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Is C-Reactive Protein a Prognostic Factor of Colorectal Cancer?

  • Original Contribution
  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose

C-reactive protein, a commonly used inflammation marker, has been reported to be a prognostic factor of colorectal cancer. This prospective study was designed to confirm the prognostic value of its preoperative levels and to observe their perioperative change.

Methods

Between January 2001 and September 2005, preoperative C-reactive protein levels were obtained for 212 consecutive patients (140 males) receiving elective open resection of colorectal cancer. A level higher than 0.5 mg/dl was defined as positive. They were analyzed against clinicopathologic factors. The survival of 158 curative resections was analyzed. Postoperative levels (at months 1, 3, and 6) were collected for analysis of changing trend, from the patients receiving curative surgeries.

Results

Median value of preoperative C-reactive protein was 0.54 mg/dl (48.6 percent positive). Positive rate was significantly correlated with ulcerative type, larger size, higher stage, and positive carcinoembryonic antigen (>5 ng/ml). In both univariate log-rank test and multiple Cox proportional hazards regression, stage (univariate P = 0.011, and multivariate P = 0.016; hazard ratio, 6.23; 95 percent confidence interval, 1.41–27.54), C-reactive protein (0.5 mg/dl; P = 0.005, and P = 0.016; hazard ratio: 6.51; 95 percent confidence interval: 1.41–30.05), and differentiation (P = 0.006, and P = 0.043; hazard ratio, 3.53; 95 percent confidence interval, 1.04–11.98) were significant factors. Analysis of disease-free interval showed C-reactive protein was significant (P = 0.03): as level rose, prognosis worsened. The quiescent inflammation-response group (≤0.1 mg/dl) had excellent outcomes. Postoperatively, the C-reactive protein levels declined at the third postoperative month.

Conclusions

Preoperative C-reactive protein is an independent prognostic factor. The levels declined postoperatively, although with a lag. These findings seem to support the response hypothesis regarding C-reactive protein.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, Taipei-Veterans General Hospital, No 201, Sec 2, Shih-Pai Rd, 11217, Taipei, Taiwan

    Yu-Chen Shiu M.D., Jen-Kou Lin M.D., Ph.D., Jeng-Kai Jiang M.D., Ph.D. & Shung-Haur Yang M.D., Ph.D.

  2. Department of Surgery, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan

    Jen-Kou Lin M.D., Ph.D., Jeng-Kai Jiang M.D., Ph.D. & Shung-Haur Yang M.D., Ph.D.

  3. Molecular Genetics and Biochemistry Laboratory, Cathay Medical Research Institute, Cathay General Hospital, Taipei, Taiwan

    Chi-Jung Huang Ph.D.

  4. Cancer Center, Taipei Veterans General Hospital, Taipei, Taiwan

    Ling-Wei Wang M.D.

  5. Department of Internal Medicine, Cheng Hsin Rehabilitation Medical Center, Taipei, Taiwan

    Huei-Chen Huang M.D.

Authors
  1. Yu-Chen Shiu M.D.
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  2. Jen-Kou Lin M.D., Ph.D.
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  3. Chi-Jung Huang Ph.D.
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  6. Huei-Chen Huang M.D.
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  7. Shung-Haur Yang M.D., Ph.D.
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Corresponding author

Correspondence to Shung-Haur Yang M.D., Ph.D..

Additional information

Supported by Taipei Veterans General Hospital Grant 97.

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Shiu, YC., Lin, JK., Huang, CJ. et al. Is C-Reactive Protein a Prognostic Factor of Colorectal Cancer?. Dis Colon Rectum 51, 443–449 (2008). https://doi.org/10.1007/s10350-007-9133-z

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  • DOI: https://doi.org/10.1007/s10350-007-9133-z

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