初诊鼻咽癌患者血清C反应蛋白检测临床意义分析  

Prospective analysis of pre-treatment C-reactive protein in patients with nasopharyngeal carcinoma

作　　者：李晓惠[1,2,3] 徐冰清[1,4] 高劲[1,5] 夏云飞[1,2] 

机构地区：[1]华南肿瘤学国家重点实验室,广东广州510060 [2]中山大学肿瘤防治中心放疗科,广东广州510060 [3]解放军第四二一医院肿瘤科,广东广州510318 [4]宜昌市中心人民医院肿瘤科,湖北宜昌443003 [5]安徽省肿瘤医院放疗科,安徽合肥230031

出　　处：《中华肿瘤防治杂志》2016年第11期727-731,738,共6页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家863计划项目(2006AA02Z4B4);国家自然科学基金(30070237)

摘　　要：目的C反应蛋白（creactiveprotein，CRP）可能是肿瘤和炎症之间的桥梁，有研究证实CRP水平和鼻咽癌分期相关。本研究旨在探讨放疗前血清中CRP水平与临床特征之间的关系，并判断其在预测鼻咽癌患者疗效和预后的价值。方法随访2006—12—27—2011-07—27中山大学肿瘤防治中心治疗的初诊鼻咽癌患者227例。227例患者全部入组了国家863计划项目资助的课题“以生物学行为和分子特征为基础的鼻咽癌个性化治疗新方案的研究”。临床分期依据2002AJcc／uIcc分期标准。所有患者接受直线加速器6--8MV高能x射线放疗，216例患者均接受同期化疗。采用Y。检验，分析CRP表达情况与患者一般临床特征的相关性；采用Kaplan—Meier法，分析治疗前CRP对鼻咽癌患者近期疗效以及总生存率、局部无复发率和无远处转移率等远期疗效的影响。结果在227例鼻咽癌患者血清中，cRP在不同的N分期（P=0．017）、M分期（P=0．010）及病理分型（P〈0．001）之间差异有统计学意义。227例鼻咽癌患者治疗前，CRP正常195例，异常32例。血清CRP正常患者的总生存率（88．2oA）高于异常患者（71．8％），P=0．022；无远处转移率（86．7％）也高于异常患者（68．7％），P=0．027。结论鼻咽癌患者治疗前CRP表达升高，会显著降低鼻咽癌患者的总生存率及无远处转移生存率，是影响预后的不利因素。OBJECTIVE C-reactive protein may be a bridge between tumor and inflammation. Previous studies have confirmed that CRP associated with nasopharyngeal cancer staging. The objective of this study to detect the relationship between CRP and clinical characteristics and effect in patients with nasopharyngeal carcinoma （NPC）. METHODS Two hundred and twenty-seven patients with nasopharyngeal carcinoma were initially diagnosed and treated between December 27, 2006 and July 27, 2011 in Sun Yat-sen University Cancer Center. All of the patients were into the prospective clinical trial supported by the national 863 plan project ＂A study of a new project on individualized treatment of nasopharyngeal carcinoma based on the biological behavior and molecular characteristics＂. The clinical staging was based on the staging system of 2002 AJCC/UICC. All patients were received 6--8 MV high-energy X-ray radiotherapy delivered using a linear accelerator, 216 patients were given concurrent chemotherapy. In this prospective study,plasma CRP was measured before treatment in 227 histologically-proved NPC patients in Sun Yat-sen University Cancer Center. Count data was comparedusing X2 test. Overall survival （OS）, local recurrence-free survivat（LRFS） and distant metastasis-free survival（DMFS） were compared using Kaplan-Meier analysis and the log rank test. RESULTS The pre-treatment CRP of 195 patients were normal,and 32 patients were abnormal between 227 patients with nasopharyngeal carcinoma. There was statistically significant difference between N staging （P=0. 017）, M staging （P= 0. 010）, and pathologic stage classification （P〈0. 001） of CRP in 227 patients. Patients with normal CRP （〈8.2 mg/L） had a significantly better OS and DMFS than the patients with high CRP in serum （OS, 88.2% vs 71.8%, P=0. 022%PFS, 86.7% vs 68.7%, P=0. 027）. CONCLU- SION NPC patients with high pre-treatment plasma CRP expression can reduced OS and DMFS significantly, and may be a poor prognostic factor.

关 键 词：鼻咽癌 C反应蛋白 预后 炎症 

分 类 号：R739.63[医药卫生—肿瘤]