治疗前c反应蛋白预测小细胞肺癌患者的生存率

Onco Pub Date : 2021-11-08 DOI:10.3390/onco1020010
Anne Stensvold, N. Aggerholm-Pedersen, Anne Winther-Larsen, Birgitte Sandfeld-Paulsen
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摘要

改善小细胞肺癌(SCLC)患者的预后可以加强治疗策略,从而有可能提高这些患者的总生存期(OS)。c反应蛋白(CRP)已被提出作为不良生存的预后指标,尽管到目前为止,仅基于小型研究的数据。2009年1月至2018年6月诊断的SCLC患者数据提取自丹麦肺癌登记处和临床实验室信息系统。CRP测量值按临床临界值(8 mg/L或75 nmol/L)划分,并按四分位数分层。Cox比例风险模型评估CRP水平的预后价值。C-statistics进一步评估生物标志物的预后价值。共纳入923例患者。治疗前CRP水平高于临床临界值与不良OS显著相关(校正风险比(HR) = 1.25(95%可信区间(CI): 1.08-1.46)。当分为四分位数时,观察到水平相关,只有最高的四分位数与OS显著相关(第3四分位数:调整HR = 1.26 (95% CI: 1.03-1.55),第4四分位数:调整HR = 1.44 (95% CI: 1.17-1.77))。将CRP水平添加到已经确定的预后因素中可以改善SCLC患者的预后。总之,治疗前高CRP水平是SCLC患者预后的一个独立因素。
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Pre-Treatment C-Reactive Protein Predicts Survival in Small Cell Lung Cancer Patients
Improved prognostication of small cell lung cancer (SCLC) patients could strengthen the treatment strategy and, thereby, potentially improve the overall survival (OS) of these patients. C-reactive protein (CRP) has been proposed as a prognostic indicator of inferior survival, although so far, only based on data from smaller studies. Data on SCLC patients diagnosed from January 2009 to June 2018 were extracted from the Danish Lung Cancer Registry and the clinical laboratory information system. CRP measurements were divided at the clinical cut-off value of 8 mg/L or 75 nmol/L) and stratified into quartiles. Cox proportional hazards model assessed the prognostic value of the CRP level. C-statistics further evaluated the biomarker’s prognostic value. In total, 923 patients were included. A pre-treatment CRP level above the clinical cut-off significantly correlated to inferior OS (adjusted hazard ratio (HR) = 1.25 (95% confidence interval (CI): 1.08–1.46). When divided into quartiles, a level-dependent correlation was observed with only the highest quartiles significantly associated with OS (3rd quartile: adjusted HR = 1.26 (95% CI: 1.03–1.55) 4th quartile: adjusted HR = 1.44 (95% CI: 1.17–1.77)). Adding CRP level to already well-established prognostic factors improved the prognostication of SCLC patients. In conclusion, high pre-treatment CRP level is an independent prognostic factor in SCLC patients.
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