Pretreatment serum C-reactive protein level predicts poor prognosis in patients with hepatocellular carcinoma

Abstract

C-reactive protein (CRP) is known to be associated with poor prognosis in patients with various malignancies. We investigated the relationship between the pretreatment serum CRP level and survival in patients with hepatocellular carcinoma (HCC) in various stages of the disease. A cohort of 133 patients with newly diagnosed HCC was prospectively evaluated. The patients were divided into two groups: high-CRP group (n=27) with the pretreatment serum CRP level≧1.0 mg/dl and low-CRP group (n=106) with the CRP level<1.0 mg/dl. They were followed 22 months in average (1-69 months) and clinicopathological variables, and overall survivals between the two groups were compared at the end of the follow-up period. There was a significant difference between the two groups in aspartate aminotransferase, alanine aminotransferase, total serum bilirubin, albumin, α-fetoprotein level, maximal tumor diameter, frequency of vascular invasion and extrahepatic metastases. Patients in the high-CRP group had higher Child-Pugh scores, higher Cancer of the Liver Italian Program scores and higher Japan Integrated Staging scores than patients in the low-CRP group. The overall survival rates in the high-CRP group were significantly lower than those in the low-CRP group. Survival rates were similar in tumor stage and liver function-matched patients. On multivariate analysis, pretreatment serum CRP level was independently associated with overall survival. Our results demonstrate that the pretreatment serum CRP level is associated with tumor progression and reduced liver function and is an independent poor prognostic marker in patients with HCC.

Clinical significance of the C‑reactive protein‑to‑albumin ratio for the prognosis of patients with esophageal squamous cell carcinoma

“…Serum CRP, an acute-phase protein, is produced in hepatocytes, predominantly under the control of interleukin-6, and is a very sensitive prognostic indicator of inflammation in various cancers (21,22). Based on our current observations, it is suggested that CAR, which is calculated from both serum CRP concentrations and albumin levels, may better predict cancer outcome.…”

C-Reactive Protein Downregulates TRAIL Expression in Human Peripheral Monocytes via an Egr-1–Dependent Pathway

“…In conclusion, our data suggest that long-term suppression of TRAIL expression and release by CRP might contribute to increase the risk of tumors associated to chronic diseases, which are characterized by systemic inflammation and CRP elevation (55)(56)(57). However, only in vivo experiments carried out by simultaneously analyzing the levels of CRP and TRAIL in patients with premalignant lesions or overt cancer will reveal whether our in vitro data have clinical relevance.…”

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

“…In assessing crp elevation, the presence of other inflammatory disease should be considered, because crp is a nonspecific inflammatory marker [15][16][17] . However, measurements of serum crp are simple and low-cost.…”