagnosis is 50, and over 70% of patients are over 40. This retrospective study aimed to examine the role of C-reactive protein (CRP) as a prognostic factor in relation to the histopathological findings in chondrosarcoma.
In this retrospective study, 70 patients diagnosed with chondrosarcoma and treated between 2004 and 2019 were included. Preoperative CRP levels were measured in mg/dL, with non-pathological values defined as below 0.5 mg/dL. Disease-free survival time was calculated from the initial diagnosis to events such as local recurrence or metastasis. Follow-up status was categorized as death from disease, no evidence of disease, or alive with disease. Patients were excluded if they had insufficient laboratory values, missing follow-up information, or incomplete histopathological reports.
The calculated risk estimation of a reduced follow-up time was 2.25 timed higher in the patients with a CRP level >0.5 mg/dL (HR 2.25 and 95% CI 1.13-4.45) and 3 times higher in patients with a tumor size > pT2 (HR 3 and 95% CI 1.59-5.92). We can easily confirm that risk factors for reduced prognosis lie in chondrosarcoma high grading, preoperative pathological CRP- level, and a size > 8 cm.
A pretreatment CRP value greater than 0.5 mg/dL can be considered a sensitive prognostic and risk factor for distant metastasis for chondrosarcoma patients.
以病理细胞或炎症为特征的异常细胞微环境是各种癌症类型的一个额外风险因素。虽然慢性炎症在大多数弥漫性肿瘤发生中的重要性已得到广泛研究，但在软骨肉瘤的背景下，这一分析存在例外情况。软骨肉瘤占所有骨肉瘤的20%-30%，全球估计发病率为十万分之一。诊断时的平均年龄为50岁，超过70%的患者年龄超过40岁。这项回顾性研究旨在探讨C反应蛋白（CRP）作为软骨肉瘤组织病理学结果相关预后因素的作用。
在这项回顾性研究中，纳入了2004年至2019年间诊断为软骨肉瘤并接受治疗的70例患者。术前CRP水平以mg/dL为单位进行测量，非病理值定义为低于0.5mg/dL。无病生存时间从初始诊断计算至局部复发或转移等事件。随访状态分为疾病死亡、无疾病证据或带瘤生存。如果患者实验室值不足、随访信息缺失或组织病理学报告不完整，则将其排除。
CRP水平>0.5mg/dL的患者随访时间缩短的计算风险估计值高2.25倍（HR 2.25，95%CI 1.13-4.45），肿瘤大小>pT2的患者高3倍（HR 3，95%CI 1.59-5.92）。我们可以很容易地确认，预后降低的风险因素在于软骨肉瘤高分级、术前病理CRP水平和大小>8cm。
对于软骨肉瘤患者，预处理时CRP值大于0.5mg/dL可被视为远处转移的敏感预后和风险因素。
