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。

Predictive Value of C-reactive Protein/Albumin Ratio on Prognosis of Patients with Primary Hepatocellular Carcinoma

Objective To assess the prognostic value of C-reactive protein/albumin (CRP/Alb) ratio on patients with primary hepatocellular carcinoma (HCC). Methods A total of 178 cases with HCC were enrolled. The pre-operative CRP/Alb ratio was calculated. The receiver operating characteristic curve, survival analysis and multivariate analysis were performed to identify the effect of CRP/Alb ratio on the prognosis of HCC patients. Results The best cutoff level for CRP/Alb ratio was 0.46, sensitivity was 70.45%, and specificity was 73.97%. Compared with the low CRP/Alb group, the high CRP/Alb group showed higher CRP levels, lower Alb level, higher Child-Pugh grade, larger tumor maximum diameter and larger proportion of vascular invasion, with statistical significance (P<0.001). The Kaplan-Meier curve displayed that lower survival rate in the high CRP/Alb group than that in low CRP/Alb group (26.8% vs. 56.8%, P<0.001). The Cox multivariate analysis showed that CRP/Alb, Child-Pugh grade and vascular invasion were independent risk factors for the prognosis. Conclusion The elevated CRP/Alb ratio at baseline indicates poor prognosis of patients with HCC, and may be an important independent prognostic factor for the prognosis.