Abstract. The aim of the present study was to evaluate correlations between preoperative C-reactive protein (CRP) serum concentration and the clinical-pathological parameters of epithelial ovarian cancer (EOC), as well as cancer antigen 125 (CA125) concentration, in patients with EOC. The preoperative serum CRP concentrations of 107 patients with EOC were compared with values of 44 control patients and defined as positive if values were >8 mg/l. Correlations between CRP expression and serum CA125 concentrations, International Federation of Gynecologists and Obstetricians (FIGO) staging, lymph node metastasis, ascites and size of postoperative residual lesions were evaluated for the EOC cases. A total of 69% (74/107) of the EOC cases were CRP-positive, with a mean serum CRP concentration of 14.32 mg/l (versus 2.18 mg/l in the control patients) (P<0.001). A rank correlation analysis showed a positive correlation between serum CRP and CA125 concentrations (P<0.001). The five-year survival rate of the CRP-positive patients with EOC was significant lower than that of the patients that were CRP-negative (33.3 vs. 75.8%, P<0.001). Non-parametric and multivariate analyses showed significant correlations between CRP concentrations and FIGO staging (P=0.001), lymph node metastasis (P=0.001) and ascites (P=0.033). In contrast to previous reports, the mean CRP serum concentration of the CRP-positive patients with EOC also correlated significantly with the CA125 values, and the increases in the CRP serum concentration in the Chinese patients were lower than those described for Caucasian EOC cases. In conclusion, the CRP serum concentration may be a useful clinical marker, solely or in combination with CA125, in patients with EOC.
IntroductionThe incidence of ovarian cancer is gradually rising and its mortality rate ranks first among the gynecological malignant tumors; the majority of cases are epithelial ovarian cancer (EOC) derived from the ovarian epithelial tissue (1). The pathogenesis and development of ovarian cancer have been closely linked to inflammatory processes associated with several cytokines (2,3), such as vascular endothelial growth factor (4) interleukin-6 (5) and interleukin-12 (6). Among the already established prognostic indicators, ovarian tumor stage and postoperative residual tumor mass at primary cytoreductive surgery have been shown to most reliably predict the outcome of patients with ovarian cancer (7). Clinical decisions regarding adjuvant therapies are largely based on the International Federation of Gynecologists and Obstetricians (FIGO) stage and tumor grade, particularly in the early stages of the disease (8). With the progress in the surgical techniques, management of the perioperative period and range of combined treatments, the survival rate of patients with ovarian cancer has been increased significantly; however, the high recurrence rate following treatment remains the primary reason for poor prognoses (9). Reliable indicators for the identification of those patients that are at high risk ...