| CRP/Alb比值在肺癌诊断和预后中的临床价值分析 |
| 投稿时间：2018-04-24 修订日期：2018-05-16 点此下载全文 |
| 引用本文：胡丽娟,王瑜敏,陈坚,林向阳.CRP/Alb比值在肺癌诊断和预后中的临床价值分析[J].医学研究杂志,2018,47(12):27-30,36 |
| DOI：
10.11969/j.issn.1673-548X.2018.12.008 |
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| 基金项目:国家自然科学基金资助项目（81401736） |
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| 中文摘要:目的 研究C反应蛋白/白蛋白（CRP/Alb比值）在肺癌诊断和预后中的临床价值。方法 回顾性分析2006~2017年温州医科大学附属第一医院收治的肺癌患者，收集其确诊时的炎性指标数据，包括C反应蛋白/白蛋白（CRP/Alb比值）、中性粒细胞绝对值/淋巴细胞绝对值（NLR）、淋巴细胞绝对值/单核细胞绝对值（LMR）、血小板计数/淋巴细胞绝对值（PLR）、全身免疫炎性指数（SⅡ）和格拉斯哥预后评分（GPS），并以健康体检人群数据作为对照组，根据肺癌预后分为死亡组和未死亡组，把肺癌死亡组按生存时间分为两组（<12个月和≥12个月）；将各组数据进行比较并分析。结果 CRP/Alb比值、NLR、PLR、SⅡ、GPS在肺癌死亡组和肺癌未死亡组均明显高于对照组（P均为0.000），而LMR在肺癌死亡组和肺癌未死亡组均明显低于对照组（P均为0.000）；肺癌死亡组CRP/Alb比值显著高于肺癌未死亡组（P=0.000），但两组间NLR、LMR、PLR、SⅡ、GPS差异无统计学意义（P均 > 0.05）。ROC曲线显示CRP/Alb比值在肺癌诊断中有较高的准确性，AUC为0.904，临界值0.10，有较高的敏感度（82.49%）和特异性（82.26%）。Logistic回归分析显示CRP/Alb比值、GPS在肺癌发生中OR值分别为12.233、3.974。不同病理类型、临床分期、分化程度、有无淋巴结转移和远处转移的肺癌患者间的CRP/Alb比值差异无统计学意义（P均>0.05）。生存时间≥12个月组的CRP/Alb比值明显低于生存时间<12个月组（P=0.011），Spearman相关分析显示，肺癌患者生存时间与CRP/Alb比值有一定相关性（r=-0.251，P=0.011）。结论 CRP/Alb比值在肺癌诊断和预后中有一定的临床价值，优于GPS、NLR、LMR、PLR、SⅡ等常规炎性指标。 |
| 中文关键词:肺癌 CRP/Alb比值 炎性指标 诊断 预后 |
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| Clinical Value of CRP/Alb Ratio in Diagnosis and Prognosis of Lung Cancer |
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| Abstract:Objective To evaluate the clinical value of C-reactive protein/albumin (CRP/Alb ratio) in the diagnosis and prognosis of lung cancer. Methods A retrospective analysis of lung cancer patients admitted to the First Affiliated Hospital of Wenzhou Medical University from 2006 to 2017 was conducted to collect data on inflammatory markers at the time of diagnosis, including C-reactive protein/albumin (CRP/Alb ratio), a neutrophil/lymphocyte ratio(NLR), lymphocyte/monocyte ratio (LMR), and platelet/lymphocyte ratio(PLR), systemic immune inflammation index (SⅡ), and Glasgow prognostic score(GPS).Set Healthy population data as a control group. The death group and non-death group were divided according to the prognosis. The death group of lung cancer was divided into two groups according to their survival time (<12 months and ≥ 12 months); the data of each group were compared and analyzed. Results The CRP/Alb ratio, NLR, PLR, SⅡ, GPS were significantly higher in both lung cancer death group and lung cancer non-death group than in the control group (P=0.000), LMR was significantly lower in the lung cancer death group and non-death group than in the control group.There was a significant difference in the CRP/Alb ratio between the death group and the non-dead group (P=0.000) with no significant difference in NLR, LMR, PLR, SⅡ, and GPS (P>0.05). The ROC curve showed that the CRP/Alb ratio had a higher accuracy in the diagnosis of lung cancer, with AUC of 0.904,and a cutoff value of 0.10, and a high sensitivity (82.49%) and specificity (82.26%). Logistic regression analysis showed that the OR of CRP/Alb ratio and GPS in lung cancer were 12.233 and 3.974, respectively. There was no significant difference in the ratio CRP/Alb among lung cancer patients with different pathological types, clinical stages, differentiation, lymph node metastasis, and distant metastasis (P>0.05). The CRP/Alb ratio was significantly lower in the group of survival time ≥ 12months than in group of survival time <12months. Spearman correlation analysis showed that the survival time of lung cancer patients had a certain correlation with the CRP/Alb ratio (r=-0.251, P=0.011). Conclusion The CRP/Alb ratio has a certain clinical value in the diagnosis and prognosis of lung cancer. It is superior to conventional inflammatory markers such as GPS, NLR, LMR, PLR, and SⅡ. |
| keywords:Lung cancer CRP/Albratio Inflammatory markers Diagnosis Prognosis |
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