C反应蛋白高表达可增加胃癌患者的不良预后风险：Meta分析  

High expression of C-reactive protein increases the risk of poor prognosis in patients with gastric cancer:a Meta-analysis

作　　者：杨静[1] 李福轮[1] 常锐霞 芦永斌 YANG Jing LI Fulun CHANG Ruixia LU Yongbin(Department of Child Psychology and Behavior, Children＇s Hospital of Gansu Province, Second Hospital of Lanzhou University, Lanzhou 730030, Gansu Province, China Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu Province, China)

机构地区：[1]兰州大学第二医院甘肃省儿童医院儿童心理行为科,甘肃兰州730030 [2]兰州大学公共卫生学院流行病与卫生统计学研究所,甘肃兰州730000

出　　处：《肿瘤》2016年第12期1335-1343,共9页Tumor

摘　　要：目的：用Meta分析的方法评价C反应蛋白（C-reactive protein,CRP）表达水平与胃癌患者预后的相关性及其剂量效应。方法：计算机检索中国知网、万方、Pub Med、Embase和Web of Science数据库。按照文献纳入和排除标准,选择有关CRP和胃癌患者不良预后风险关系的队列研究,提取数据并进行质量评价。采用STATA 11.0软件进行Meta分析,计算合并风险比（hazard ratio,HR）及95%可信区间（confidence interval,CI）,并进行亚组分析、多因素分析、敏感性分析和发表偏倚的检测。结果：共纳入18项队列研究,包括3 656例胃癌患者。Meta分析结果显示,CRP高表达与胃癌患者的不良预后存在相关性（HR=1.50;95%CI为1.24~1.81,P〈0.001）,且CRP〉10 mg/L时预后较差。亚组分析结果显示,不同样本量、随访时间、肿瘤病理分期和治疗方法对CRP与患者预后风险的关系无明显影响（P值均〉0.05）,而且CRP水平升高会增加不同临床分期胃癌患者的不良预后风险（P值均〈0.05）。多因素分析结果显示,腹膜转移和复发是胃癌患者不良预后的危险因素（P值均〈0.05）。结论：CRP水平与不同临床分期胃癌患者的预后存在相关性,且当CRP〉10 mg/L时患者的不良预后风险明显增加。Objective： To investigate the correlation between the expression level of C-reactive protein （CRP） and the prognosis of patients with gastric cancer, and its dose-response relationship. Methods： A computer-based online search was performed by using China National Knowledge Infrastructure, Wanfang, PubMed, Embase, and Web of Science database. The cohort studies on the relationship between CRP and the risk of poor prognosis in patients with gastric cancer were selected according to the inclusion and exclusion criteria, and the data were extracted and evaluated. Then Meta-analysis was performed by using STATA 11.0 software. The pooled hazard ratio （HR） and its 95% confidence interval （CI） were calculated. Furthermore, the subgroup analysis, multivariate analysis, sensitivity analysis and publication bias test were performed, respectively. Results： A total of eighteen cohort studies were included, involving 3 656 patients with gastric cancer. Meta-analysis showed a significant association between the expression of CRP and prognosis in patients with gastric cancer （HR = 1.50, 95% CI： 1.24-1.81, P 〈 0.001）, and the prognosis was poor when the level of CRP 〉 10 mg/L. Subgroup analysis showed no significant difference when the included studies were divided by the number of samples, follow-up time, TNM staging, and treatment methods （all P 〉 0.05）. According to multivariate analysis, the peritoneal metastasis and recurrence were the independent factors associated with poor prognosis of patients with gastric cancer （both P 〉 0.05）. Conclusion： The level of CRP was significantly associated with the prognosis of patients with gastric cancer in different clinical stages, and the risk of poor prognosis was significantly increased when CRP level 〉 10mg/L.

关 键 词：胃肿瘤 C反应蛋白质 预后 META分析 

分 类 号：R195.1[医药卫生—卫生统计学]