术前CRP/ALB、P-CRP与宫颈癌预后的预测价值

作     者：陈艳飞 张晶晶 

作者机构：临沂市肿瘤医院妇科山东 临沂 青岛大学附属医院妇科山东 青岛 

出 版 物：《临床医学进展》 (Advances in Clinical Medicine)

年 卷 期：2025年第15卷第1期

页      面：2141-2150页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：C反应蛋白/ALB比值 血小板与CRP乘积 宫颈癌 生存率 预测价值 

摘      要：目的:探讨术前CRP/ALB、P-CRP与宫颈癌预后的预测价值。方法:选取临沂市肿瘤医院自2015年1月至2019年1月收治的265例行经腹广泛性子宫切除的FIGO 2009 IB1-IIA2期宫颈癌患者的临床病理资料及随访资料。检测术前:CRP与ALB、血小板,计算CRP/ALB、P-CRP值,绘制受试者工作特征(ROC)曲线得到上述指标的最佳cut-off值并根据cut-off值分为相应指标的高水平组、低水平组。比较相应指标的高水平组、低水平组临床病理资料,采用Kaplan-Meier进行相应生存分析。采用COX多因素分析宫颈癌患者预后的相关影响因素。结果:随访最终截止时间为2024年1月,根据纳入患者随访期间生存、死亡情况将患者分为生存组(223例)、死亡组(42例)。ROC结果显示:CRP/ALB预测IB1-IIA2期宫颈癌生存的曲线下面积(AUC)为:0.866 (95%CI: 0.828~0.944, P χ2 = 23.302, P χ2 =12.305, P χ2 =28.237, P χ2 = 101.439, P χ2 = 8.348, P= 0.004;χ2 =7.225, P = 0.007;χ2 = 9.887, P = 0.002);高P-CRP组共死亡28例(66.67%),低P-CRP组死亡14例(33.33%),两组死亡率差异有统计学意义(χ2 = 27.411, P χ2 = 125.945, P χ2 = 26.830, P 0.359、P-CRP 3.386是IB1-IIA2期宫颈癌生存的独立危险因子,且CRP/ALB、P-CRP对宫颈癌生存率具有一定的预测价值。术前检测CRP、白蛋白、血小板水平并及时干预对提高生存率具有一定意义。Objective: To investigate the predictive value of preoperative CRP/ALB and P-CRP in the prognosis of cervical cancer. Methods: The clinicopathological data and follow-up data of 265 patients with FIGO 2009 IB1-IIA2 cervical cancer who underwent radical abdominal hysterectomy admitted to Linyi Cancer Hospital from January 2015 to January 2019 were enrolled. Preoperatively, CRP, ALB and platelets were detected, CRP/ALB and P-CRP values were calculated, and the receiver operating characteristic (ROC) curve was drawn to obtain the best cut-off values of the above indexes, and the cut-off values were divided into high-level group and low-level group of corresponding indexes. The clinicopathological data of the high-level group and the low-level group were compared, and Kaplan-Meier was used for survival analysis. COX univariate and multivariate analysis were used to analyze the prognosis of cervical cancer patients. Results: The final cut-off time of follow-up was January 2024, and the patients were divided into survival group (223 cases) and death group (42 cases) according to their survival and death during the follow-up period. The ROC results showed that the area under the curve (AUC) of CRP/ALB for predicting mortality from stage