PDF(Pubmed)
Abstract：
BACKGROUND: An aberrant cellular microenvironment characterized by pathological cells or inflammation represents an added risk factor across various cancer types. While the significance of chronic inflammation in the development of most diffuse tumors has been extensively studied, an exception to this analysis exists in the context of chondrosarcomas. Chondrosarcomas account for 20-30% of all bone sarcomas, with an estimated global incidence of 1 in 100,000. The average age at diagnosis is 50, and over 70% of patients are over 40. This retrospective study aimed to examine the role of C-reactive protein (CRP) as a prognostic factor in relation to the histopathological findings in chondrosarcoma.
METHODS: In this retrospective study, 70 patients diagnosed with chondrosarcoma and treated between 2004 and 2019 were included. Preoperative CRP levels were measured in mg/dL, with non-pathological values defined as below 0.5 mg/dL. Disease-free survival time was calculated from the initial diagnosis to events such as local recurrence or metastasis. Follow-up status was categorized as death from disease, no evidence of disease, or alive with disease. Patients were excluded if they had insufficient laboratory values, missing follow-up information, or incomplete histopathological reports.
RESULTS: The calculated risk estimation of a reduced follow-up time was 2.25 timed higher in the patients with a CRP level >0.5 mg/dL (HR 2.25 and 95% CI 1.13-4.45) and 3 times higher in patients with a tumor size > pT2 (HR 3 and 95% CI 1.59-5.92). We can easily confirm that risk factors for reduced prognosis lie in chondrosarcoma high grading, preoperative pathological CRP- level, and a size > 8 cm.
CONCLUSIONS: A pretreatment CRP value greater than 0.5 mg/dL can be considered a sensitive prognostic and risk factor for distant metastasis for chondrosarcoma patients.
METHODS: In this retrospective study, 70 patients diagnosed with chondrosarcoma and treated between 2004 and 2019 were included. Preoperative CRP levels were measured in mg/dL, with non-pathological values defined as below 0.5 mg/dL. Disease-free survival time was calculated from the initial diagnosis to events such as local recurrence or metastasis. Follow-up status was categorized as death from disease, no evidence of disease, or alive with disease. Patients were excluded if they had insufficient laboratory values, missing follow-up information, or incomplete histopathological reports.
RESULTS: The calculated risk estimation of a reduced follow-up time was 2.25 timed higher in the patients with a CRP level >0.5 mg/dL (HR 2.25 and 95% CI 1.13-4.45) and 3 times higher in patients with a tumor size > pT2 (HR 3 and 95% CI 1.59-5.92). We can easily confirm that risk factors for reduced prognosis lie in chondrosarcoma high grading, preoperative pathological CRP- level, and a size > 8 cm.
CONCLUSIONS: A pretreatment CRP value greater than 0.5 mg/dL can be considered a sensitive prognostic and risk factor for distant metastasis for chondrosarcoma patients.
摘要：
背景：以病理细胞或炎症为特征的异常细胞微环境代表了各种癌症类型的额外风险因素。虽然慢性炎症在大多数弥漫性肿瘤发展中的意义已被广泛研究，在软骨肉瘤的背景下，这种分析存在一个例外。软骨肉瘤占所有骨肉瘤的20-30%，估计全球发病率为1/100,000。诊断时的平均年龄为50岁，超过70％的患者超过40岁。这项回顾性研究旨在研究C反应蛋白（CRP）作为与软骨肉瘤组织病理学发现有关的预后因素的作用。
方法：在这项回顾性研究中，纳入了2004年至2019年期间诊断为软骨肉瘤并接受治疗的70例患者。术前CRP水平以mg/dL计,非病理值定义为低于0.5mg/dL。从最初诊断到局部复发或转移等事件，计算无病生存时间。随访状态被归类为疾病死亡，没有疾病的证据,或者活着带着疾病。如果患者的实验室值不足，则将其排除在外，缺少后续信息，或者组织病理学报告不完整.
结果：在CRP水平>0.5mg/dL（HR2.25和95％CI1.13-4.45）的患者中，减少随访时间的计算风险估计为2.25，在肿瘤大小>pT2（HR3和95％CI1.59-5.92）的患者中高3倍。我们可以很容易地证实，预后降低的危险因素在于软骨肉瘤高分级，术前病理CRP水平，尺寸>8厘米。
结论：治疗前CRP值大于0.5mg/dL可视为软骨肉瘤患者远处转移的敏感预后和危险因素。
方法：在这项回顾性研究中，纳入了2004年至2019年期间诊断为软骨肉瘤并接受治疗的70例患者。术前CRP水平以mg/dL计,非病理值定义为低于0.5mg/dL。从最初诊断到局部复发或转移等事件，计算无病生存时间。随访状态被归类为疾病死亡，没有疾病的证据,或者活着带着疾病。如果患者的实验室值不足，则将其排除在外，缺少后续信息，或者组织病理学报告不完整.
结果：在CRP水平>0.5mg/dL（HR2.25和95％CI1.13-4.45）的患者中，减少随访时间的计算风险估计为2.25，在肿瘤大小>pT2（HR3和95％CI1.59-5.92）的患者中高3倍。我们可以很容易地证实，预后降低的危险因素在于软骨肉瘤高分级，术前病理CRP水平，尺寸>8厘米。
结论：治疗前CRP值大于0.5mg/dL可视为软骨肉瘤患者远处转移的敏感预后和危险因素。
