Chen Bo, Zhang Tonghe, Wang Yisong, Li Zhaoyang, Liu Haoyu, Jiang Zhan, Yang Huitang, Cai Yandong, Fan Guoju, Wang Kaiqiang, Zhang Hongwei, Hu Hailong, Li Yankui
Department of Vascular Surgery, The Second Hospital of Tianjin Medical University, Tianjin, China.
Center for Cardiovascular Diseases, The Second Hospital of Tianjin Medical University, Tianjin, China.
Front Immunol. 2025 Aug 13;16:1652139. doi: 10.3389/fimmu.2025.1652139. eCollection 2025.
This study evaluated C-reactive protein (CRP) in hospitalized patients with bladder cancer (BC) and explored the predictive value of CRP for venous thromboembolism (VTE), combining CRP and D-dimer (D-D) levels to improve the ability to predict the risk of VTE in BC patients, thereby better guiding clinical prevention and treatment of this disease.
Clinical data from 4,438 patients with BC admitted between January 2015 and December 2020 were reviewed. After screening, 2,164 patients remained.52 VTE cases were identified, and 104 matched controls were selected (1:2 ratio). Conditional logistic regression, receiver operating characteristic (ROC) curve analysis, stratified analysis, and interaction tests were conducted to assess predictive performance and control for confounding bias.
Conditional logistic regression analysis indicated that elevated CRP and D-D levels were associated with higher risk of VTE in hospitalized patients with BC. Moreover, the areas under the ROC curves were 0.734 for CRP, 0.817 for D-D, and 0.865 for the combined model, indicating that the combined model offers superior predictive performance. Stratified and interaction analyses further revealed that the predictive value of CRP and D-D levels was influenced by the infection status.
Elevated CRP and D-D levels may be potential indicators of VTE in BC patients. Their combined use improves predictive accuracy, and their predictive value may be better in non-infected patients.
本研究评估了膀胱癌(BC)住院患者的C反应蛋白(CRP),并探讨了CRP对静脉血栓栓塞症(VTE)的预测价值,结合CRP和D-二聚体(D-D)水平以提高预测BC患者VTE风险的能力,从而更好地指导该疾病的临床防治。
回顾了2015年1月至2020年12月期间收治的4438例BC患者的临床资料。筛选后,剩余2164例患者。确定了52例VTE病例,并选择了104例匹配对照(1:2比例)。进行条件逻辑回归、受试者工作特征(ROC)曲线分析、分层分析和交互检验,以评估预测性能并控制混杂偏倚。
条件逻辑回归分析表明,CRP和D-D水平升高与BC住院患者发生VTE的较高风险相关。此外,CRP的ROC曲线下面积为0.734,D-D为0.817,联合模型为0.865,表明联合模型具有更好的预测性能。分层和交互分析进一步显示,CRP和D-D水平的预测价值受感染状态影响。
CRP和D-D水平升高可能是BC患者VTE的潜在指标。联合使用可提高预测准确性,且在未感染患者中其预测价值可能更好。