Prognostic evaluation of high sensitivity-C reactive protein in peripheral T-cell lymphoma
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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. -
Key words:
- lymphoma /
- T-cell /
- peripheral /
- high sensitivity-C reactive protein /
- prognostic evaluation
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图 1 ROC曲线法建立患者预后分组示意图
AUC=0.636; P<0.001
Figure 1. ROC curve method was used to establish the prognosis map of patients
图 2 Hs-CRP≤10 mg/L和Hs-CRP>10 mg/L患者的OS比较
Figure 2. Comparison of OS in patients with Hs-CRP ≤10 mg/L and HsCRP >10 mg/L
图 3 PTCL患者不同亚型的OS生存曲线比较
Figure 3. Comparison of OS curves among PTCL patients with different subtypes
表 1 PTCL患者不同亚型之间生存期的比较
Table 1. Comparison of OS in different PTCL subtypes
表 2 血清Hs-CRP与其他用于判断PTCL预后指标的关系
Table 2. Clinical characteristics and serum Hs-CRP of 234 patients
表 3 应用Cox模型进行多因素生存分析
Table 3. COX multivariate regression analysis in PTCL patients
表 4 Hs-CRP水平与PTCL各亚型OS相关性分析
Table 4. Correlation analysis of Hs-CRP and OS of different PTCL subtypes
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