肝细胞癌术前血清C-反应蛋白水平与术后早期复发的关系

目的：研究肝细胞癌术前检测血清C-反应蛋白（CRP）水平与术后早期复发的关系。方法：2000年1月至2004年1月，72例肝细胞癌行肝切除术，术前30min采静脉血，采用散射免疫比浊法检测血清CRP水平血清CRP≥8mtg／L为CRP阳性，血清CRP〈8mg／L为CRP阴性。分析血清CRP水平与肝细胞癌I临床病理的关系、结果：肝细胞癌血清CRP表达阳性率为72．2％（52／72）。肝细胞癌术前血清CRP水平与术后早期复发、血清AFP滴度水平及包膜浸润、门静脉侵犯、肝内转移、肿瘤大小等肿瘤恶性生物学行为明显相关．术前血清CRP阳性及阴性患者术后早期复发率分别为44．2％（23／52）及10％（2／20）。结论：肝细胞癌术前血清CRP水平可能是术后早期复发的良好的预后指标     

血清HE4在卵巢癌患者预后判断中的临床价值

[目的]探讨人附睾蛋白4(HE4)在判断卵巢癌患者预后中的价值。[方法]检测76例卵巢癌患者治疗前血清HE4和CA125水平,分析HE4水平与患者无病生存期的关系。[结果]76例患者血清HE4中位浓度为208pmol/L。血清HE4水平同卵巢癌患者病理类型及临床分期相关(P=0.014,P<0.001)。HE4低水平患者(≤208pmol/L)的无进展生存期为29.0个月,而血清HE4高水平组(>208pmol/L)为19.0个月(P=0.005)。多因素回归分析证明HE4血清水平为判断卵巢癌患者预后的独立指标(HR=1.001,95%CI:1.000～1.002;P=0.021)。[结论]血清HE4可为卵巢癌患者预后判断提供重要的临床参考依据。     

鼻咽癌中血清C反应蛋白水平与临床分期的关系

背景与目的:炎症导致肿瘤的重要性近来引起了学者的高度关注,而C反应蛋白(C reactive protein,CRP)是联系肿瘤和炎症之间的桥梁.本文旨在探讨CRP水平与鼻咽癌临床分期的关系.方法:采用免疫比浊法测定20例健康人群、20例鼻咽良性炎症及68例鼻咽癌不同分期患者的CRP水平,经相关性分析,初步探讨CRP水平与炎症及肿瘤的关系.结果:放疗前鼻咽癌患者的血清CRP水平[(19.8±4.7)mg/L]显著高于健康对照组[(6.2±1.8)mg/L],但显著低于良性炎症组[(45.6+7.9)mg/L,P<0.05] ;鼻咽癌T4组CRP水平[(25.6±3.9)mg/L]均高于T1期组[(17.4±5.8)mg/L]、T2期组[(18.6±8.5)mg/L]和T3期组[(15.6±1.8)mg/L],N3期组CRP水平[(28.0±7.1)mg/L]均高于N0期组[(17.6±6.8)mg/L]、N1组[(21.3±5.1)mg/L]和N2组[(18.6±5.6)mg/L],Ⅳ期组CRP水平[(25.7±5.5)mg/L]均高于Ⅰ期组[(14.2±1.9)mg/L]、Ⅱ期组[(16.1±3.9)mg/L]和Ⅲ期组[(23.0±7.7)mg/L],差异有显著性(P<0.05).其余各组组间经比较无统计学差异.结论:CRP与鼻咽癌和鼻咽良性炎症的发生有一定的关系,鼻咽癌分期越晚CRP值越高.     

血清降钙素原与C-反应蛋白联合检测急诊恶性肿瘤患者早期感染的价值

目的:探讨血清降钙素原与C-反应蛋白联合检测急诊恶性肿瘤患者早期感染的价值研究。方法:选取我院于2015年12月至2017年1月期间收治的急诊恶性肿瘤早期感染患者67例为观察组;另选取我院于2015年12月至2017年1月期间收治的恶性肿瘤未感染患者60例为对照组。均于入院后空腹采集外周静脉血,分离血清,采用电化学发光法测定降钙素原含量,采用免疫比浊法测定C-反应蛋白含量。比较两组血清C-反应蛋白和降钙素原含量、C-反应蛋白和降钙素原阳性率及C-反应蛋白联合降钙素原诊断的灵敏度和特异度。结果:观察组血清C-反应蛋白和降钙素原含量高于对照组,且有统计学差异（P<0.05）;观察组C-反应蛋白和降钙素原阳性率高于对照组,且有统计学差异（P<0.05）;C-反应蛋白联合降钙素原诊断灵敏度和特异度高于 C-反应蛋白和降钙素原单项诊断,具有统计学差异（P<0.05）。结论:急诊恶性肿瘤患者早期感染血清降钙素原与C-反应蛋白含量升高,C-反应蛋白联合降钙素原诊断的灵敏度和特异度高,具有重要研究意义。     

C反应蛋白与白蛋白比值对原发性肝癌患者预后的判断价值

目的 探讨C反应蛋白（CRP）与白蛋白（Alb）比值对原发性肝癌患者预后的判断价值。方法 纳入首次行手术治疗的原发性肝癌患者178例,计算术前CRP/Alb,运用受试者工作特征曲线、生存分析和Cox多元回归分析评价CRP/Alb与预后的关系。结果 CRP/Alb比值的最佳界点为0.46,敏感度为70.45%,特异度为73.97%。与低CRP/Alb组相比,高CRP/Alb组的CRP水平较高、Alb水平较低、Child-Pugh分级较高、肿瘤最长径较大、血管浸润比例较多,差异均有统计学意义（P<0.001）。Kaplan-Meier曲线显示高CRP/Alb组的生存率较低（26.8% vs. 56.8%, P<0.001）。Cox多元回归分析显示CRP/Alb、Child-Pugh分级、血管浸润是预后的独立危险因素。结论 术前CRP/Alb比值升高提示原发性肝癌患者预后不良,是影响患者预后的独立危险因素。     

C-反应蛋白与清蛋白比值对微创食管癌患者术后感染的早期预测价值

目的探讨C-反应蛋白与清蛋白比值对微创食管癌患者术后感染的早期预测价值。方法选取2015年10月至2018年10月间在云南省玉溪市人民医院心胸外科行微创食管癌手术的60例患者的临床资料进行回顾性分析,按照患者是否出现术后感染进行分组,未发生感染的46例患者纳入A组,发生感染的14例患者纳入B组。比较两组患者的年龄、性别等一般资料,通过单因素分析与多因素分析的方式筛选微创食管癌手术后感染的独立影响因素,计算C-反应蛋白与清蛋白比值(CAR)对微创食管癌术后感染的早期预测价值。结果患者的年龄、失血量和手术后3d时的CAR可能与微创食管癌手术后感染有关,差异均有统计学意义(均P <0. 05)。多因素分析结果显示,患者的年龄、失血量和手术后3d时CAR均为微创食管癌手术后感染的独立危险因素,差异均有统计学意义(均P <0. 05)。食管癌患者年龄、失血量和手术后3d时CAR对术后感染的预测价值进行计算,最佳截断值分别为63. 32岁、233. 63ml和4. 72,约登指数分别为43. 5%、29. 2%和56. 2%。结论 C-反应蛋白与清蛋白比值对微创食管癌术后感染有良好的早期预测价值,但是在实际临床工作中,还需要从患者的实际情况出发,进行综合考虑。     

膀胱癌患者手术前后血清前梯度蛋白水平变化及其预后判断价值

目的:检测膀胱癌患者手术前后血清前梯度蛋白2(anterior gradient 2,ACR2)的水平变化,并探讨其预后判断价值.方法:采集厦门大学附属成功医院2013年6月至2015年12月40例行手术治疗的膀胱癌患者(膀胱癌组)和20例健康体检者(对照组)外周静脉血,采用ELISA法检测血清AGR2水平,分析血清AGR2水平与膀胱癌临床病理特征及预后的关系.结果:膀胱癌组患者术前血清AGR2水平明显高于正常对照组[(28.93±6.03) vs(10.20±3.76) ng/ml,P＜0.01],术后血清AGR2水平明显低于手术前[(16.63±4.31)vs (28.93±6.03)ng/ml,P＜0.01];患者术前血清AGR2水平与临床病理分期、淋巴结转移有关(P＜0.05或P＜0.01),术前血清AGR2＞ 27.9 ng/ml组中位患者PFS与OS均明显低于≤27.9 ng/ml组(P＜0.05);COX模型多因素分析结果显示,病理分期、淋巴结转移以及不同AGR2水平是影响膀胱癌患者预后的独立危险因素(P＜0.05).结论:膀胱癌患者血清AGR2水平增高,其与膀胱癌的恶性生物学行为有关,术前检测血清AGR2水平对于判断膀胱癌患者预后有一定临床价值.     

C-反应蛋白在肾癌预后评价中的意义

越来越多的证据显示炎症在肿瘤发生发展过程中扮演了极其重要的角色.C-反应蛋白（CRP）作为最具代表性的炎症反应指标,被认为与肾癌等多种肿瘤的预后密切相关.许多研究表明,CRP可以为实施手术、细胞因子治疗和分子靶向治疗的肾癌患者提供有价值的预后信息,并且已有预后模型将CRP纳入其中应用于患者的预后评估.     

血清C反应蛋白水平与非小细胞肺癌患者近期疗效及预后的关系

[目的]探讨非小细胞肺癌(NSCLC)患者治疗前后血清C反应蛋白(CRP)的水平及其与肿瘤近期疗效及预后的关系.[方法]用免疫比浊法分别检测215例NSCLC患者(其中105例患者行手术治疗,110例患者行化疗)和102名健康对照者血清中的CRP表达水平,并进行24个月的随访.[结果] NSCLC患者手术后血清CRP浓度(12.52±4.37)mg/L与术前(18.13±5.78)mg/L相比,差异有统计学意义(P＜0 05).经化疗后,30例缓解组患者血清CRP浓度(10.49±3.85)mg/L与治疗前(18.64±4.63)mg/L相比显著下降(P＜0.05);44例进展组患者血清CRP浓度(20.14±7.68)mg/L与治疗前(14.53±4.56)mg/L相比显著升高(P＜0.05); 36例稳定组患者血清CRP浓度治疗前后差异无统计学意义(P＞0.05).手术后CRP阳性率显著下降,而化疗后阳性率下降不明显.手术前CRP阳性患者肿瘤复发或转移率(26.7％)高于术前阴性患者(7.5％).[结论]检测NSCLC患者血清CRP水平对预测肿瘤转移有一定的临床意义,有助于疗效的评估以及预后的预测.     

DCE-MRI定量参数在卵巢癌分期诊断及预后评估中的应用研究

目的探究DCE-MRI定量参数在卵巢癌分期诊断及预后评估中的应用研究。方法选择卵巢癌患者61例作为观察组,并同期选择体检的健康女性50例作为对照组,比较两组的DCE-MRI定量参数(速率常数Kep、容量转移常数Ktrans及血管外细胞外间隙容积Ve)及表观扩散系数(ADC),并比较观察组的不同临床分期患者的DCE-MRI定量参数及ADC。随访3年,比较存活组及死亡组卵巢癌患者的DCE-MRI定量参数。结果观察组的Ktrans、Kep、Ve、ADC值水平均高于对照组,差异有统计学意义(P<0.05);不同临床分期卵巢癌患者的Ktrans、Kep、Ve、ADC值水平比较,差异有统计学意义(P<0.05);Ktrans、Kep、Ve水平与卵巢癌分期呈正相关(P<0.05),ADC值水平与卵巢癌分期呈负相关(P<0.05);存活组的Ktrans、Kep、Ve水平均低于死亡组(P<0.05)。结论 DCE-MRI定量参数能够有助临床判断卵巢癌分期,并了解肿瘤微血管状态,从而判断预后。     

Prognostic Value of C-Reactive Protein in Esophageal Cancer: a Meta-analysis

Background: The classical inflammatory biomarker, C-reactive protein (CRP), has been identified to be relatedto progression of esophageal cancer. Some research showed that elevated pretreatment serum CRP indicated apoor prognosis, but results have been inconsistent. Materials and Methods: We searched the Medline, Embaseand the Cochrane Central Search Library for suitable studies and a meta–analysis of eleven (1,886 patients) wasconducted to examine the relationship between elevated serum CRP level and overall survival (OS) in esophagealcancer cases. Moreover, correlation analyses were conducted to assess links between pretreatment serum CRPlevel and tumor node metastasis (TNM) stage as well as T, N, M grade, respectively. Results: The pooled analysisshowed that elevated pretreatment serum CRP level was significantly associated with poorer overall survival (HR2.09, 95%CI 1.52-2.87, p<0.01). Subgroup analyses were conducted by “country”, “cut-off value”, “treatment”and “number of patients”, and no single factor could alter the result. Elevated pretreatment serum CRP wassignificantly correlated with more advanced TNM stage and T, N, M grade respectively. Conclusions: Elevatedpretreatment serum CRP levels are associated with poorer prognosis in esophageal cancer patients, and couldserve as a useful biomarker for outcome prediction.     

High Serum Vitamin B12 Levels Associated with C-Reactive Protein in Older Patients with Cancer

BackgroundA Comprehensive Geriatric Assessment (CGA) has been proposed to assess prognosis and to adapt oncological care in older patients with cancer. However, few biological markers are incorporated in the CGA.MethodsThis comparative study on older patients with cancer was realized before final therapeutic decision and during a CGA that included biological markers. Our objective study was to know if the serum vitamin B12–C‐reactive protein index (BCI) can help to estimate early death and unplanned hospitalization. Associations between BCI and unplanned hospitalization or mortality were analyzed using ordered multivariate logistic regression.FindingsWe included 621 older cancer adults in outpatient care with a median age of 81 years (range, 70–98 years) from September 2015 to May 2018. In this study, 5.6% of patients died within 3 months, 8.8% had unplanned hospitalization within 1 month, and 11.4% had unplanned hospitalization within 3 months. Hypercobalaminemia was present in 83 patients (13.4%), and 34 patients (5.5%) had BCI >40,000. According to the multivariate analysis, BCI was a prognostic factor of mortality within 3 months and unplanned hospitalizations at 1 and 3 months. Impaired activities of daily living (ADL) and palliative care were also risk factors for mortality within 3 months. Impaired instrumental ADL, low albumin level, and palliative care were risk factors for unplanned hospitalization at 1 month.InterpretationBCI could be routinely added to the CGA process, as part of a pretreatment workup, in order to assess more precisely the frailties and to adapt oncological care in older patients treated for cancer.Implications for PracticeAging comes with an increase of frailties and comorbidities. To identify frailties in older patients with cancer, this study used a Comprehensive Geriatric Assessment, which allowed for the adaptation of each treatment plan in accordance with the individual needs of the patients. However, biological characteristics were not included in this assessment. This study showed that hypercobalaminemia and vitamin B12 ‐C‐reactive protein index may be potential markers for cancer with poor prognosis, particularly in the older population. These biological markers can be used in geriatric oncology and general medicine.     

Clinical Value of Serial Measurement of Serum C-Reactive Protein Level in Neutropenic Patients

C-reactive protein (CRP) is an acute phase reactant of inflammation. We evaluated the clinical value of serial measurement of CRP in neutropenic patients. CRP was shown to be useful to monitor the response to therapy for febrile episodes in neutropenia. However, we failed to show statistically significant differences in CRP levels between febrile episodes with or without clinically documented infection (p = 0.10) and with or without bacteremia (p = 0.55). Also, we could not predict febrile episodes within three days by the elevation of CRP value. The area under receiver-operating characteristic curve depicting the relationship between CRP levels and forthcoming febrile episodes was only 0.60. In conclusion, serial measurement of CRP was considered to be not useful to predict fever within three days, or to differentiate the types of infection.     

上皮性卵巢癌二次手术14例临床分析

目的：探讨上皮性卵巢癌二次手术的；临床意义。方法：对14例上皮性卵巢癌二次手术病人进行临床分析。14例初次手术时为Ⅲ~Ⅳ期，均行瘤细胞减灭术，术后时间6月-1年。4例经过规律化疗后行SLL以了解治疗效果及判断预后，10例为病灶复发欲行SCR。结果：SLL阳性1例，显微观阳性2例，阴性1例，手术后4－18个月复发；SCR理想减灭2例，非理想减灭6例，姑息手术3例，术后平均存活时间6．5月，术后生活质量明显下降。结论：二次手术对病人生活质量及生存时间无明显改善，其意义有待进一步探讨。     

Influence of Serum VEGF Levels on Therapeutic Outcome andDiagnosis/Prognostic Value in Patients with Cervical Cancer

Objective: To explore the influence of serum vascular endothelial growth factor (VEGF) level on therapeuticoutcome and diagnosis/prognostic value in patients with cervical cancer. Materials and Methods: A total of 37patients diagnosed with cervical cancer by biopsy were selected and treated with concurrent chemoradiotherapy.Double-antibody sandwich enzyme-linked immunosorbent assay (ELISA) was adopted before treatment toassess VEGF levels, and its relationships with clinicopathological features and short-term therapeutic effectswere analyzed. Results: The median VEGF level in 37 patients before treatment was 647.15 (393.35~1125.16) pg/mL. Serum VEGF levels in patients aged <50 years, in International Federation of Gynecology and Obstetrics(FIGO) stage Ⅲa~Ⅳa, with lymph node metastasis and tumor size >4 cm were significantly increased (P<0.05).The complete remission (CR) rate was 48.7% (18/37), partial remission (PR) rate was 35.1% (13/37), stabledisease (SD) rate was 13.5% (5/37) and progressive disease (PD) rate was 2.70% (1/37), so the objective remissionrate (ORR) after treatment was 83.8% (31/37). Logistic regression analysis showed that tumor size and serumVEGF level before treatment were independent risk factors affecting the therapeutic outcome, and the higherthe level of serum VEGF, the worse the prognosis when tumor size>4 cm. Some 56.8% of patients manifestedwith myelosuppression, 37.8% with leucopenia, 24.3% with thrombocytopenia, 5.41% with diarrhea, 46.0%with nausea and vomiting, 21.6% with hair loss and 8.11% with hepatic and renal injury during the treatment.Conclusions: Serum VEGF level may reflect the degree of malignancy of cervical cancer and predict therapeuticeffect, which is of great importance to cancer diagnosis and prognosis.     

恶性肿瘤患者血清中PKM2水平的诊断和预后预测价值

PKM2作为有氧糖酵解关键酶,与肿瘤发生发展密切相关,在其诊断、预后及治疗方面均有很好的临床应用价值。恶性肿瘤患者血清中PKM2的浓度显著高于非恶性肿瘤患者及正常人,但在不同亚型的泌尿系统肿瘤中PKM2的诊断价值不同;PKM2与传统肿瘤标志物联合时,能显著提高诊断的灵敏度和特异性;PKM2浓度的上升与OS和PFS降低相关;治疗有效时PKM2浓度随之下降。另外,基础研究提示PKM2是重要的治疗靶点。     

结肠癌患者术前血清中细胞因子的表达对预后的意义

目的探究Ⅲ期结肠癌患者术前血清中细胞因子,包括表皮生长因子(EGF)、白细胞介素-6(IL-6)和C-反应蛋白(CRP)的表达水平与预后的关系,并评价循环EGF的表达水平与病灶中表皮生长因子受体(EGFR)之间的关系。方法收集经结肠癌根治术的83例Ⅲ期结肠癌患者的临床资料。分析患者术前血清中细胞因子的表达水平与预后的关系。结果 83例患者中,EGF、IL-6和CRP水平的中位数分别为189.4 pg/m L、9.09 pg/m L和1.4 mg/m L。与无病生存率显著相关的因素是术前IL-6水平(P<0.05),而CRP和EGF水平与无病生存率并无显著关系(P>0.05)。血清中EGF的表达水平与肿瘤EGFR阳性以及血清IL-6水平并无显著相关性(P>0.05)。结论检测结肠癌患者术前血清IL-6水平对预后的判断具有重要的价值。