Predictive Value of C-reactive Protein/Albumin Ratio on Prognosis of Patients with Primary Hepatocellular Carcinoma
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摘要: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。
Abstract:ObjectiveTo assess the prognostic value of C-reactive protein/albumin (CRP/Alb) ratio on patients with primary hepatocellular carcinoma (HCC).
MethodsA 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.
ResultsThe 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.
ConclusionThe elevated CRP/Alb ratio at baseline indicates poor prognosis of patients with HCC, and may be an important independent prognostic factor for the prognosis.
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Key words:
- Hepatocellular carcinoma /
- C-reactive protein /
- Albumin /
- Prognosis
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图 1 CRP/Alb比值评估原发性肝癌患者生存情况的受试者工作特征曲线
Figure 1 Receiver operating characteristic curves of CRP/Alb ratio on assessing overall survival of HCC patients
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图 2 两组患者生存分析的Kaplan-Meier曲线
Figure 2 Kaplan-Meier curve of survival analysis of two groups
表 1 低CRP/Alb组与高CRP/Alb组患者的临床特征比较
Table 1 Comparison of clinical characteristics between low CRP/Alb group and high CRP/Alb group
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表 2 HCC患者预后影响因素的Cox回归分析
Table 2 Risk factors of prognosis of HCC patients analyzed by Cox multivariate model
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