Lei Zhixiang, Wang Ya, Yu Tiantian, Zhang Yiting, Cui Wenting, Luo Cancan, Luo Qingqing, Zhou Lili, Gao Yuchen, Yu Li
The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Jiangxi Provincial Children's Hospital, Nanchang, China.
Front Med (Lausanne). 2025 Apr 16;12:1544250. doi: 10.3389/fmed.2025.1544250. eCollection 2025.
Idiopathic Multicentric Castleman disease (iMCD) is a type of the rare lymphoproliferative diseases. C-reactive protein (CRP) is a well-recognized biomarker of inflammation, frequently exhibits elevated levels in individuals diagnosed with iMCD. However, its prognostic value of this factor in iMCD remains uncertain.
The clinical manifestations, biochemical information, treatment plan and overall survival time (OS) of 68 iMCD patients with basic information such as age, sex, time of first diagnosis, blood routine and serum CRP level data from 6 medical institutionsin China and abroad were retrospectively analyzed. The median follow-up time of the study was 44.47 months. The serum CRP level was divided into two groups according to the prognostic relationship by X-tile software, and then it was included in the risk model CRP-A for predicting death, together with the age of first visit > 60 years old, Hemoglobin (HGB) ≤ 80g/L, hepatomegaly and/or splenomegaly and plasma cell (PC) type. The predictive ability of the clinical model was evaluated by drawing calibration curve and ROC curve. The factors affecting the level of serum CRP were analyzed.
Using the Kaplan-Meier method, our analysis suggested that a higher serum CRP level (>26.8 mg/L) was associated with worse overall survival in patients ( = 0.004). We developed a multivariable prognostic model based on serum CRP levels to assess survival outcomes in iMCD. The discriminative performance of the model for mortality events was validated through calibration plots and receiver operating characteristic (ROC) curves highlighting CRP as a key biomarker associated with disease prognosis. Additionally, analyzing by chi-square test and Fisher's exact test showed that age, B-symptoms, hypoalbuminemia, ECOG and plasma cell type were significantly associated with high serum CRP level in patients with iMCD, and that fibrinogen levels was positively correlated with CRP level.
High serum CRP levels are associated with a variety of clinical manifestations and laboratory abnormalities.
特发性多中心Castleman病（iMCD）是一种罕见的淋巴增殖性疾病。C反应蛋白（CRP）是一种公认的炎症生物标志物，在诊断为iMCD的个体中经常表现出升高水平。然而，该因素在iMCD中的预后价值仍不确定。
回顾性分析了来自国内外6家医疗机构的68例iMCD患者的临床表现、生化信息、治疗方案和总生存时间（OS），以及年龄、性别、首次诊断时间、血常规和血清CRP水平等基本信息。该研究的中位随访时间为44.47个月。通过X-tile软件根据预后关系将血清CRP水平分为两组，然后将其与首次就诊年龄>60岁、血红蛋白（HGB）≤80g/L、肝肿大和/或脾肿大以及浆细胞（PC）类型一起纳入预测死亡的风险模型CRP-A。通过绘制校准曲线和ROC曲线评估临床模型的预测能力。分析影响血清CRP水平的因素。
采用Kaplan-Meier方法，我们的分析表明，较高的血清CRP水平（>26.8mg/L）与患者较差的总生存率相关（P=0.004）。我们基于血清CRP水平建立了一个多变量预后模型，以评估iMCD的生存结果。通过校准图和受试者操作特征（ROC）曲线验证了该模型对死亡事件的判别性能，突出了CRP作为与疾病预后相关的关键生物标志物。此外，通过卡方检验和Fisher精确检验分析表明，年龄、B症状、低白蛋白血症、ECOG和浆细胞类型与iMCD患者的高血清CRP水平显著相关，并且纤维蛋白原水平与CRP水平呈正相关。
高血清CRP水平与多种临床表现和实验室异常相关。
