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

    摘要
  • 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。

     

    Abstract:
      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, P < 0.001), 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, P < 0.001), hemoglobin concentration (r=-0.239, P < 0.001), and platelet count (r=0.131, P=0.045), and is uncorrelated with age (P>0.05), gender (P>0.05), fitness score (P>0.05), and leukocyte count (P>0.05). Patients with serum Hs-CRP levels ≤10 mg/L had better OS than patients with serum Hs-CRP levels>10 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.

     

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