Journal of Gastrointestinal Cancer

, Volume 45, Issue 2, pp 161–167

Elevation in Multiple Serum Inflammatory Biomarkers Predicts Survival of Pancreatic Cancer Patients with Inoperable Disease

  • A. Alkhateeb
  • L. Zubritsky
  • B. Kinsman
  • K. Leitzel
  • C. Campbell-Baird
  • S. M. Ali
  • J. Connor
  • A. Lipton
Original Research

DOI: 10.1007/s12029-013-9564-9

Cite this article as:
Alkhateeb, A., Zubritsky, L., Kinsman, B. et al. J Gastrointest Canc (2014) 45: 161. doi:10.1007/s12029-013-9564-9

Abstract

Purpose

Cancer-associated inflammation plays a driver role in pancreatic tumor development and progression. Moreover, recent studies have implicated the inflammatory tumor microenvironment in modulating therapy response and inducing resistance. The aim of this study is to investigate the prognostic and predictive value of the inflammatory biomarkers serum ferritin and C-reactive protein (CRP) in advanced pancreatic cancer patients.

Methods

We measured pretreatment serum ferritin and CRP levels in 159 patients with inoperable pancreatic cancer participating in a phase III trial.

Results

Serum ferritin and CRP levels were examined for correlations with overall survival using Kaplan–Meier analysis. When analyzed on a categorical basis, patients with higher ferritin (>median) or CRP (>25th percentile) had shorter overall survival. Moreover, the two biomarkers were not correlated suggesting independent mechanisms of production and release. However, when patients were evaluated by their ferritin and CRP levels, only patients with elevation in both inflammatory biomarkers showed a significant decrease in overall survival.

Conclusions

Serum ferritin and CRP are independent prognostic factors for shorter survival in patients with inoperable pancreatic tumors. Moreover, the evaluation of patients based on both biomarkers suggested that their prognostic value, although independent, reflected the broader state of cancer-associated inflammation. Thus, serum ferritin and CRP should be further explored as clinical biomarkers.

Keywords

Serum ferritin CRP Pancreatic cancer Inflammation 

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • A. Alkhateeb
    • 1
  • L. Zubritsky
    • 2
  • B. Kinsman
    • 1
  • K. Leitzel
    • 2
  • C. Campbell-Baird
    • 2
  • S. M. Ali
    • 2
    • 3
  • J. Connor
    • 1
  • A. Lipton
    • 2
  1. 1.Department of NeurosurgeryThe Pennsylvania State University Hershey Medical CenterHersheyUSA
  2. 2.Division of Hematology-Medical OncologyThe Pennsylvania State University Hershey Medical CenterHersheyUSA
  3. 3.Lebanon VA Medical CenterLebanonUSA