Pre-Treatment Levels of C-Reactive Protein and Squamous Cell Carcinoma Antigen for Predicting the Aggressiveness of Pharyngolaryngeal Carcinoma

Chen, Hsuan-Ho; Wang, Hung‐Ming; Fan, Kang‐Hsing; Lin, Chien‐Yu; Yen, Tzu‐Chen; Liao, Chun‐Ta; Chen, I-How; Kang, Chung‐Jan; Huang, Shiang‐Fu

doi:10.1371/journal.pone.0055327

Cited by 18 publications

(25 citation statements)

References 48 publications

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“…In the present study of the association of serum crp with prognosis in patients with locoregionally advanced npc treated with chemoradiotherapy, serum crp before chemoradiotherapy predicted poor prognosis. That finding is consistent with reports that serum crp is an independent unfavourable prognostic factor in patients with head-and-neck cancer 10,11 . The presence of a systemic inflammatory response is reported to be associated with poor prognosis in patients with various malignancies.…”

Section: Discussionsupporting

confidence: 93%

Serum C-Reactive Protein Predicts Poor Prognosis in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy

Zeng

Xiao

et al. 2015

Current Oncology

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Background: We aimed to evaluate the association of serum C-reactive protein (crp) with prognosis in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy. Methods: We retrospectively reviewed 79 patients with locoregionally advanced nasopharyngeal carcinoma (cT3–4N0–3M0) treated with chemoradiotherapy. Chemoradiotherapy consisted of external-beam radiotherapy to the nasopharynx (70–80 Gy), the lymph node–positive area (60–70 Gy), and the lymph node–negative area (50–60 Gy) combined with 3 cycles of various platinum-based regimens delivered at 3-week intervals. Elevated crp was defined as more than 8 mg/L. The survival rate was calculated using the Kaplan–Meier method, and univariate and multivariate analyses (Cox proportional hazards model) were used to identify factors significantly associated with prognosis. Results: During the median follow-up of 3.9 years (range: 1–5.5 years), 23 patients died from nasopharyngeal cancer. The 5-year cancer-specific survival (css) rate was 62.90%. Before chemoradiotherapy, 18 patients had high serum crp; the css rate in that subgroup was significantly worse than the rate in the remaining patients (p = 0.0002). Multivariate analysis showed that crp was an independent prognostic indicator of css, with a hazard ratio of 3.04 (95% confidence interval: 1.22 to 7.55; p = 0.017). Among the 18 patients with elevated serum crp, 9 achieved normal serum crp after chemoradiotherapy, of whom 5 remained living with no evidence of recurrence or metastasis during follow-up. By contrast, the remaining 9 patients in whom serum crp did not normalize after chemoradiotherapy died within 4.2 years. Conclusions: Elevated serum crp before treatment predicts poor prognosis in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy.

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Section: Discussionsupporting

confidence: 93%

Serum C-Reactive Protein Predicts Poor Prognosis in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy

Zeng

Xiao

et al. 2015

Current Oncology

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“…This study made use of an SCC-Ag reference cutoff value of 2 ng/mL, established previously [6,10,[16][17][18] to analyze the correlation with tumor volume. In the group of patients with an SCC-Ag level < 2 ng/mL, the mean tumor volume was 7.90 mL.…”

Section: Discussionmentioning

confidence: 99%

Correlation between Serum Squamous Cell Carcinoma Antigen Level and Tumor Volume in Head and Neck Cancer

Jantharapattana

Kotamnivates

Hirunpat

et al. 2018

ORL

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Purpose of Study: An association of squamous cell carcinoma antigen (SCC-Ag) level with cancer prognosis has been reported in many studies. Our investigators conducted the first study determining a correlation between the SCC-Ag level and the tumor volume in head and neck cancer. Procedures: The SCC-Ag level of patients were measured from the serum, whilst the tumor volume was calculated by the ellipsoid formula and verified by logistic software on radiology. The correlation between SCC-Ag level and tumor volume was analyzed. Results: Fifty-two patients were studied, with the mean age of 62.4 years. Tumor types were: oral cavity cancer (11 cases, 21.6%), oropharyngeal cancer (21 cases, 40.38%), hypopharyngeal cancer (8 cases, 15.7%), and laryngeal cancer (12 cases, 23.5%). Mean tumor volume was 20.01 mL (range 0.02–91.46 mL). Mean SCC-Ag level was 2.69 ng/mL (range 0.5–14.6 ng/mL). The critical point of SCC-Ag was 5.8 ng/mL. The Pearson’s correlation coefficient between SCC-Ag level and tumor volume was 0.524 (p = 0.0002). Conclusions: SCC-Ag moderately correlates with tumor volume in head and neck cancer patients, with statistical significance. We suggest that using tumor volume, rather than a one-dimensional measurement such as tumor size, to analyze correlation with SCC-Ag offers a more accurate means of cancer prognosis.

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“…The reference cut-off value for the serum SCC-Ag level was set at 2.0 ng/ml, as previously established [4], [13], [19].…”

Section: Methodsmentioning

confidence: 99%

Using SCC Antigen and CRP Levels as Prognostic Biomarkers in Recurrent Oral Cavity Squamous Cell Carcinoma

et al. 2014

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Squamous cell carcinoma antigen (SCC-Ag) and C-reactive protein (CRP) levels have been successfully used to stratify risk groups in primary oral squamous cell carcinoma (OSCC) patients; however, related biomarkers have rarely been investigated in recurrent OSCC. The purpose of the present study was to analyze the relationships of SCC-Ag and CRP levels at the time of recurrence with clinical factors and prognosis. We retrospectively recruited patients with recurrence in a cohort of 534 OSCC patients between March 2001 and July 2013. One hundred patients had recurrence. The serum SCC-Ag and CRP levels were measured at the time of cancer diagnosis, 3 to 6 months after treatment with clinical disease-free, and at the time of recurrence. The SCC-Ag levels were significantly lowered after treatment (paired t-test: p = 0.001) and re-elevated at the time of recurrence (paired t-test: p = 0.027). An SCC-Ag level ≥2.0 ng/ml and a CRP level ≥5.0 mg/L at the time of recurrence were significantly associated with recurrent tumor status (P<0.001), recurrent nodal metastasis (χ2 trend test: P = 0.020), distant metastasis (P<0.001), and overall survival (P<0.001). Moreover, the influence of both elevated SCC-Ag and CRP levels on overall survival (P<0.001, H.R. [95% CI]: 5.406 [2.210–13.222]) still existed after adjusting for the recurrent tumor stage and patient age. The present study demonstrates that concurrent high levels of both SCC-Ag and CRP at the diagnosis of recurrence acts as a predictor of recurrent tumor status, recurrent advanced tumor stage, distant metastasis, and survival after the diagnosis of recurrence. This study expands the applicability of these two markers in the risk stratification in recurrent OSCC.

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Pre-Treatment Levels of C-Reactive Protein and Squamous Cell Carcinoma Antigen for Predicting the Aggressiveness of Pharyngolaryngeal Carcinoma

Cited by 18 publications

References 48 publications

Serum C-Reactive Protein Predicts Poor Prognosis in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy

Serum C-Reactive Protein Predicts Poor Prognosis in Patients with Locoregionally Advanced Nasopharyngeal Carcinoma Treated with Chemoradiotherapy

Correlation between Serum Squamous Cell Carcinoma Antigen Level and Tumor Volume in Head and Neck Cancer

Using SCC Antigen and CRP Levels as Prognostic Biomarkers in Recurrent Oral Cavity Squamous Cell Carcinoma

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