Prognostic importance of serum CRP, prealbumin, and transferrin levels in patients with advanced stage esophageal cancer

Abstract

Amaç: Bu çalışmada stent takılarak tedavi edilen ileri evre özofagus kanserli hastalarda serum C-reaktif protein (CRP), prealbumin ve transferrin düzeylerinin prognostik değeri araştırıldı. Ça lış ma pla nı: Temmuz 2007 ve Aralık 2008 tarihleri arasında gerçekleştirilen prospektif randomize bir çalış-mada lokal olarak ilerlemiş hastalık veya uzak organ metastazı nedeniyle stent takılarak tedavi edilen ardışık 61 hastada, stent takılmadan 1-3 gün önce serum CRP, prealbumin ve transferrin düzeyleri çalışıldı. Tüm hastalar ölünceye kadar takip edildi. Bul gu lar: Stent tüm hastalarda başarı ile takılarak oral alım tekrar sağlandı. İşleme bağlı mortalite gözlenmedi. Hastaların ortalama sağkalım süresi 164.3±120.3 gün (dağılım 15-450 gün) idi. Serum CRP seviyesi ≥10 mg/L olan hastalarda (n=38) ortalama sağkalım 103.2±82.3 gün iken serum CRP seviyesi <10 mg/L olan hastalarda (n=23) ortalama sağkalım 265.4±121.2 gün idi. Serum prealbumin seviyesi ≥15 mg/L olan hastalarda (n=28) ortalama sağkalım 237.5±132.7 gün iken serum prealbumin seviyesi <15 mg/L olan hastalarda (n=33) ortalama sağkalım 102.3±79.6 gün idi. Serum transferrin seviyesi ≥200 mg/L olan hastalarda (n=25) ortalama sağkalım 211.6±130.2 gün iken serum transferrin seviyesi <200 mg/L olan hastalarda (n=36) ortalama sağkalım 131.5±113.8 gün idi. Referans serum CRP, prealbumin ve transferrin seviyelerinin sağ-kalımla ilişkisi istatistiksel olarak anlamlı idi (sırasıyla p<0.001, p<0.001 ve p= 0.003). So nuç: İleri evre özofagus kanserli hastalarda özofageal stent uygulamasından önce serum CRP, prealbumin ve transferrin düzeyleri kolaylıkla saptanabilir ve hastaların prognozları hakkında fikir elde edilebilir.Anah tar söz cük ler: C-reaktif protein; özofagus kanseri; prealbü-min; sağkalım; transferrin.Background: This study investigated the prognostic value of serum C-reactive protein (CRP), prealbumin, and transferrin levels in patients with advanced stage esophageal cancers treated with stent placement. Methods: In a prospective, randomized study conducted between July 2007 and December 2008, serum CRP, prealbumin, and transferrin levels were determined 1-3 days prior to stent placement in 61 consecutive patients who underwent stent placement due to locally advanced disease or distant organ metastasis. All patients were followed until death. Results:The stent was successfully placed in all patients and oral intake was restored. There was no procedure-related mortality. The mean survival period of the patients was 164.3±120.3 days (range 15 to 450 days). Whereas the mean survival period was 103.2±82.3 days in patients with a serum CRP level ≥10 mg/L (n=38), it was 265.4±121.2 days in patients with a serum CRP level <10 mg/L (n=23). While the mean survival period was 237.5±132.7 days in patients with a serum prealbumin level ≥15 mg/L (n=28), the mean survival period was 102.3±79.6 days in patients with a serum prealbumin level <15 mg/L (n=33). The mean survival period was 211.6±130.2 days in patients with a serum transferrin level ≥200 mg/L (n=25) while the mean ...

The role of prognostic nutritional index for clinical outcomes of gastric cancer after total gastrectomy

“…Some limitations of the present study need to be noticed, Firstly, this is a retrospective study and the limited single study institute and population need to be enlarged in the future study; Secondly, patients with neo-adjuvant therapy were excluded in this study to ensure that all patients are in the same state before blood sampling, this excludes the difference between the West where neo-adjuvant treatment is routine practice and the East where neo-adjuvant treatment is not so common 39 . Therefore, the results of this study are not applicable to gastric patients undergoing neo-adjuvant therapy; Finally, the last one but certainly not the least one, PNI is a dynamic indicator, the previous controversy on its critical point is largely due to the difference in the nutritional status of patients in different disease states and treatment states, so it is necessary to distinguish between the early, advanced and inoperable state or different stratifications such as part resection, total resection and resection together with adjacent organs removal among the gastric cancer patients which may be more clinically valuable.…”

Preoperative prognostic nutritional index as an independent prognostic factor for resected ampulla of Vater cancer

“…Although patients with AoV cancers have a typical characteristic that presents a history of obstructive jaundice, our results showed the growing type of tumor did not have much effect on preoperative PNI by chronic loss of appetite with slow-growing. (fast-growing pancreatobiliary type PNI-median 44.9, slow-growing intestinal type PNI-median 47.5, p = 0.032) Albumin, prealbumin, and transferrin are well known prognostic factors in various kinds of solid cancer [39][40][41][42][43][44][45][46]. Albumin can be routinely checked and the impact of albumin is thought to be incorporated in the concept of PNI (albumin (g/dL)×10 + preoperative lymphocytic count×0.005).…”

Association of transthyretin and nutritional status in patients with cancer

“…11 A low transthyretin concentration may therefore be considered first as a sign of nutritional risk, which requires prior monitoring and care of the patient. 12 Given these characteristics, transthyretin has been able to detect nutritional change and determine treatment efficacy and nutritional prognosis, 11,13 making it an important indicator to screen and diagnose malnutrition, since it is relatively low cost, can be used in the laboratory and can be used in various clinical conditions. 9,14 This work was based on the hypothesis that the transthyretin can to predict malnutrition in cancer patients when compared to the classical methods of nutritional assessment.…”