C反应蛋白对晚期恶性肿瘤患者的预测价值

摘要

目的 检测并探讨晚期恶性肿瘤(复发转移和终末期)患者血清中C反应蛋白(CRP)水平对病情转归的评估价值.方法 收集住院治疗的60例晚期肿瘤患者(化学治疗组)、60例姑息支持治疗患者(支持组)的临床资料,记录其临床转归情况,检测患者血清标本中的CRP水平,随访预后结果.结果 治疗前支持组血清CRP、白细胞(WBC)、癌胚抗原(CEA)水平高于化学治疗组(均P＜0.05)；支持组CRP与CEA呈正相关(r=0.26,P＜0.05),化学治疗组CRP与WBC、CEA呈正相关(r1 =0.26,P ＜0.05;r2 =0.32,P ＜0.05)；化学治疗有效者CRP较化学治疗前明显下降(t=2.64.P＜0.05),而化学治疗无效者CRP较化学治疗前升高(t=-2.96,P＜0.01)；多因素分析提示共患疾病、CRP水平与晚期肿瘤患者预后有关(均P＜0.05).结论 血清中CRP水平可作为评估晚期恶性肿瘤患者病情转归的一项参考指标.%Objective To evaluate the predictive value of serum C-reactive protein( CRP) on advanced cancer patients with malignant tumor( relapse and transfer and terminal stage) ,through detecting the serum CRP. Methods Data of 120 patients , including 60 patients with palliative chemotherapy (chemotherapy group) and 60 cases with best supportive care (supportive group) were analyzed. The level of serum CRP was quantitatively determined. Prognosis of all patients was followed up. Results Before the treatment,the levels of CRP,white blood cell( WBC) and carcinoembryonic antigen(CEA) in supportive group were higher than those in chemotherapy group(P<0.05). Before the treatment,the relationship between the serum CRP level and serum CEA level was positive(r=0.26,/3<0.05) in supportive group,the serum CRP level was positive correlated with WBC level(r=0.26,P<0.05) and serum CEA level(r = 0.32,P<0.05) in chemotherapy group. The change levels of CRP before or after the chemotherapy in chemotherapy group,consistency with the therapeutic effectiveness. Significant drop of CRP levels were observed in chemosensitive patients before and after chemotherapy (t = 2.64, P < 0.05) , conversely, raised in the non-responding patients(t = -2. 96,P <0. 01 ). Multifactor logistic analysis showed that the prognosis of the advanced cancer patients with malignant tumor was related with CRP level and combined with complications. Conclusion The levels of CRP may be served as a useful index in the assessment of mortality in advanced cancer patients.