C反应蛋白与白蛋白比值对P-Gemox方案联合放疗治疗早期结外NK/T细胞淋巴瘤患者预后的影响

目的 探讨外周血C反应蛋白与白蛋白比值（C-reactive protein to albumin ratio，CRP/Alb）对P-Gemox方案联合放疗治疗早期结外NK/T细胞淋巴瘤（extranodal NK/T cell lymphoma，ENKTL）患者预后的影响。方法 回顾性分析四川省肿瘤医院2012年至2017年收治的83例ENKTL患者的临床资料。采用X-Tile软件计算CRP/Alb的截断值，根据截断值将患者分为低CRP/Alb组（CRP/Alb＜0.4，n=64）和高CRP/Alb组（CRP/Alb≥0.4，n=19），采用Cox回归分析CRP/Alb与预后的关系。结果 低CRP/Alb组患者的3年无进展生存率高于高CRP/Alb组（77.1% vs 30.7%，χ²=20.954，P<0.001），3年总生存率亦高于高CRP/Alb组（87.4% vs 36.1%，χ²=22.559，P<0.001）。多因素Cox回归分析显示，CRP/Alb≥0.4是影响ENKTL患者无进展生存期（HR=4.163，95%CI：1.899~9.128，P<0.001）和总生存期（HR=4.424，95%CI：2.026~9.662，P<0.001）的独立危险因素。低危ENKTL患者和中高危ENKTL患者中，低CRP/Alb组的中位无进展生存期和中位总生存期均高于高CRP/Alb组（P<0.05）。结论 高CRP/Alb的早期ENKTL患者接受P-Gemox方案联合放疗治疗预后较差。

Effect of C-reactive protein to albumin ratio onprognosis of P-Gemox regimen combined with radiotherapy in patients with earlyextranodal NK/T cell lymphoma

Objective To explore the prognostic significance of C-reactive protein to albumin ratio for（CRP/Alb） extranodal NK/T cell lymphoma（ENKTL） treated with P-Gemox chemotherapy regimen combined radiotherapy. Methods The clinical data of 83 ENKTL patients treated in Sichuan Cancer Hospital from 2012 to 2017 were retrospectively analyzed. X-Tile software was used to calculate the cutoff value of CRP/Alb. According to the cutoff value，patients were divided into low CRP/Alb group（CRP/Alb<0.4，n=64） and high CRP/Alb group（CRP/Alb≥0.4，n=19）. Cox regression was used to analyze the relationship between CRP/Alb and prognosis. Results The 3-year progression-free survival（PFS） rate in the low CRP/Alb group was higher than that in the high CRP/Alb group（77.1% vs 30.7%，χ²=20.954，P<0.001），and the 3-year overall survival（OS） rate was also higher than in the high CRP/Alb group（87.4% vs 36.1%，χ²=22.559，P<0.001）. Multivariate Cox regression showed that CRP/Alb≥0.4 was an independent risk factor for PFS（HR=4.163，95%CI：1.899-9.128，P<0.001） and OS（HR=4.424，95%CI：2.026-9.662，P<0.001） in ENKTL patients. Further analysis showed that the median PFS and median OS of the low CRP/Alb group were higher than those of the high CRP/Alb group in both low-risk ENKTL patients and medium-high risk ENKTL patients（P<0.05）. Conclusion  The prognosis of patients with high CRP/Alb in early ENKTL treated with P-Gemox combined with radiotherapy is poor.