| C反应蛋白/白蛋白比值在胃MALT淋巴瘤中的预后价值 |
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| 引用本文： | 施淼颉,魏征,刘澎. C反应蛋白/白蛋白比值在胃MALT淋巴瘤中的预后价值[J]. 中国临床医学, 2024, 31(1) |
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| 作者姓名： | 施淼颉 魏征 刘澎 |
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| 作者单位： | 复旦大学附属中山医院,复旦大学附属中山医院,复旦大学附属中山医院 |
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| 摘 要： | 目的：研究C反应蛋白与白蛋白比值（C-creative protein to albumin ratio,CAR）在胃黏膜相关淋巴组织淋巴瘤中的预后价值。方法：通过X-tile软件获取最佳CAR临界值0.05,根据此将患者分为低CAR组（66例）和高CAR组（27例）。分析两组患者的基线数据及生存资料。应用COX回归分析和Kaplan-Meier法分析CAR在胃MALT淋巴瘤中的预后意义。结果：C反应蛋白在76例患者中正常水平,17例患者中升高。白蛋白在87例患者中正常,6例患者中降低。CRP值与ALB值存在相关性（χ2=6.89,P=0.009）。高CAR组中高龄（70岁以上）患者更多（33.3% vs 13.6%,P=0.029）,具有更高的CRP水平（5.40 [2.70,11.50]mg/L vs 0.60 [0.40,1]mg/L,P=0.000）、β2-MG水平（2.83 [2.25,3.49]mg/L vs 1.94 [1.63,2.33]mg/L,P=0.000）和更低的ALB水平(39.22±4.07g/L vs 43.64±4.10g/L,P=0.000）,贫血发生率更高（33.3% vs 12.1%,P=0.035）。COX单因素分析显示最终疗效（HR=0.0.027, 95% CI=0.003-0.266, P=0.002）、白蛋白水平（HR=0.676, 95% CI=0.494-0.924, P=0.014）和免疫球蛋白G（IgG）水平（HR=0.634, 95% CI=0.427-0.944, P=0.025）具有统计学意义。然而,多因素分析结果提升仅IgG对预后存在统计学意义（HR=0.528, 95% CI=0.304-0.915, P=0.023）。低CAR组的总体生存期（Overall survival,OS）更长（P=0.020）,中位OS达172.8个月。单独应用MALT-IPI评分对胃MALT患者进行预后评估并无统计学意义（(P=0.358）。而CAR联合MALT-IPI评分（高CAR记1分,低CAR记0分,与MALT-IPI值相加）对胃MALT患者进行预后评价存在显著的统计学意义（P=0.042）,优于单独应用MALT-IPI评分或单独应用CAR。结论：CAR是评估胃MALT淋巴瘤患者预后的有效预测因子,值得进一步研究分析。
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| 关 键 词： | 胃MALT淋巴瘤 C反应蛋白/白蛋白比值（CAR） 生存 预后 MALT-IPI |
| 收稿时间： | 2023-10-16 |
| 修稿时间： | 2024-01-24 |
The Prognostic Value of the C-reactive protein to albumin ratio in Gastric MALT lymphoma |
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| Shi Miaojie,Wei Zheng and Liu Peng. The Prognostic Value of the C-reactive protein to albumin ratio in Gastric MALT lymphoma[J]. Chinese Journal Of Clinical Medicine, 2024, 31(1) |
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| Authors: | Shi Miaojie Wei Zheng Liu Peng |
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| Affiliation: | Zhongshan Hospital,Fudan University,Zhongshan Hospital,Fudan University,Zhongshan Hospital,Fudan University |
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| Abstract: | Objective: To investigate the prognostic value of C-reactive protein to albumin ratio (CAR) in gastric mucosa-associated lymphoid tissue lymphoma.Methods: Divide patients into a low-CAR (66 cases) and high-CAR group (27 cases) according to the best cut-off value of CAR, obtained by X-tile software. Analyze the baseline indicators and survival states between the two groups. The COX regression analysis and Kaplan–Meier method were used to assess the prognostic significance of CAR in gastric MALT lymphoma.Results: The C-reactive protein (CRP) values were normal in 76 cases and elevated in 17 cases. Albumin (ALB) was normal in 87 cases and decreased in 6 cases. CRP was correlated to ALB (χ2=6.89,P=0.009). The high-CAR group was characterized with an advanced age (older than 70 years old) (33.3% vs 13.6%, P=0.029), anemia (33.3% vs 12.1%, P=0.035）, hypoalbuminemia (39.22±4.0g/L vs 43.64±4.10g/L, P=0.000), elevated β2-microglobulin (2.83 [2.25,3.49]mg/L vs 1.94 [1.63,2.33]mg/L, P=0.000), and a high CRP value (5.40 [2.70,11.50]mg/L vs 0.60[0.40,1]mg/L, P=0.000). COX univariate analysis revealed that final response, ALB, and immunoglobulin G (IgG) were statistically significant. However, only IgG was statistically significant in multivariate analysis (HR=0.528, 95% CI=0.304-0.915, P=0.023). OS in the low-CAR group was significantly higher (P=0.020). There was no statistical significance in the prognostic evaluation of gastric MALT lymphoma using MALT-IPI independently (P=0.358). The prognostic importance of the CAR combined with MALT-IPI (P=0.042) was significantly higher than that of MALT-IPI independently.Conclusion: The CAR is a good indicator for predicting and evaluating the prognosis of gastric MALT lymphoma, which is worthy of further study. |
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| Keywords: | Gastric MALT lymphoma C-reactive protein/albumin ratio (CAR) survival prognosis MALT-IPI |
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