Preoperative elevation of serum C-reactive protein as an independent prognostic indicator of colorectal carcinoma
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
The preoperative elevation of serum C-reactive protein (CRP) is thought to be a prognosticator of carcinomas of the digestive tract. We conducted this study to investigate the clinical importance of the preoperative elevation of serum CRP in patients with colorectal carcinoma (CRC).
We investigated the correlation between an elevated preoperative serum CRP level and the clinicopathologic factors, including prognosis, of 116 patients who underwent resection of CRC.
Forty-seven (40.5%) patients had an elevated serum CRP value preoperatively (group H) and 69 (59.5%) did not (group L). There were significant differences in the tumor size, proportion of poorly differentiated tumors, depth of invasion, lymph node metastasis, lymphatic invasion, and tumor stage between the two groups. Survival was significantly lower in group H than in group L (P < 0.0001). Multivariate analysis showed that the preoperative elevation of serum CRP (P = 0.0007), as well as poor differentiation (P = 0.027) and advanced tumor stage (P = 0.007) were independent prognostic factors in patients with CRC.
We found the preoperative elevation of serum CRP to be an independent prognostic indicator of CRC.
- Zimmerman MA, Selzman CH, Cothren C, Sorensen AC, Raeburn CD, Harken AH. Diagnostic implications of C-reactive protein. Arch Surg 2003;138:220–224. CrossRef
- Nozoe T, Matsumata T, Kitamura M, Sugimachi K. Significance of preoperative elevation of serum C-reactive protein as an indicator for prognosis in colorectal cancer. Am J Surg 1998;176:335–338. CrossRef
- McMillan DC, Wotherspoon HA, Fearon KC, Sturgeon C, Cooke TG, McArdle CS. A prospective study of tumor recurrence and acute-phase response after apparently curative colorectal cancer surgery. Am J Surg 1995;170:319–322. CrossRef
- McMillan DC, Canna K, McArdle CS. Systemic inflammatory response predicts survival following curative resection of colorectal cancer. Br J Surg 2003;90:215–219. CrossRef
- Chung YC, Chang YF. Serum C-reactive protein correlates with survival in colorectal cancer patients but is not an independent prognostic indicator. Eur J Gastroenterol Hepatol 2003;15:369–373. CrossRef
- Nielsen HJ, Christensen IJ, Sorensen S, Moesgaard F, Brunner N. Preoperative plasma plasminogen activator inhibitor type-1 and serum C-reactive protein levels in patients with colorectal cancer. The RANX05 Colorectal Cancer Study Group. Ann Surg Oncol 2000;7:617–623.
- Erlinger TP, Platz EA, Rifai N, Helzlsouer KJ. C-reactive protein and the risk of incident colorectal cancer. JAMA 2004;291:585–590. CrossRef
- Japanese Research Society for Cancer of the Colon and Rectum:General rules for clinical and pathologic studies on cancer of the colon, rectum and anus. Jpn J Surg 1983;13:557–573. CrossRef
- Senju O, Takagi Y, Uzawa R, Iwasaki Y, Suzuki T, Gomi K, et al. A new immuno quantitative method by latex agglutination — application for the determination of serum C-reactive protein (CRP) and its clinical significance. J Clin Lab Immunol 1986;19:99–103.
- Dukes CE, Bussey HJR. The spread of rectal cancer and its effect on prognosis. Br J Cancer 1958;12:309–320.
- Nozoe T, Saeki H, Sugimachi K. Significance of preoperative elevation of serum C-reactive protein as an indicator of prognosis in esophageal carcinoma. Am J Surg 2001;182:197–201. CrossRef
- Nozoe T, Korenaga D, Futatsugi M, Saeki H, Maehara Y, Sugimachi K. Immunohistochemical expression of C-reactive protein in squamous cell carcinoma of the esophagus—significance as a tumor marker. Cancer Lett 2003;192:89–95. CrossRef
- Dong Q, Wright JR. Expression of C-reactive protein by alveolar macrophages. J Immunol 1996;156:4815–4820.
- Oka M, Yamamoto K, Takahashi M, Hakozaki M, Abe T, Iizuka N, et al. Relationship between serum levels of interleukin 6, various disease parameters and malnutrition in patients with esophageal squamous cell carcinoma. Cancer Res 1996;56:2776–2780.
- Castell JV, Gomez-Lechon MJ, David M, Fabra R, Trullenque R, Heinrich PC. Acute phase response of human hepatocytes: regulation of acute-phase protein synthesis by interleukin-6. Hepatology 1990;12:1179–1186. CrossRef
- Chung YC, Chang YF. Serum interleukin-6 levels reflect the disease status of colorectal cancer. J Surg Oncol 2003;83:222–226. CrossRef
- Galizia G, Orditura M, Romano C, Lieto E, Castellano P, Pelosio L, et al. Prognostic significance of circulating IL-10 and IL-6 serum levels in colon cancer patients undergoing surgery. Clin Immunol 2002;102:169–178. CrossRef
- Belluco C, Nitti D, Frantz M, Toppan P, Basso D, Plebani M, et al. Interleukin-6 blood level is associated with circulating carcinoembryonic antigen and prognosis in patients with colorectal cancer. Ann Surg Oncol 2000;7:133–138. CrossRef
- Nozoe T, Matsumata T, Sugimachi K. Preoperative elevation of serum C-reactive protein is related to impaired immunity in patients with colorectal cancer. Am J Clin Oncol 2000;23:263–266.
- Durdey P, Williams NS, Brown DA. Serum carcinoembryonic antigen and acute phase reactant proteins in the pre-operative detection of fixation of colorectal tumours. Br J Surg 1984;71:881–884. CrossRef
- Simpson WG, Heys SD, Whiting PH, Eremin O, Broom J. Acute phase proteins and recombinant IL-2 therapy: prediction of response and survival in patients with colorectal cancer. Clin Exp Immunol 1995;99:143–147.
- Vetter ML, Gewurz H, Hansen B, James K, Baum LL. Effects of C-reactive protein on human lymphocyte responsiveness. J Immunol 1983;130:2121–2126.
- Nozoe T, Yasuda M, Honda M, Inutsuka S, Korenaga D. Fas ligand expression is correlated with metastasis in colorectal carcinoma. Oncology 2003;65:83–88. CrossRef
- Nozoe T, Honda M, Inutsuka S, Yasuda M, Korenaga D. Significance of immunohistochemical expression of manganese superoxide dismutase as a marker of malignant potential in colorectal carcinoma. Oncol Rep 2003;10:39–43.
- Zheng S, Han MY, Xiao ZX, Peng JP, Dong Q. Clinical significance of vascular endothelial growth factor expression and neovascularization in colorectal carcinoma. World J Gastroenterol 2003;9:1227–1230.
- Nozoe T, Anai H, Nasu S, Sugimachi K. Clinicopathological characteristics of mucinous carcinoma of the colon and rectum. J Surg Oncol 2000;75:103–107. CrossRef
- Handa K, Yamakawa M, Takeda H, Kimura S, Takahashi T. Expression of cell cycle markers in colorectal carcinoma: superiority of cyclin A as an indicator of poor prognosis. Int J Cancer 1999;84:225–233. CrossRef
- Preoperative elevation of serum C-reactive protein as an independent prognostic indicator of colorectal carcinoma
Volume 38, Issue 7 , pp 597-602
- Cover Date
- Print ISSN
- Online ISSN
- Springer Japan
- Additional Links
- Colorectal carcinoma
- C-reactive protein
- Prognostic indicator
- Industry Sectors