超敏C反应蛋白水平对外周T细胞淋巴瘤患者预后意义的临床研究  

Prognostic evaluation of high sensitivity-C reactive protein in peripheral T-cell lymphoma

作　　者：陈叶龙 谢万灼[1] 马珊珊[1] 陆丹蕾 李黎[1] 朱晶晶[1] 杨秀娣[1] 朱丽霞[1] 郑龙 周德[1] 叶琇锦[1] Yelong CHEN Wanzhuo XlE Shanshan MA Danlei LU Li LI Jingjing ZHU Xiudi YANG Lixia ZHU Yanlong ZHENG De ZHOU Xiujin YE(Department of Hematology, First Affiliated Hospital of Medical School of Zhejiang University, Hangzhou 310003, China)

机构地区：[1]浙江大学医学院附属第一医院血液科,杭州市310003

出　　处：《中国肿瘤临床》2017年第17期851-856,共6页Chinese Journal of Clinical Oncology

基　　金：国家自然科学基金项目(编号:81372256)资助~~

摘　　要：目的:探讨超敏C反应蛋白(high sensitivity-C reactive protein,Hs-CRP)水平在外周T细胞淋巴瘤(peripheral T-cell lymphoma,PTCL)患者预后中的意义。方法:回顾性分析2005年1月1日至2016年12月31日浙江大学医学院附属第一医院就诊的初治PTCL患者247例,其中在随访过程中失访13例,实际入组234例,患者中位年龄48岁;治疗前检测Hs-CRP水平,同时完善相关检查以明确肿瘤分期及国际预后指数(international prognostic index,IPI),中位随访时间23个月,观察Hs-CRP水平与患者总生存期(overall survival,OS)的关系。结果:Hs-CRP水平与IPI评分(r=0.132,P<0.01)、Ann Arbor分期(r=0.183,P=0.005)、B症状(r=0.225,P=0.001)、乳酸脱氢酶(lactate dehydrogenase,LDH)(r=0.169,P=0.009)呈正相关(P<0.05);与血浆白蛋白水平(r=-0.343,P<0.001)、血红蛋白浓度(r=-0.239,P<0.001)、血小板计数(r=0.131,P=0.045)呈负相关(P<0.05);与年龄、性别、体能(ECOG)评分、白细胞计数无显著相关性(P>0.05),血清Hs-CRP≤10 mg/L较Hs-CRP>10 mg/L患者具有更好的OS(P<0.05)。单因素分析及多因素Cox回归模型显示血小板计数、Hs-CRP、白蛋白水平、IPI评分是OS的独立预后不良因素(P<0.05)。结论:PTCL患者治疗前血清Hs-CRP水平可以和IPI评分一样作为PTCL预后的指标。Objective： To investigate the prognostic significance of high sensitivity-C reactive protein（Hs-CRP） in patients with peripheral T-cell lymphoma（PTCL）. Methods： A total of 234 newly diagnosed PTCL patients with a median age of 48 years were analyzed retrospectively. Serum Hs-CRP levels and other factors, including tumor stage and international prognostic index（IPI）, were determined. After a median follow-up of 23 months, the relationship between Hs-CRP and overall survival（OS） was observed. Results： Serum Hs-CRP level positively correlated with IPI score（r=0.132, P0.001）, tumor stage（r=0.183, P=0.005）, B symptoms（r=0.225, P=0.001）, and lactic dehydrogenase（r=0.169, P=0.009）, but negatively correlated with plasma albumin levels（r=-0.343, P0.001）, hemoglobin concentration（r=-0.239, P0.001）, and platelet count（r=0.131, P=0.045）, and is uncorrelated with age（P0.05）, gender（P0.05）, fitness score（P0.05）, and leukocyte count（P0.05）. Patients with serum Hs-CRP levels ≤10 mg/L had better OS than patients with serum Hs-CRP levels10 mg/L. Univariate and multivariate Cox regression models showed that platelet count, Hs-CRP, albumin levels, and IPI score were independent adverse prognostic factors. Conclusion： The baseline Hs-CRP level can serve as a major indicator of prognosis in PTCL patients.

关 键 词：淋巴瘤 T细胞 外周 超敏C反应蛋白 预后评估 

分 类 号：R733.1[医药卫生—肿瘤]