Journal Article

Serum C-reactive protein is an important and powerful prognostic biomarker in most adult solid tumors

Nowacki, Amy S., Estfan, Bassam, Benanni-Baiti, Nabila, Ayvaz, Serkan, Shrotriya, Shiva, Aktas, Aynur, Hullihen, Barbara, Walsh, Declan, Lorton, Cliona, Hauser, Katherine

2018

Overview

Prognostication in cancer is challenging and inaccurate. C-Reactive Protein (CRP), a cheap and sensitive marker of inflammation may help. This study investigated the relationship between CRP and prognosis in a large cohort of solid tumors with mixed cancer diagnoses and stages. Electronic medical records of 4931 adults with solid tumors who attended the Taussig Cancer Institute from 2006-2012 were reviewed. Demographic and clinical characteristics were recorded. Maximum CRP (mCRP) was identified for each individual. CRP was analysed as a time-dependent, continuous and categorical variable for association with survival. Two thirds of patients had a high mCRP. This was consistently associated with shorter survival, even after correction for time from diagnosis, and when analysed as a continuous or a categorical variable. When mCRP values above 10 mg/L were subcategorized, a higher mCRP was always worse. Even among those with normal values, statistically and clinically significant shorter survival was noted at mCRP levels >5 mg/L. In a large representative cohort of consecutive solid tumor patients the risk of death was clinically and statistically significantly greater with a high mCRP. This was independent of other variables and regardless of statistical method from both dates of diagnosis and test. CRP appeared to be underutilized. Our results support the routine use of CRP as a universal cost-effective independent prognostic indicator in most solid tumors.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Adults / Aged / Analysis / Antigens / Bioindicators / Biological markers / Biology and Life Sciences / Biomarkers / Biomarkers, Tumor - blood / C-reactive protein / C-Reactive Protein - metabolism / Cancer / Cancer diagnosis / Care and treatment / Continuity (mathematics) / Cytokines / Demographics / Diagnosis / Disease / Electronic health records / Electronic medical records / Female / Gene expression / Health aspects / Health sciences / Humans / Independent variables / Inflammation / Inflammation - blood / Inflammation - pathology / Male / Medical diagnosis / Medical prognosis / Medical records / Medicine / Medicine and Health Sciences / Metastasis / Middle Aged / Mortality / Neoplasms - blood / Neoplasms - pathology / Oncology / Palliative care / Patients / Prognosis / Proteins / Risk factors / Solid tumors / Statistical analysis / Statistical methods / Survival / Systematic review / Time dependence / Tumor necrosis factor-TNF / Tumors