术前血清 C反应蛋白对骨癌感染患者生存率的预测价值

摘要

Objective To study the predictive value of preoperative serum CRP in survival in osteosarcoma patients with infection.Methods Preoperative serum CRP levels and survival of 79 cases of high grade osteosarcoma treated with resection were retrospectively analyzed .Results The mean preoperative serum CRP level of all 79 patients was 0.53 mg/dl ( SD,1.27 mg/dl) .Patients died of their underlying disease had significantly higher CRP levels compared with patients survived throughout the follow-up period (1.09 mg/dl ±2.02 mg/dl versus 0.32 mg/dl ±0.75 mg/dl,respectively;P=0.015).CRP levels were sig-nificantly correlated with survival (Pearson's correlation coefficient =-0.25;P=0.026)and histological subtype (Pearson's cor-relation coefficient=-0.42;P<0.001),but not with sex,age,histological response,tumor size or metastatic disease.Univariate and multivariate survival analysis showed that age ,response to chemotherapy and serum CRP were associated with disease-specific survival.Patients with a CRP level over 1 mg/dl had a significantly lower 5-year disease-specific survival of 36.7% compared with 73.8%in patients with normal CRP values (P=0.020).Infection was not correlated with disease-specific survival.Preoper-ative serum CRP levels were not correlated with postoperative infection or deep prosthetic infection .Conclusion Preoperative se-rum CRP seems to be an independent predictor of survival in patients with high -grade osteosarcoma .Further studies are needed on a large-scale basis.%目的：探讨术前血清C反应蛋白作为骨癌感染患者生存率预测因素的价值。方法回顾性分析79例接受手术切除的高度恶性骨肉瘤患者术前血清CRP 水平和生存资料。结果79例患者的术前血清CRP水平平均为（0．53±1．27）mg／dl。因病死亡患者CRP水平（1．09 mg／dl ±2．02 mg／dl），显著高于生存患者（0．32 mg／dl ±0．75 mg／dl），P＝0．015。术前CRP水平与生存率（Pearson 相关系数＝－0．25，P＝0．026）和组织学亚型（Pearson 相关系数＝－0．42，P＜0．001）显著相关，而与性别、年龄、病理反应、肿瘤大小或转移性疾病无关。单变量和多变量生存分析，年龄、化疗反应、血清CRP均与疾病特异性生存率相关。 CRP水平超过1 mg／dl的患者疾病特异性5年生存率为36．7％，低于正常CRP患者的5年生存率73．8％（P＝0．020）。感染与疾病特异性生存无相关性。术前血清CRP水平与术后感染或深部假肢感染无相关性。结论术前血清CRP似乎是骨肉瘤患者生存率的独立预测因子，但仍需进一步研究证实。