C反应蛋白水平对晚期肺癌患者肿瘤进展速度的预见性价值研究

Objective To explore the predictive value of serum C-reactive protein(CRP) levels for tumor progression rate in patients with advanced lung cancer, determine the optimal threshold and monitoring points for CRP in clinical assessment of disease progression risk, and provide a basis for individualized treatment strategies. Methods A total of 105 patients with advanced lung cancer admitted to the General Medicine Department of our hospital from March 2023 to March 2025 were selected as the study subjects. Serum CRP levels were measured at three time points: at enrollment(T0), after one month of treatment(T1), and after three months of treatment(T2). Tumor markers such as carcinoembryonic antigen(CEA) and cytokeratin 19 fragment(CYFRA21-1) were also assessed. Tumor progression time(TTP) was calculated. Based on the progression speed, patients were divided into three groups: rapid progression group, moderate progression group, and slow progression group. The optimal threshold for CRP predicting rapid progression was determined using the ROC curve, and univariate and multivariate Cox regression analyses were performed to identify independent risk factors for tumor progression. Results Among the 105 patients, 32 were in the rapid progression group, 42 in the moderate progression group, and 31 in the slow progression group. Significant differences in CRP levels were observed across the three groups at T0, T1, and T2(P<0.05). The highest AUC for CRP predicting rapid tumor progression was at T2(0.852), with an optimal threshold of 37.5 mg/L, yielding a sensitivity of 83.0% and specificity of 79.4%. The median TTP for patients with CRP≥37.5 mg/L was significantly shorter than that for patients with CRP<37.5 mg/L(P<0.05). Multivariate Cox regression analysis identified T2 time point, ECOG score of 2, and no immunotherapy as independent risk factors for rapid progression in advanced lung cancer. Conclusion Dynamic monitoring of serum CRP levels demonstrates good predictive value for tumor progression rate in advanced lung cancer patients. A CRP level ≥ 37.5 mg/L at three months of treatment can serve as a critical early warning indicator for rapid tumor progression, providing a reference for timely clinical treatment adjustments.