C-反应蛋白/血清白蛋白比值与原发性肝癌临床病理特征及预后的关系  

Correlation of C-reaction protein/albumin ratio with pathological feature and prognosis of primary liver cancer

作　　者：杜学峰[1] 徐永富[1] 戴启强[1] 杨健[1] 朱昱[1] DU Xue-feng;XU Yong -fu;DAI Qi-qiang;YANG Jian;ZHU Yu(Department of Hepatobiliary and Pancreatic Surgery, Taizhou Hospital, Linhai, Zhejiang 317000, China)

机构地区：[1]浙江省台州医院肝胆胰外科

出　　处：《中国卫生检验杂志》2019年第10期1189-1193,共5页Chinese Journal of Health Laboratory Technology

基　　金：浙江省基础公益研究计划项目(LQ18H160028)

摘　　要：目的探讨C-反应蛋白/血清白蛋白比值(CRP/Alb)与原发性肝癌临床病理特征及预后的关系。方法回顾性分析2013年1月-2016年12月于本院行手术治疗的119例肝癌患者,利用受试者工作曲线确定术前CRP/Alb的最佳临界值,比较不同CRP/Alb水平肝癌患者的临床病理特征,并分析影响肝癌预后的危险因素。结果参照患者的生存状态,术前CRP/Alb的最佳临界值为0.44,曲线下面积为0.665,敏感度为60.0%,特异度为64.4%。与CRP/Alb低水平组比较,高水平组的甲胎蛋白(AFP)水平、肿瘤大小、肿瘤个数、血管侵犯率和巴塞罗那分期(BCLC)更高或更晚,且分化程度和包膜完整率更低(P<0.05)。CRP/Alb高水平组的中位生存时间明显低于低水平组,差异均有统计学意义(28.5个月vs.47.4个月,P<0.05)。单因素分析结果显示,肝癌患者预后与AFP水平、肿瘤大小、肿瘤个数、分化程度、包膜、血管侵犯、BCLC分期和CRP/Alb有关(P<0.05)。多因素分析结果显示,AFP≥400ng/ml、多发肿瘤、不完整或无包膜、BCLCB期和CRP/Alb≥0.44是肝癌预后的独立危险因素(P<0.05)。结论术前CRP/Alb与原发性肝癌的临床病理特征相关,并是肝癌预后的独立危险因素。术前CRP/Alb水平升高预示预后不良。Objective To explore the correlation of C - reaction protein/albumin ratio ( CRP/Alb) with clinical prognostic feature and prognosis in patients with primary liver cancer. Methods The clinical data of 119 cases undergoing surgery with liver cancer from Jan. 2013 to Dec. 2016 were reviewed. The optimal cut - off value of preoperative CRP/Alb was determined by receiver operating curve. The clinicopathological features of patients with different levels of CRP/Alb were compared and the risk prognostic factors of liver cancer were analyzed. Results Based on the survival status of patients, the optimal cut - off value of CRP/Alb was 0. 44, the area under the curve was 0. 665, the sensitivity was 60. 0% and the specificity was 64. 4%. Compared with low CRP/Alb group, the level of alpha - fetal protein ( AFP), tumor size, number of tumors and rate of vascular invasion were higher, the stage of Barcelona Clinic Liver Cancer ( BCLC) was later and the degree of differentiation and the integrity of the capsule were lower in the high CRP/Alb group ( P < 0. 05). Meanwhile, the median overall time in high CRP/Alb group was significant lower than that in low CRP/Alb group ( P < 0. 05). Univariate analysis identified the following risk factors of prognosis of liver cancer as level of AFP, tumor size, number of tumors, degree of differentiation, capsule, vascular invasion, stage of BCLC and level of CRP/Alb ( P < 0. 05). Cox multivariate analysis showed that level of AFP≥ 400 ng /ml, multiple tumor, incomplete or without capsule, stage B of BCLC and level of CRP/Alb≥0. 44 were independent risk factors affecting the prognosis of liver cancer ( P < 0. 05). Conclusion The level of CRP/Alb is associated with the clinicopathological features of liver cancer, and is independent risk factor for the prognosis of liver cancer. The high level of preoperative CRP/Alb indicates poor prognosis.

关 键 词：C-反应蛋白 白蛋白 原发性肝癌 预后 

分 类 号：R735.7[医药卫生—肿瘤]