The Application Of C-reactive Protein In The Stage Ⅳ Gastric Cancer Patients

Objective:CRP and albumin as independent predictors Ⅳ period (stIVGC) inpatients with gastric cancer, One of the best threshold for these twoindicators were studied.Methods:Selection in November2008to January2015jilin medical universitysecond hospital and china-japan fellowship at jilin university hospitalxinmin CGMH between125patients with stage IV gastric cancer, Wereretrospectively analyzed, All patients were accredited by the associationof cancer control based cancer lymph node metastasis (TNM) ordersystem CVICC,7th edition,2010) on the case diagnosis and staging, Menamong them,91cases, female,34cases, aged49+12, primary focal spot,distal tumor in68cases,57cases of proximal tumor, tumor integrityappearance (Borrmann type),53BorrmannIII type, BorrmannIV type72cases. Histology:57cases of signet ring cell carcinoma,47cases ofpoorly differentiated adenocarcinoma, high, moderately differentiatedadenocarcinoma of21cases, T2tumor infiltration depth in2cases, T3in37cases,86cases of T4, lymph node metastasis N1,15cases; N2,22cases; N3,88; The distal metastasis,61cases of peritoneal metastasis;Lier43patients; Peritoneal lavage cytology was21cases; Among125patients underwent surgery to remove tumor patients with39cases,41patients with palliative surgery. Systemic chemotherapy in patients with 38cases,7cases of patients with treatment, symptomatic treatment. Allpatients with stage IV gastric cancer diagnosis basis by barium meal,stomach, duodenum endoscopy, computed tomography, magneticresonance imaging (mri), ultrasound based uplink after laparotomy orlaparoscopy exploration stage. Parameters observed include: patient’s age,sex, tumor site, tumor overall appearance (Borrmann type), histology,CEA and CA19-9, serum albumin, C-reactive protein, TNM stage,invasion depth, lymph node metastasis, and distal metastasis asprocessing parameters. in order to determine the independent predictorsin multiple factors analysis to introduce a single factor, P value is lessthan0.1for the choice of step by step forward, and the overall survivalrate definition to the term for the initial treatment, includingchemotherapy, surgery, or other supportive therapy), until the death ofpatients due to any reason. When forward step by step to choose the Pvalue is less than0.05, the test is particularly important, the operatingcharacteristic (ROC) analysis is on the basis of the peak and continuousvariable point, to find the best pair with high sensitivity and specificityvalues, the area under the curve (AUC) calculated on the basis of themethod of using Statfex version5. The relationship between the clinicalpathological features and cancer specific survivalRates are as follows: to survive in the single factor analysis: patients withage (P=0.05), serum levels of CA19-9(P <0.01), C-reactive protein (P <0.01), serum albumin (P <0.01), liver metastasis (P=0.02), surgery (P<0.01), and systemic chemotherapy (P <0.01), are associated with asignificant cancer specific survival, sex, tumor infiltration depth, lymphnode metastasis and patients, peritoneal metastasis, abdominal cavityflushing fluid cytology in the single factor analysis are not related tocancer specific survival, in the analysis of multivariable variablessignificantly: C-reactive protein (HR:1.10,95%CI:1.021.17; P <0.01).Surgery (HR:3.38,95%CI:2,3-5.64; P <0.01), systemic chemotherapy(HR:2.44,95%CI:1.244.78; P <0.01) were independently associatedwith cancer specific survival. Other has nothing to do with cancer specificsurvival clinicopathological characteristics. Use of3,6,12,18and24months mortality rate of end point, measured the area under the ROCcurve of CRP were0.84,0.68,0.71,0.72and0,65. The critical value(mg/dl) were1.7,0.9,0.5,0.4,0.3. Sensitivity, specificity and accuracyare shown in table4. To sum up, in this study, three months forecast ofROC curve is the most reliable. Using ROC curve calculation, C-reactive protein cancer specific survival curve, the critical value of1.7mg/dl.Conclusion:CRP can be considered Ⅳ period an independent predictors forsurial in patients with gastric cancer and can be used for short-termsurvival prediction.