Baseline C-Reactive Protein Level Predicts Survival of Early-Stage                     Lung Cancer: Evidence from a Systematic Review and Meta-Analysis

Leuzzi, Giovanni; Galeone, Carlotta; Gisabella, Mara; Duranti, Leonardo; Taverna, Francesca; Suatoni, Paola; Morelli, Daniele; Pastorino, Ugo

doi:10.5301/tj.5000522

Cited by 44 publications

(43 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As defined by MCSHANE et al [15] and DE GRUTTOLA et al [16], an ideal biomarker must possess several combined properties: 1) a biological role in pathogenesis of disease, 2) easy to measure accurately, 3) sensitive to change in order to be repeatedly evaluated, 4) modifiable by therapies or interventions, 5) a long half-life and 6) associated with outcome. As recently evidenced [17], CRP could be one of the ideal biomarkers available in common clinical practice.…”

Section: Introductionmentioning

confidence: 97%

C-reactive protein level predicts mortality in COPD: a systematic review and meta-analysis

et al. 2017

Self Cite

View full text Add to dashboard Cite

The prognostic role of baseline C-reactive protein (CRP) in chronic obstructive pulmonary disease (COPD) is controversial. In order to clarify this issue, we performed a systematic review and meta-analysis to assess the predictive effect of baseline CRP level in COPD patients. 15 eligible articles focusing on late mortality in COPD were included in our study. We performed a random-effects meta-analysis, and assessed heterogeneity and publication bias. We pooled hazard ratio (HR) estimates and their 95% confidence intervals on mortality for the comparison between the study-specific highest category of CRP level versus the lowest category. In overall analysis, elevated baseline CRP levels were significantly associated with higher mortality (HR 1.53, 95% CI 1.32-1.77, I=68.7%, p<0.001). Similar results were observed across subgroups. However, higher mortality risk was reported in studies using a cut-off value of 3 mg·L (HR 1.61, 95% CI 1.12-2.30) and in those enrolling an Asiatic population (HR 3.51, 95% CI 1.69-7.31). Our analysis indicates that baseline high CRP level is significantly associated with higher late mortality in patients with COPD. Further prospective controlled studies are needed to confirm these data.

show abstract

Section: Introductionmentioning

confidence: 97%

C-reactive protein level predicts mortality in COPD: a systematic review and meta-analysis

et al. 2017

Self Cite

View full text Add to dashboard Cite

show abstract

“…Elevated levels of circulating CRP are associated with an increased risk of LC in cancerfree individuals [9], as well as low-dose computed tomography screening participants [10], and the value of CRP in predicting disease progression and response to therapy has been widely explored in the setting of chronic inflammatory, cardiovascular and chronic obstructive pulmonary disease [11,12]. A recent metaanalysis outlined that higher baseline CRP level is associated with significantly poorer prognosis in resected LC [13], thereby suggesting that pretreatment CRP levels could be used as prognostic factors in early-stage LC, alone or in combination with other tumour or patient features [14].…”

Section: Introductionmentioning

confidence: 99%

Baseline and postoperative C-reactive protein levels predict mortality in operable lung cancer

Pastorino

Morelli

Leuzzi

et al. 2017

European Journal of Cancer

Self Cite

View full text Add to dashboard Cite

Background: Higher blood levels of C-reactive protein (CRP) have been associated with shorter survival in patients with cardiovascular, chronic obstructive pulmonary disease and cancer. We investigated the impact of baseline and postoperative CRP levels on survival of patients with operable lung cancer (LC). Patients and methods: CRP values at baseline (CRP 0 ) and 3 days after surgery (CRP 3 ) were measured in a consecutive series of 1750 LC patients who underwent complete resection between 2003 and 2015. Patients were classified as having 0 (N Z 593), 1 (N Z 658) or 2 (N Z 553) risk factors: CRP 0 and/or CRP 3 values above the respective median value. The effect of higher CRP was evaluated by KaplaneMeier mortality curves and adjusted hazard ratio (HR) with 95% confidence interval (CI), by fitting Cox proportional hazards models. Results: Cumulative proportions of 5-year survival were 67% for 0 risk factors, 58% for 1 risk factor and 41% for 2 risk factors (P < 0.0001). The overall 5-year mortality risk was significantly higher in patients with 1 risk factor (adjusted hazard ratio [aHR] 1.43 [95% CI 1.14e1.79]), or 2 risk factors (aHR 2.49 [95% CI 1.99e3.11]). A significant impact on survival was observed in each tumour-node-metastasis stage group, and in the subset of non-smokers. Postoperative 30-

show abstract

“…CRP is a non-specific marker of inflammation [13,14]. High CRP level has been reported to be significantly associated with poor prognosis in NSCLC [13,14].…”

Section: Discussionmentioning

confidence: 99%

“…CRP is a non-specific marker of inflammation [13,14]. High CRP level has been reported to be significantly associated with poor prognosis in NSCLC [13,14]. The underlying molecular mechanism by which serum CRP level is associated with a worse outcome of NSCLC is still not clear.…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Values of a Novel Preoperative Inflammation-Based Score in Japanese Patients With Non-Small Cell Lung Cancer

et al. 2019

View full text Add to dashboard Cite

Background: Several previous researchers have investigated the prognostic value of the combinations of systemic inflammatory markers. However, the prognostic power of these systemic inflammatory markers is not identical. We aimed to establish a novel prognostic score based on systemic inflammatory markers. Methods: Four hundred non-small cell lung cancer (NSCLC) patients who underwent surgery and were followed more than 5 years were included. Univariate and multivariate analyses were calculated by the Cox proportional hazards regression model. Results: Among systemic inflammatory markers which were used for the previously reported indexes, preoperative serum C-reactive protein (CRP) and body mass index (BMI) were independent prognostic markers in multivariate analysis, while serum albumin level, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio were not. Based on this result, a novel score was established. Patients with both normal CRP (< 0.13 ng/dL) and high BMI (> 20.6 kg/m 2) were allocated a score of 0. Patients in whom only one of these abnormalities was present were allocated a score of 1, whilst those with both high CRP and low BMI were given a score of 2. Patients with score 0 had 84.44% of 5-year cancer-specific survival, while patients with score 1-2 had a 61.88%. On multivariate analysis, this novel score was an independent prognostic factor. Conclusion: This novel score based on CRP and BMI might serve as an efficient prognostic indicator in resected NSCLC.

show abstract

Baseline C-Reactive Protein Level Predicts Survival of Early-Stage Lung Cancer: Evidence from a Systematic Review and Meta-Analysis

Abstract: Based on our analysis, baseline high CRP level is significantly associated with poor prognosis in early-stage NSCLC. Further prospective controlled studies are needed to confirm these data.

Cited by 44 publications

References 56 publications

C-reactive protein level predicts mortality in COPD: a systematic review and meta-analysis

C-reactive protein level predicts mortality in COPD: a systematic review and meta-analysis

Baseline and postoperative C-reactive protein levels predict mortality in operable lung cancer

The Prognostic Values of a Novel Preoperative Inflammation-Based Score in Japanese Patients With Non-Small Cell Lung Cancer

Contact Info

Product

Resources

About