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.

Correlation Between the Serum Level of C-reactive Protein with Short-term Response and Prognosis in Patients with Non-small Cell Lung Cancer

Purpose] To investigate the serum level of C-reactive protein (CRP) in non-small cell lung cancer(NSCLC) and its correlation with short-term response and prognosis.Methods]The concentration of CRP in serum was detected by immunoturbidimetry in 215 cases with NSCLC(105 cases for surgery,and 110 cases for chemotherapy) and 102 healthy controls.The patients were followed for 24 months.Results] The post-operative patients showed marked reduction in serum CRP comparing with pre-operative patients (12.52±4.37)mg/L vs (18.13±5.78)mg/L,P<0.05].In the 30 patients with tumor remission,CRP post-chemotherapy was significantly lower than that pre-chemotherapy(10.49±3.85)mg/L vs (18.64±4.63)mg/L,P<0.05].In the 44 patients with progressive disease,CRP post-chemotherapy was significantly higher than that pre-chemotherapy (20.14±7.68)mg/L vs (14.53±4.56)mg/L,P<0.05].The CRP concentration did not differ significantly before and after chemotherapy in 36 patients with stable disease.The positive rates of CRP decreased significantly post-operation,but there was no significant change after chemotherapy.During the follow-up for operation patients,the rate of relapse and metastasis(26.7%) was higher in patients with a preoperative positive CRP than those with a negative CRP(7.5%).Conclusions]Serum CRP might be a useful marker in the prediction of tumor metastases in NSCLC and is helpful for evaluating treatment response and prognosis.