结直肠癌患者血中C反应蛋白对预后影响的系统评价  

Prognostic value of C-reactive protein in patients with colorectal cancer:Metaanalysis

作　　者：章志丹[1] 李鑫[1] 鲁翀[2] 

机构地区：[1]中国医科大学附属第一医院重症医学科,辽宁省沈阳市110001 [2]中国医科大学附属第一医院胃肠肿瘤外科,辽宁省沈阳市110001

出　　处：《世界华人消化杂志》2016年第13期2093-2101,共9页World Chinese Journal of Digestology

基　　金：辽宁省自然科学基金优秀青年人才培育课题基金资助项目;No.2014021078 ~~

摘　　要：目的:系统评价结直肠癌血中C反应蛋白(C-reactive protein,CRP)对预后的影响.方法:在PubMed和Embase数据库中系统检索关于血中CRP和结直肠癌预后关系的文献,文献检索日期截止至2015-05.使用Stata12.0统计软件对数据进行Meta分析,以风险比(hazard risk,HR)及95%可信区间(95%confidence interval,95%CI)作为效应量.同时进行亚组和敏感性分析.结果:本研究共纳入21篇文献,包含4242例结直肠癌患者.我们的结果显示结直肠癌患者血中CRP水平与总生存率、肿瘤特异性生存率和无病生存率相关且具有统计学差异.总生存率:HR=1.89,95%CI:1.52-2.35(P<0.001);肿瘤特异性生存率:HR=2.08,95%CI:1.42-3.04(P<0.001);无病生存率:HR=1.44,95%CI:1.25-1.67(P<0.001).基于取样时间、样本量和研究区域的亚组分析也得到相似的结果.此外,敏感性分析证实了我们结果的稳定性、准确性和可靠性.结论:我们的研究结果表明血中CRP高水平与结直肠癌患者不良预后相关.因此,CRP可以作为结直肠癌患者预后的重要指标.AIM：To evaluate the association between prognosis and C-reactive protein（CRP） in patients with colorectal cancer.METHODS：We systematically searched the relevant studies assessing prognostic value of C-reactive protein in patients with colorectal cancer in PubMed and Embase database（up to May 2015）.This meta-analysis was completed with hazard ratio（HR） and 95% confidence intervals（CI） as effect measures,using Stata12.0software.Subgroup and sensitivity analyses were also performed.RESULTS：Twenty-one eligible studies were included in the present meta-analysis,including4242 patients with colorectal cancer.Our results showed that elevated CRP was associated with poor survival in patients with colorectal cancer（overall survival：HR = 1.89,95%CI：1.52-2.35,P〈0.001;cancer-specific survival：HR = 2.08,95%CI：1.42-3.04,P〈0.001;disease-free survival：HR =1.44,95%CI：1.25-1.67,P〈0.001）.The subgroup analyses based on the sampling time,sample size and study region obtained similar results.Moreover,sensitivity analyses confirmed the stability of our results.CONCLUSION：Our meta-analysis indicates that CRP is significantly associated with a poorprognosis for patients with colorectal cancer.

关 键 词：C反应蛋白 结直肠癌 预后 

分 类 号：R735.34[医药卫生—肿瘤]