摘要目的 探讨血清C反应蛋白(CRP)在弥漫大B细胞淋巴瘤(DLBCL)预后中的意义.方法 回顾性分析初诊DLBCL患者106例,患者平均年龄55.32岁,治疗前检测血清CRP水平,同时完善相关检查以明确肿瘤分期及修订的国际预后指数(R-IPI)评分.中位随访62个月,观察血清CRP与总生存(OS)、无事件生存(EFS)的关系.结果 106例DLBCL患者按Ann Arbor分期,Ⅰ期患者血清CRP平均水平为(9.49±2.73)mg/L,Ⅱ期为(14.96±2.60) mg/L,Ⅲ期为(22.03±3.39) mg/L,Ⅳ期为(28.96±4.56) mg/L,各分期患者CRP水平差异均有统计学意义(均P＜ 0.05).CRP水平与肿瘤分期、R-IPI呈正相关(r值分别为0.833、0.344,均P=0.000),与年龄、性别无相关性(r值分别为-0.118、0.085,均P＞0.05).CRP≤19.0 mg/L患者较＞19.0 mg/L患者有更好的EFS和OS(均P＜ 0.05).单因素分析及多因素Cox回归模型显示患者年龄大、R-IPI评分高及CRP水平高是OS的独立预后不良因素(均P＜ 0.05).结论 对于DLBCL患者,初诊时血清CRP水平高不仅提示肿瘤负荷重,也是判断预后的指标之一.

abstractsObjective To investigate the prognostic significance of serum C-reactive protein (CRP) in diffuse large B-cell lymphoma (DLBCL).Methods 106 cases of newly diagnosed DLBCL patients with average age of 55.23 years old were analyzed retrospectively.Determine the level of serum CRP and other factors,including tumour stage,revised Internation Prognostic Index (R-IPI) before the treatment.After median follow-up of 62 months,the relationships between serum CRP and overall survival (OS) and event-free survival (EFS) were observed.Results 106 DLBCL patients were divided into 4 Ann Arbor stages.Median serum CRP levels significantly increased in higher Ann Arbor stages [stage Ⅰ (9.49±2.73) mg/L,stage Ⅱ (14.96± 2.60) mg/L,stage Ⅲ (22.03±3.39) mg/L,stage Ⅳ (28.96±4.56) mg/L] (all P ＜ 0.05).The serum CRP level was positively correlated with tumor stage (r =0.833,P =0.000),R-IPI (r =0.344,P =0.000),and no correlated with age (r =-0.118,P ＞ 0.05),sex (r =0.085,P ＞ 0.05).The patients with serum CRP levels ＞19.0 mg/L had shorter 5-year ESF and OS than patients with serum CRP levels ≤ 19.0 mg/L (P ＜ 0.05).Univariate and multivariate Cox regression models showed that old age,high R-IPI score and high CRP level were independent adverse prognostic factors.Conclusion In DLBCL patients,high CRP level not only reflects tumor burded,but also delivers prognostic information.