CRP evaluation in non-small cell lung cancer

Aref, Hassan; Refaat, Sherif

doi:10.1016/j.ejcdt.2014.02.003

Cited by 33 publications

(21 citation statements)

References 24 publications

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“…The C-reactive protein level and leukocyte count are blood test markers for inflammation. Elevated C-reactive protein levels and leukocytes counts have been found to be associated with pulmonary diseases [57,58] and lung cancer [59], suggesting an etiologic role of pulmonary inflammation in lung cancer pathophysiology [59]. Consistent with these studies, our model recognized abnormal C-reactive protein levels and leukocyte counts as top features (Multimedia Appendix 5).…”

Section: Discussionsupporting

confidence: 80%

Prediction of the 1-Year Risk of Incident Lung Cancer: Prospective Study Using Electronic Health Records from the State of Maine

Wang¹,

Zhang²,

Hao³

et al. 2019

J Med Internet Res

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Background Lung cancer is the leading cause of cancer death worldwide. Early detection of individuals at risk of lung cancer is critical to reduce the mortality rate. Objective The aim of this study was to develop and validate a prospective risk prediction model to identify patients at risk of new incident lung cancer within the next 1 year in the general population. Methods Data from individual patient electronic health records (EHRs) were extracted from the Maine Health Information Exchange network. The study population consisted of patients with at least one EHR between April 1, 2016, and March 31, 2018, who had no history of lung cancer. A retrospective cohort (N=873,598) and a prospective cohort (N=836,659) were formed for model construction and validation. An Extreme Gradient Boosting (XGBoost) algorithm was adopted to build the model. It assigned a score to each individual to quantify the probability of a new incident lung cancer diagnosis from October 1, 2016, to September 31, 2017. The model was trained with the clinical profile in the retrospective cohort from the preceding 6 months and validated with the prospective cohort to predict the risk of incident lung cancer from April 1, 2017, to March 31, 2018. Results The model had an area under the curve (AUC) of 0.881 (95% CI 0.873-0.889) in the prospective cohort. Two thresholds of 0.0045 and 0.01 were applied to the predictive scores to stratify the population into low-, medium-, and high-risk categories. The incidence of lung cancer in the high-risk category (579/53,922, 1.07%) was 7.7 times higher than that in the overall cohort (1167/836,659, 0.14%). Age, a history of pulmonary diseases and other chronic diseases, medications for mental disorders, and social disparities were found to be associated with new incident lung cancer. Conclusions We retrospectively developed and prospectively validated an accurate risk prediction model of new incident lung cancer occurring in the next 1 year. Through statistical learning from the statewide EHR data in the preceding 6 months, our model was able to identify statewide high-risk patients, which will benefit the population health through establishment of preventive interventions or more intensive surveillance.

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Section: Discussionsupporting

confidence: 80%

Prediction of the 1-Year Risk of Incident Lung Cancer: Prospective Study Using Electronic Health Records from the State of Maine

Wang¹,

Zhang²,

Hao³

et al. 2019

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…The present study also demonstrated that the DFS and OS of the VATS group were better than those in the thoracotomy group; however, a multivariate analysis of DFS and OS confirmed the nonsuperiority of VATS. Because other reports demonstrated that long-term survival after VATS is not inferior in comparison to thoracotomy, it might be revealed that a less invasive operative approach itself is not a prognostic factor [24][25][26][27]. The present study identified the preCRP level as a significant prognostic factor for recurrence in patients who received surgery.…”

Section: Discussionmentioning

confidence: 52%

Operative invasiveness does not affect the prognosis of patients with non-small cell lung cancer

et al. 2020

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Background The relationship between operative invasiveness and the prognosis in non-small cell lung cancer (NSCLC) patients who have undergone surgery has been controversial. Methods Clinical data were analyzed for 463 NSCLC patients. Operative invasiveness was defined by wound length, operation time, and the postoperative C-reactive protein (postCRP) level. The operative approach was divided into video-assisted thoracic surgery (VATS) and thoracotomy. Results The wound length and operation time were significantly correlated with the postCRP level (correlation coefficient (CC) = 0.39, p < 0.01; CC = 0.54, p < 0.01, respectively). The postCRP level in the VATS group was significantly lower than that in the thoracotomy group (12.2 mg/dl vs 20.58 mg/dl, p < 0.01). The relapse-free survival differed significantly based on wound length (p < 0.01), operation time (p = 0.01), CRP level (p < 0.01), and operative approach (p < 0.01). The carcinoembryonic antigen level (hazard ratio [HR], 1.58; p = 0.02), pathological stage (pStage) (HR, 2.57; p < 0.01), vascular invasion (HR, 1.95; p = 0.01), and preoperative CRP level (preCRP) (HR, 1.91; p < 0.01) were identified as significant prognostic factors for relapse-free survival in a multivariate analysis. Furthermore, the multivariate analysis showed that smoking history (HR, 2.36; p = 0.03), pStage (HR, 3.26; p < 0.01), and preCRP level were significant prognostic factors for overall survival. Conclusion Preoperative CRP level was associated with poor prognosis. Although the VATS approach might be less invasive procedure for NSCLC patients, operative invasiveness does not affect the prognosis.

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“…Our results showed that CRP was higher in patients with infective effusions in keeping with its property as an acute - phase reactant , whereas serum LDH was higher in cancer patients. An increase in CRP level in lung cancer patients compared to healthy individuals has been described [ 27 , 28 ]. However such comparison is not adequate for attributing raised CRP to cancer, as lung cancer patients may have concomitant inflammation from other sources such as cancer-related pulmonary infection.…”

Section: Discussionmentioning

confidence: 99%

Identifying Malignant Pleural Effusion by A Cancer Ratio (Serum LDH: Pleural Fluid ADA Ratio)

Verma

Abisheganaden

Light

2015

Lung

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AimWe studied the diagnostic potential of serum lactate dehydrogenase (LDH) in malignant pleural effusion.MethodsRetrospective analysis of patients hospitalized with exudative pleural effusion in 2013.ResultsSerum LDH and serum LDH: pleural fluid ADA ratio was significantly higher in cancer patients presenting with exudative pleural effusion. In multivariate logistic regression analysis, pleural fluid ADA was negatively correlated 0.62 (0.45–0.85, p = 0.003) with malignancy, whereas serum LDH 1.02 (1.0–1.03, p = 0.004) and serum LDH: pleural fluid ADA ratio 0.94 (0.99–1.0, p = 0.04) was correlated positively with malignant pleural effusion. For serum LDH: pleural fluid ADA ratio, a cut-off level of >20 showed sensitivity, specificity of 0.98 (95 % CI 0.92–0.99) and 0.94 (95 % CI 0.83–0.98), respectively. The positive likelihood ratio was 32.6 (95 % CI 10.7–99.6), while the negative likelihood ratio at this cut-off was 0.03 (95 % CI 0.01–0.15).ConclusionHigher serum LDH and serum LDH: pleural fluid ADA ratio in patients presenting with exudative pleural effusion can distinguish between malignant and non-malignant effusion on the first day of hospitalization. The cut-off level for serum LDH: pleural fluid ADA ratio of >20 is highly predictive of malignancy in patients with exudative pleural effusion (whether lymphocytic or neutrophilic) with high sensitivity and specificity.

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CRP evaluation in non-small cell lung cancer

Cited by 33 publications

References 24 publications

Prediction of the 1-Year Risk of Incident Lung Cancer: Prospective Study Using Electronic Health Records from the State of Maine

Prediction of the 1-Year Risk of Incident Lung Cancer: Prospective Study Using Electronic Health Records from the State of Maine

Operative invasiveness does not affect the prognosis of patients with non-small cell lung cancer

Identifying Malignant Pleural Effusion by A Cancer Ratio (Serum LDH: Pleural Fluid ADA Ratio)

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