Original Article : Impact of serum C-reactive protein Level on the prognosis of patients with hepatocellular carcinoma undergoing TACE
의약학 > 내과학
( Chung Hwan Jun ) , ( Ho Seok Ki ) , ( Ki Hoon Lee ) , ( Kang Jin Park ) , ( Seon Young Park ) , ( Sung Bum Cho ) , ( Chang Hwan Park ) , ( Young Eun Joo ) , ( Hyun Soo Kim ) , ( Sung Kyu Choi ) , ( Jong Sun Rew )
Clinical and Molecular Hepatology(대한간학회지) 2013년, 제19권 제1호, 70~77페이지(총8페이지)
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    Background/Aims: The aim of this study was to determine the relationship between serum CRP levels and the prognosis of hepatocellular carcinoma (HCC) patients. Methods: HCC patients who underwent the first session of transcatheter arterial chemoembolization (TACE) between January 2005 and December 2009 (n=211) were analyzed retrospectively. The patients were divided into two groups: high C-reactive protein (CRP; ≥1 mg/dL, n=51) and low CRP (<1 mg/dL, n=160). They were followed for a mean of 22.44 months and their clinicoradiological variables and overall survival were compared. Results: There were significant differences between the two groups in regard to tumor type, tumor-progression-free survival, 10-month mortality, white blood cell (WBC) count, tumor size, and TNM stage. Multivariate analysis revealed that a high serum CRP level was independently associated with tumor size and tumor type. Subgroup analysis of CRP groups according to tumor size demonstrated that a high serum level of CRP was significantly associated with poorly defined (diffuse) tumor type in the tumor size <5 cm group [hazard ratio (HR)=4.81, P=0.018]. A Lipiodol dose exceeding 7 mL (HR=5.55, P=0.046) and the 10-month mortality (HR=7.693, P=0.004) were significantly associated with high serum CRP level in the group of patients with a tumor size of ≥5 cm. In addition, subgroup analysis of matched CRP according to TNM stage revealed that elevated serum CRP was independently associated with tumor type, WBC count, and tumorprogression-free survival. Conclusions: A high serum CRP level is associated with large tumors and a poorly defined tumor type, and is significantly associated with 10-month mortality in patients with large HCC (size ≥5 cm) who undergo TACE. (Clin Mol Hepatol 2013;19:70-77)
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