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Huynh Thanh L, Dao Bui Quy Q, Nguyen Manh K, Nguyen Huu D, Nguyen Trung K, Le Viet T. Preoperative urine neutrophil gelatinase-associated lipocalin predicts mortality in colorectal cancer patients after laparoscopic surgery: A single-center study. Health Sci Rep 2023; 6:e1612. [PMID: 37808929 PMCID: PMC10556407 DOI: 10.1002/hsr2.1612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/18/2023] [Accepted: 09/22/2023] [Indexed: 10/10/2023] Open
Abstract
Purpose To determine the rate of acute kidney injury (AKI) after laparoscopic colorectal cancer (CRC) surgery and the predictive value of urine neutrophil gelatinase-associated lipocalin (uNGAL) for postoperative AKI and mortality during 3 years of follow-up. Methods A total of 216 CRC patients who had undergone laparoscopic surgery were included in our study. We divided all patients into two groups, including group 1 (n = 31) with postoperative AKI and group 2 (n = 185) without postoperative AKI. Urine NGAL was measured using the ELISA technique. Clinical and laboratory data were collected the day before surgery. Postoperative AKI included events occurring within 7 days of the index operation, and mortality was obtained during 3 years of follow-up. Results The ratio of postoperative AKI was 14.35% (31/216 patients). The urine NGAL level in group 1 was significantly higher than in group 2, p < 0.001. At cut-off value = 14.94 ng/mL, uNGAL has a predictive value for AKI (area under the curve [AUC] = 0.858, p < 0.001). After 3 years of follow-up, the total mortality rate was 7.9%. The mortality rate in group 1 (45.2%) was significantly higher than in group 2 (1.6%) with p < 0.001). At cut-off value = 19.85 ng/mL, uNGAL has a predictive value for mortality (AUC = 0.941, p < 0.001). Conclusions The rate of acute kidney injury after laparoscopic CRC surgery was 14.35%. Preoperative urine NGAL has a good predictive value for postoperative acute kidney injury and mortality during 3 years of follow-up.
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Affiliation(s)
- Long Huynh Thanh
- Nguyen Tri Phuong HospitalHo Chi MinhVietnam
- Nguyen Tat Thanh UniversityHo Chi MinhVietnam
| | | | | | | | - Kien Nguyen Trung
- Military Hospital 103Ha NoiVietnam
- Vietnam Military Medical UniversityHa NoiVietnam
| | - Thang Le Viet
- Military Hospital 103Ha NoiVietnam
- Vietnam Military Medical UniversityHa NoiVietnam
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2
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Mao Y, Liu J, Li J, Qiu Y, Wang Z, Li B, Liu S, Tian L, Chen J. Elevation of preoperative serum hs-CRP is an independent risk factor for malnutrition in patients with gastric cancer. Front Oncol 2023; 13:1173532. [PMID: 37293590 PMCID: PMC10247225 DOI: 10.3389/fonc.2023.1173532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/12/2023] [Indexed: 06/10/2023] Open
Abstract
Background Recent studies have reported hypersensitive C-reactive protein (hs-CRP) linked to clinicopathological characteristics and nutritional status of the tumor, but its clinical significance in GC remains unclear. This study aimed to investigate the relationship between preoperative serum hs-CRP level and clinicopathological features and nutritional status in gastric cancer (GC) patients. Methods The clinical data of 628 GC patients who met the study criteria were analyzed retrospectively. The preoperative serum hs-CRP level was divided into two groups (<1 mg/L and ≥1 mg/L) to evaluate clinical indicators. Nutritional Risk Screening and nutritional assessment of GC patients were performed by the Nutritional Risk Screening 2002 (NRS2002) and the Patient-Generated Subjective Global Assessment (PG-SGA), respectively. The data were subjected to chi-square test, univariate and multivariate logistic regression analyses, respectively. Results The analysis of 628 GC cases revealed that 338 patients (53.8%) were on malnutrition risk(NRS2002≥3 points), and 526(83.8%) had suspected/moderate to severe malnutrition(PG-SGA≥ 2 points). Preoperative serum hs-CRP level was significantly correlated with age, tumor maximum diameter (TMD), peripheral nerve invasion (PNI), lymph-vascular invasion (LVI), depth of tumor invasion (DTI), lymph node metastasis (LNM), pTNM stage, body weight loss (BWL), body mass index (BMI), NRS2002 score, PG-SGA grade, hemoglobin (HB), total protein (TP), albumin (ALB), prealbumin (PAB) and total lymphocyte count (TLC). Multivariate logistic regression analysis revealed that hs-CRP (OR=1.814, 95%CI=1.174-2.803; P=0.007), age, ALB, BMI, BWL and TMD were independent risk factors for existing malnutritional risk in GC. Similarly, non-malnutrition and suspected/moderate to severe malnutrition groups presented that hs-CRP (OR=3.346, 95%CI=1.833-6.122; P< 0.001), age, HB, ALB, BMI and BWL were independent risk factors for malnutrition in GC. Conclusion In addition to the generally used nutritional evaluation indicators such as age, ALB, BMI, and BWL, the hs-CRP level may be used as a nutritional screening and evaluation indicator for GC patients.
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Affiliation(s)
- Yuantian Mao
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, Guangxi Zhuang Autonomous Region, China
- Guangxi Clinical Research Center for Enhanced Recovery After Surgery, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jinlu Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
- Guangxi Clinical Research Center for Enhanced Recovery After Surgery, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Jiaming Li
- Department of General Surgery, The Wuzhou Red Cross Hospital, Wuzhou, Guangxi Zhuang Autonomous Region, China
| | - Yue Qiu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Zhen Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, Guangxi Zhuang Autonomous Region, China
- Guangxi Clinical Research Center for Enhanced Recovery After Surgery, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Bopei Li
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, Guangxi Zhuang Autonomous Region, China
- Guangxi Clinical Research Center for Enhanced Recovery After Surgery, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Siyu Liu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, Guangxi Zhuang Autonomous Region, China
- Guangxi Clinical Research Center for Enhanced Recovery After Surgery, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Lei Tian
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, Guangxi Zhuang Autonomous Region, China
- Guangxi Clinical Research Center for Enhanced Recovery After Surgery, Nanning, Guangxi Zhuang Autonomous Region, China
| | - Junqiang Chen
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China
- Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Nanning, Guangxi Zhuang Autonomous Region, China
- Guangxi Clinical Research Center for Enhanced Recovery After Surgery, Nanning, Guangxi Zhuang Autonomous Region, China
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Memon SM, Kumar N, Rahman AAU, Syed BM. Evaluation of C-reactive protein and hematological parameters in smokeless tobacco users: A comparative cross-sectional study. Pak J Med Sci 2021; 37:983-987. [PMID: 34290770 PMCID: PMC8281176 DOI: 10.12669/pjms.37.4.3841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/04/2020] [Accepted: 02/25/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: To investigate the changes in levels of C-reactive protein (CRP) and hematological parameters among smokeless tobacco (SLT) users. Methods: A comparative cross-sectional study was conducted at the community level in the coastal districts of Sindh province namely Badin, Thatta, and Sujawal from January 2017 to December 2019. The CRP and hematological parameters were evaluated by well-established methods among SLT and non-SLT users. Results: There was a statistically significant difference between SLT users (mean CRP = 0.77) versus non-users (mean CRP = 0.18), p = <0.001. Among hematological parameters, white blood cells (SLT users median = 7.85 versus non-SLT users median = 8.50, p = 0.004), monocytes (SLT users median = 6.00 versus non-SLT users median = 6.00, p = 0.001) and erythrocyte sedimentation rate (SLT users median = 15.00 versus non-SLT users median = 10.00, p = 0.006) showed statistically significant difference. Conclusions: Significantly elevated CRP was observed in SLT users similarly hematological parameters also showed changes. WBCs, monocytes and ESR were significantly deranged among SLT users. Further studies looking into long term effects of these changes would be helpful.
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Affiliation(s)
- Sikander Munir Memon
- Sikander Munir Memon, BDS. Medical Research Centre, Liaquat University of Medical and Health Sciences, Jamshoro 76090, Pakistan
| | - Naresh Kumar
- Naresh Kumar, BDS, PhD. Dr. Ishrat Ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan. Medical Research Centre, Liaquat University of Medical and Health Sciences, Jamshoro 76090, Pakistan
| | - Aneela Atta Ur Rahman
- Aneela Atta Ur Rahman, MBBS, MPH, PhD. Shaheed Mohtarama Benazir Bhutto Medical University, Larkana 77150, Pakistan. Medical Research Centre, Liaquat University of Medical and Health Sciences, Jamshoro 76090, Pakistan
| | - Binafsha Manzoor Syed
- Binafsha Manzoor Syed, MBBS, PhD. Medical Research Centre, Liaquat University of Medical and Health Sciences, Jamshoro 76090, Pakistan
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The Elevated Pre-Treatment C-Reactive Protein Predicts Poor Prognosis in Patients with Locally Advanced Rectal Cancer Treated with Neo-Adjuvant Radiochemotherapy. Diagnostics (Basel) 2020; 10:diagnostics10100780. [PMID: 33023215 PMCID: PMC7601888 DOI: 10.3390/diagnostics10100780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/21/2020] [Accepted: 09/30/2020] [Indexed: 01/08/2023] Open
Abstract
The aim of the present study was to investigate the association of the pre-treatment C-reactive protein (CRP) plasma level with survival outcomes in a cohort of 423 consecutive patients with locally advanced rectal cancer treated with neo-adjuvant radiochemotherapy followed by surgical resection. To evaluate the prognostic value of the CRP level for clinical endpoints recurrence-free survival (RFS), local-regional control (LC), metastases-free survival (MFS), and overall survival (OS), uni- and multivariate Cox regression analyses were applied, and survival rates were calculated using Kaplan–Meier analysis. The median follow-up time was 73 months. In univariate analyses, the pre-treatment CRP level was a significant predictor of RFS (hazard ratio (HR) 1.015, 95% CI 1.006–1.023; p < 0.001), LC (HR 1.015, 95% CI 1.004–1.027; p = 0.009), MFS (HR 1.014, 95% CI 1.004–1.023; p = 0.004), and OS (HR 1.016, 95% CI 1.007–1.024; p < 0.001). Additionally, univariate analysis identified the MRI circumferential resection margin (mrCRM) and pre-treatment carcinoembryonic antigen (CEA) as significant predictor of RFS (HR 2.082, 95% CI 1.106–3.919; p = 0.023 and HR 1.005, 95% CI 1.002–1.008; p < 0.001). Univariate analysis also revealed a significant association of the mrCRM (HR 2.089, 95% CI 1.052–4.147; p = 0.035) and CEA (HR 1.006, 95% CI 1.003–1.008; p < 0.001) with MFS. Age and CEA were prognostic factors for OS (HR 1.039, 95% CI 1.013–1.066; p = 0.003 and HR 1.005, 95% CI 1.002–1.008; p < 0.001). In multivariate analysis that included parameters with a p-level < 0.20 in univariate analysis, the pre-treatment CRP remained a significant prognostic factor for RFS (HR 1.013, 95%CI 1.001–1.025; p = 0.036), LC (HR 1.014, 95% CI 1.001–1.027; p = 0.031), and MFS (HR 1.013, 95% CI 1.000–1.027; p = 0.046). The results support the hypothesis that an elevated pre-treatment CRP level is a predictor of poor outcome. If confirmed by additional studies, this easily measurable biomarker could contribute to the identification of patients who might be candidates for more aggressive local or systemic treatment approaches or the administration of anti-inflammatory drugs.
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Vankadara S, K P, Balmuri PK, G N, G VR. Evaluation of Serum C-Reactive Protein Levels in Oral Premalignancies and Malignancies: A Comparative Study. JOURNAL OF DENTISTRY (TEHRAN, IRAN) 2018; 15:358-364. [PMID: 30842796 PMCID: PMC6399459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVES The aim was to evaluate and compare pretreatment serum C-reactive protein (CRP) levels in patients with oral premalignancies and malignancies with that in healthy controls. MATERIALS AND METHODS The study sample consisted of 90 patients of both genders. The subjects were divided into three groups. Group I comprised 30 healthy controls, while group II included 30 patients with potential oral malignancies including leukoplakia, oral submucous fibrosis (OSMF), and oral lichen planus (OLP), and group III included 30 squamous cell carcinoma (SCC) patients confirmed by histopathological examination. All samples were subjected to CRP analysis. Serum CRP levels were quantitatively determined using the automated immunoturbidimetric method. RESULTS In group I, CRP levels were ranging from 0.1 to 18.3 mg/l with the mean ± standard deviation (SD) CRP level of 3.88±4.50 mg/l. In group II, CRP levels were ranging from 0.8 to 53.9 mg/l with the mean ± SD CRP level of 5.59±9.86 mg/l. In group III, CRP levels were ranging from 3.3 to 96 mg/l with the mean ± SD CRP level of 31.72±31.01 mg/l. CONCLUSIONS According to the results, prediagnostic concentrations of CRP are associated with subsequent development of oral cancer and suggest that plasma CRP level is a potential marker of increased risk of cancer.
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Affiliation(s)
- Sairam Vankadara
- Professor and Head, Department of Oral Medicine, G. Pulla Reddy Dental College and Hospital, Kurnool, Andhra Pradesh, India,Corresponding author: S. Vankadara, Department of Oral Medicine, G. Pulla Reddy Dental College and Hospital, Kurnool, Andhra Pradesh, India
| | - Padmaja K
- Postgraduate Student, Department of Oral Medicine & Radiology, G Pullareddy Dental College & Hospital, Kurnool, Andhra Pradesh, India
| | - Praveen Kumar Balmuri
- Professor, Department of Oral Medicine & Radiology, G Pullareddy Dental College & Hospital, Kurnool, Andhra Pradesh, India
| | - Naresh G
- Reader, Department of Oral Medicine & Radiology, G Pullareddy Dental College & Hospital, Kurnool, Andhra Pradesh, India
| | - Vikas Reddy G
- Senior Lecturer, Department of Oral Medicine & Radiology, G Pullareddy Dental College & Hospital, Kurnool, Andhra Pradesh, India
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6
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Ghazi-Khanloosani M, Bandegi AR, Kokhaei P, Barati M, Pakdel A. CRP and LOX-1: a Mechanism for Increasing the Tumorigenic Potential of Colorectal Cancer Carcinoma Cell Line. Pathol Oncol Res 2018; 25:1467-1475. [PMID: 30368730 DOI: 10.1007/s12253-018-0507-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 10/15/2018] [Indexed: 12/12/2022]
Abstract
Chronic inflammation and dyslipidemia are associated with an increase in the incidence of colorectal cancer (CRC). Serum C- reactive protein (CRP) and oxidized low-density lipoprotein (oxLDL), as Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) ligands, increase during inflammation and dyslipidemia, respectively. To evaluate the effects of CRP on the expression of important genes involved in the development of CRC, the CRC cell line, LS174T, was treated with the commercial CRP. Based on the Real-time PCR data, in the presence of CRP, LOX-1, CEA, MMP1, and MMP2 mRNA expression significantly increased, compared to the control group. Moreover, in the presence of CRP, secretion, and expression of CEA in the cell lysate and conditioned media increased in a concentration-dependent manner. The results of flow cytometry showed that expression of LOX-1 receptors at the cell surface increased significantly in the presence of 10 mg/L of CRP. However, inhibition of LOX-1 receptors with a specific monoclonal antibody reduced the effects of CRP on protein/mRNA expression. In conclusion, Increased CRP level, can potentially elevate the expression of important genes in CRC by stimulating LOX-1 receptors.
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Affiliation(s)
- Mousa Ghazi-Khanloosani
- Department of Biochemistry, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Ahmad Reza Bandegi
- Department of Biochemistry, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.,Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Parviz Kokhaei
- Cancer Research Center and Department of Immunology, Semnan University of Medical Sciences, Semnan, Iran.,Immune and Gene Therapy Lab, Cancer Centre Karolinska, Karolinska University Hospital, Stockholm, Sweden
| | - Mehdi Barati
- Cancer Research Center and Department of Immunology, Semnan University of Medical Sciences, Semnan, Iran
| | - Abbas Pakdel
- Department of Biochemistry, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran. .,Nervous System Stem Cells Research Center, Semnan University of Medical Sciences, Semnan, Iran.
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Kim WR, Han YD, Min BS. C-Reactive Protein Level Predicts Survival Outcomes in Rectal Cancer Patients Undergoing Total Mesorectal Excision After Preoperative Chemoradiation Therapy. Ann Surg Oncol 2018; 25:3898-3905. [PMID: 30288654 DOI: 10.1245/s10434-018-6828-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Systemic inflammatory response, as measured by C-reactive protein (CRP), is associated with prognosis in various types of human malignancies. However, to the best of our knowledge, the clinical significance of CRP in patients with locally advanced rectal cancer that undergo preoperative chemoradiation has not been investigated in detail. This retrospective study validates CRP as a potential predictive marker for survival outcomes in rectal cancer patients. METHODS In this study, we enrolled 125 patients that received total mesorectal excision after preoperative chemoradiation for rectal cancer between January 2003 and December 2010. We investigated the association between preoperative CRP and clinicopathological characteristics and assessed the prognostic value of CRP. RESULTS The median follow-up was 41 months. Elevated CRP showed significant correlation with high histological grade (P = 0.009) and cancer recurrence (P = 0.027). The 5-year disease-free survival and cancer-specific survival were significantly lower in the elevated CRP group (P = 0.001). Moreover, CRP was the strongest predictive factor for cancer-specific survival in multivariate analysis (P = 0.001). In the subgroup analysis, elevated CRP was a significant prognostic factor in patients with node-positive disease (P = 0.025) and was associated with poorer tumor regression (TRG4-5; P = 0.011). CONCLUSIONS The results of our study suggest that preoperative CRP level shows prognostic significance in rectal cancer patients that have undergone chemoradiation. Therefore, preoperative CRP may help clinicians to identify patients that need additional therapy to reduce systemic failure.
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Affiliation(s)
- Woo Ram Kim
- Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi, Korea.,Department of Surgery, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
| | - Yoon Dae Han
- Department of Surgery, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
| | - Byung Soh Min
- Department of Surgery, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.
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Casadei Gardini A, Carloni S, Scarpi E, Maltoni P, Dorizzi RM, Passardi A, Frassineti GL, Cortesi P, Giannini MB, Marisi G, Amadori D, Lucchesi A. Prognostic role of serum concentrations of high-sensitivity C-reactive protein in patients with metastatic colorectal cancer: results from the ITACa trial. Oncotarget 2016; 7:10193-202. [PMID: 26848624 PMCID: PMC4891113 DOI: 10.18632/oncotarget.7166] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 01/24/2016] [Indexed: 11/25/2022] Open
Abstract
Serum levels of C-reactive protein are (CRP) higher in patients with neoplastic conditions and numerous studies have been performed to clarify the etiologic and prognostic role of the high-sensitivity CRP (hs-CRP) in cancer. Our study was conducted on patients enrolled in the prospective randomized “Italian Trial in Advanced Colorectal Cancer (ITACa)” to assess hs-CRP levels and their impact on overall survival (OS) and progression-free survival (PFS). Serum samples from 132 ITACa patients were collected at baseline and 2 months after starting first-line chemotherapy. The supernatant was immediately transferred to cryovials and stored at −80°C. After thawing, hs-CRP was measured with the Cobas c501 analyzer. High levels of hs-CRP (≥ 13.1 mg/L) were associated with poorer median PFS (p < 0.0001) and OS (p < 0.0001) than low hs-CRP levels (< 13.1 mg/L). hs-CRP values in 107 patients were evaluated again after 2 months of therapy, revealing that patients with low hs-CRP levels in both baseline and second serum samples had the best median PFS and OS. Our study confirms the prognostic value of hs-CRP in patients with metastatic colorectal carcinoma.
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Affiliation(s)
- Andrea Casadei Gardini
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Silvia Carloni
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Emanuela Scarpi
- Unit of Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | | | | | - Alessandro Passardi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Giovanni Luca Frassineti
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Pietro Cortesi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Maria Benedetta Giannini
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Giorgia Marisi
- Biosciences Laboratory, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Dino Amadori
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Alessandro Lucchesi
- Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
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Metabolic syndrome contributes to an increased recurrence risk of non-metastatic colorectal cancer. Oncotarget 2016; 6:19880-90. [PMID: 26082438 PMCID: PMC4637327 DOI: 10.18632/oncotarget.4166] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 06/01/2015] [Indexed: 12/16/2022] Open
Abstract
Objectives Epidemiological data suggests a close link between metabolic syndrome (MetS) and non-metastatic colorectal cancer (NMCRC). However, the relationship between MetS and the outcome of NMCRC is less well understood. We aim to evaluate the impact of MetS on the prognosis in NMCRC patients. Methods We performed a large cohort study of 1069 NMCRC patients. The Kaplan-Meier method was used to calculate the cumulative survival rate. Cox proportional hazard regression models were used to analyze the prognosis associated with MetS adjusting for clinicopathologic variables. Results MetS was identified in 20.7% of NMCRC patients. Patients with MetS were more likely to be older, higher levels of blood glucose, triglycerides, high density lipoprotein, and uric acid than patients without MS (P < 0.05 for all). During a mean period of 59.6 months follow-up, patients with MetS had a statistically significantly lower rate of disease-free survival (DFS) than the patients without MetS (P = 0.014), especially local recurrence (P = 0.040). However, there was no difference in overall survival (P = 0.116). Multivariate analysis showed that the presence of MetS was an independent risk factor for DFS (HR = 0.733, 95%CI 0.545–0.987, P = 0.041), but not for OS (P = 0.118). Conclusions MetS is associated with an increased recurrence risk of NMCRC.
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Zhang ZD, Li X, Lu C. Prognostic value of C-reactive protein in patients with colorectal cancer: Meta-analysis. Shijie Huaren Xiaohua Zazhi 2016; 24:2093-2101. [DOI: 10.11569/wcjd.v24.i13.2093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the association between prognosis and C-reactive protein (CRP) in patients with colorectal cancer.
METHODS: We systematically searched the relevant studies assessing prognostic value of C-reactive protein in patients with colorectal cancer in PubMed and Embase database (up to May 2015). This meta-analysis was completed with hazard ratio (HR) and 95% confidence intervals (CI) as effect measures, using Stata12.0 software. Subgroup and sensitivity analyses were also performed.
RESULTS: Twenty-one eligible studies were included in the present meta-analysis, including 4242 patients with colorectal cancer. Our results showed that elevated CRP was associated with poor survival in patients with colorectal cancer (overall survival: HR = 1.89, 95%CI: 1.52-2.35, P < 0.001; cancer-specific survival: HR = 2.08, 95%CI: 1.42-3.04, P < 0.001; disease-free survival: HR = 1.44, 95%CI: 1.25-1.67, P < 0.001). The subgroup analyses based on the sampling time, sample size and study region obtained similar results. Moreover, sensitivity analyses confirmed the stability of our results.
CONCLUSION: Our meta-analysis indicates that CRP is significantly associated with a poor prognosis for patients with colorectal cancer.
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Perineural Invasion is a Strong Prognostic Factor in Colorectal Cancer: A Systematic Review. Am J Surg Pathol 2016; 40:103-12. [PMID: 26426380 DOI: 10.1097/pas.0000000000000518] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Perineural invasion (PNI) is a possible route for metastatic spread in various cancer types, including colorectal cancer (CRC). PNI is linked to poor prognosis, but systematic analyses are lacking. This study systematically reviews the frequency and impact of PNI in CRC. A literature search was performed using PubMed database from inception to January 1, 2014. Data were analyzed using Review Manager 5.3. A quality assessment was performed on the basis of modified REMARK criteria. Endpoints were local recurrence (LR), 5-year disease-free survival (5yDFS), 5-year cancer-specific survival (5yCSS), and 5-year overall survival (5yOS). Meta-analysis was performed in terms of risk ratios (RR) and hazard ratios (HR) with 95% confidence interval (95% CI). In this meta-analysis, 58 articles with 22,900 patients were included. PNI was present in 18.2% of tumors. PNI is correlated with increased LR (RR 3.22, 95% CI, 2.33-4.44) and decreased 5yDFS (RR 2.35, 95% CI, 1.66-3.31), 5yCSS (RR 3.61, 95% CI, 2.76-4.72), and 5yOS (RR 2.09, 95% CI, 1.68-2.61). In multivariate analysis PNI remains an independent prognostic factor for 5yDFS, 5yCSS, and 5yOS (HR 2.35, 95% CI, 1.97-3.08; HR 1.91, 95% CI, 1.50-2.42; and HR 1.85, 95% CI, 1.63-2.12, respectively). We confirmed the strong impact of PNI for LR and survival in CRC. The prognostic value of PNI is similar to that of well-established prognostic factors as depth of invasion, differentiation grade, lymph node metastases, and lymphatic and extramural vascular invasion. Therefore, PNI should be one of the factors in the standardized reporting of CRC and might be considered a high-risk feature.
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A New Prognostic Score Supporting Treatment Allocation for Multimodality Therapy for Malignant Pleural Mesothelioma. J Thorac Oncol 2015; 10:1634-41. [DOI: 10.1097/jto.0000000000000661] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Lin MS, Huang JX, Yu H. Prognostic significance of Glasgow prognostic score in patients with stage II colorectal cancer. Int J Clin Exp Med 2015; 8:19138-19143. [PMID: 26770545 PMCID: PMC4694445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 10/10/2015] [Indexed: 06/05/2023]
Abstract
Glasgow prognostic score (GPS), one information based prognostic score, has been previously shown to be a prognostic factor in varieties cancers mostly in advanced tumors. This study aimed to explore its value in patients with relatively early stage colorectal cancer (CRC). A total of 99 CRC patients with stage II from 2005 to 2010 operated in our hospital were enrolled in this study. C-reactive protein (CRP), albumin (ALB), Karnofsky Performance Status (KPS) score as well as a variety of biochemical variables before the operation was acquired from the database retrospectively. The value of GPS was calculated and its association with the clinical factors was further investigated. The prognostic significance was analyzed by univariate and multivariate analyses. Increased preoperative GPS was found associated with elevated carcinoembryonic antigen (CEA) and decreasing of KPS. Kaplan-Meier analysis and log-rank test revealed that a higher GPS predicted a higher risk of postoperative mortality in stage II CRC (P < 0.001). Furthermore, multivariate analysis demonstrated the GPS to be a risk factor for postoperative mortality (HR 3.215; P=0.025). The preoperative GPS might be a potential useful indicator for postoperative survival in patients with stage II CRC.
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Affiliation(s)
- Mao-Song Lin
- Department of Gastroenterology, Taizhou People’s HospitalTaizhou, Jiangsu Province, P. R. China
| | - Jun-Xing Huang
- Department of Oncology, Taizhou People’s HospitalTaizhou, Jiangsu Province, P. R. China
| | - Hong Yu
- Department of Pathology, Taizhou People’s HospitalTaizhou, Jiangsu Province, P. R. China
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Yang Y, Huang X, Sun J, Gao P, Song Y, Chen X, Zhao J, Wang Z. Prognostic value of perineural invasion in colorectal cancer: a meta-analysis. J Gastrointest Surg 2015; 19:1113-22. [PMID: 25663635 DOI: 10.1007/s11605-015-2761-z] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 01/21/2015] [Indexed: 01/31/2023]
Abstract
BACKGROUND The prognostic value of perineural invasion (PNI) in colorectal cancer (CRC) does not reach a consensus. METHODS A comprehensive literature search for relevant reports published up to October 2014 was performed using the electronic databases: PubMed, Embase, and Web of Science. The pooled hazard ratio (HR) with 95 % confidence intervals (CI) was used to estimate the prognostic effects. RESULT Thirty-eight studies comprising 12,661 CRC patients were analyzed. Our results showed that PNI is significantly associated with poor prognosis in OS (overall survival) (HR = 2.07, 95 % CI = 1.87-2.29, P < 0.01) and DFS (disease-free survival) (HR = 2.23, 95 % CI = 1.79-2.78, P < 0.01). There was no significant prognostic difference in DFS between stage II CRC patients with PNI(+) and stage III patients (HR = 1.67, 95 % CI = 0.53-5.25, P = 0.38). Further subgroup analysis revealed that the significance of the association between PNI and worse prognosis in CRC patients is not affected by many factors, including geographic setting, PNI positive rate, treatment, TNM stage, tumor site, and quality of the study. CONCLUSIONS The meta-analysis indicates that PNI is a poor prognostic factor in CRC patients. The postoperative survival of stage II CRC patients with PNI(+) is probably more similar to that of stage III patients. Currently available adjuvant therapy should be considered in stage II CRC patients with PNI(+).
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Affiliation(s)
- Yuchong Yang
- Department of Surgical Oncology and General Surgery, First Hospital of China Medical University, 155 North Nanjing Street, Heping District, Shenyang City, 110001, People's Republic of China
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Zeng YC, Wu R, Xiao YP, Chi F, Xue M, Zhang ZY, Xing R, Zhong WZ, Wang SL, Tian X, Chen W, Chen JJ, Wu LN. Serum C-reactive protein predicts poor prognosis in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy. ACTA ACUST UNITED AC 2015; 22:20-4. [PMID: 25684985 DOI: 10.3747/co.22.2178] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND We aimed to evaluate the association of serum C-reactive protein (crp) with prognosis in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy. METHODS We retrospectively reviewed 79 patients with locoregionally advanced nasopharyngeal carcinoma (cT3-4N0-3M0) treated with chemoradiotherapy. Chemoradiotherapy consisted of external-beam radiotherapy to the nasopharynx (70-80 Gy), the lymph node-positive area (60-70 Gy), and the lymph node-negative area (50-60 Gy) combined with 3 cycles of various platinum-based regimens delivered at 3-week intervals. Elevated crp was defined as more than 8 mg/L. The survival rate was calculated using the Kaplan-Meier method, and univariate and multivariate analyses (Cox proportional hazards model) were used to identify factors significantly associated with prognosis. RESULTS During the median follow-up of 3.9 years (range: 1-5.5 years), 23 patients died from nasopharyngeal cancer. The 5-year cancer-specific survival (css) rate was 62.90%. Before chemoradiotherapy, 18 patients had high serum crp; the css rate in that subgroup was significantly worse than the rate in the remaining patients (p = 0.0002). Multivariate analysis showed that crp was an independent prognostic indicator of css, with a hazard ratio of 3.04 (95% confidence interval: 1.22 to 7.55; p = 0.017). Among the 18 patients with elevated serum crp, 9 achieved normal serum crp after chemoradiotherapy, of whom 5 remained living with no evidence of recurrence or metastasis during follow-up. By contrast, the remaining 9 patients in whom serum crp did not normalize after chemoradiotherapy died within 4.2 years. CONCLUSIONS Elevated serum crp before treatment predicts poor prognosis in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy.
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Affiliation(s)
- Y C Zeng
- Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China
| | - R Wu
- Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China
| | - Y P Xiao
- Cancer Insititute, No. 1 Hospital of China Medical University, Shenyang, PR China
| | - F Chi
- Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China
| | - M Xue
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, PR China
| | - Z Y Zhang
- Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China
| | - R Xing
- Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China
| | - W Z Zhong
- Lung Cancer Research Institute and Cancer Center, Guangdong Provincial People's Hospital, Guangzhou, PR China
| | - S L Wang
- Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China
| | - X Tian
- Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China
| | - W Chen
- Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China
| | - J J Chen
- Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China
| | - L N Wu
- Department of Medical Oncology, Shengjing Hospital of China Medical University, Shenyang, PR China
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Mineo TC, Tacconi F. Role of systemic inflammation scores in pulmonary metastasectomy for colorectal cancer. Thorac Cancer 2014; 5:431-7. [PMID: 26767035 DOI: 10.1111/1759-7714.12114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 03/19/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Patients with pulmonary metastases from colorectal cancer can benefit from surgical removal. However, the biological determinants of postsurgical outcome are not completely elucidated. We evaluated the role of host systemic inflammation status in this setting. METHODS The modified Glasgow prognostic score (based on serum C-reactive protein and albumin levels) and the neutrophil-to-lymphocyte (NTL) ratio were obtained from 44 patients who received curative-intent metastasectomy, and were used as indicators of systemic inflammation status. We tested the impact of both of these parameters on overall survival (OS) and progression-free survival (PFS), as well as their correlation with other well-known prognosticators. RESULTS Five-year PFS and OS rates were 18% and 49%, respectively. At univariate analysis, multiple metastases, disease-free interval <36 months, and a Glasgow score of 2 (P = 0.031) were significantly associated to a worse PFS rate. A NTL ratio >3 predicted disease progression in the short-term (P = 0.036), but the effect on late events was weaker (P = 0.079). Factors associated with worse OS were multiple metastasis (P = 0.002), elevated carcinoembryonic antigen (P = 0.009), a Glasgow score of 2 (P = 0.029), and a faster metastasis growth (P = 0.008). At Cox regression analysis, neither a Glasgow score of 2, nor elevated NTL ratio showed an independent effect on survival rates. CONCLUSIONS Systemic inflammation scores did not perform well as independent survival prognosticators in patients undergoing curative-intent pulmonary metastasectomy. Further investigation is warranted to evaluate whether these measurements could still be useful when restricting the analysis to specific patient subcategories or to diverse postoperative phases.
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Affiliation(s)
- Tommaso Claudio Mineo
- Division of Thoracic Surgery, Department of Thoracic Surgery, Tor Vergata University Rome, Italy
| | - Federico Tacconi
- Division of Thoracic Surgery, Department of Thoracic Surgery, Tor Vergata University Rome, Italy
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Prognostic significance of the preoperative serum C-reactive protein level in patients with stage IV colorectal cancer. Surg Today 2014; 45:315-21. [PMID: 24817059 DOI: 10.1007/s00595-014-0909-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 04/01/2014] [Indexed: 12/27/2022]
Abstract
PURPOSE Previous studies have revealed that an elevated preoperative serum C-reactive protein (CRP) level is associated with a poor prognosis in patients with various malignant tumors. The aim of this study was to determine the clinical significance of the preoperative serum CRP level in patients with stage IV colorectal cancer. METHODS We enrolled 144 patients who underwent surgery for stage IV colorectal cancer. A total of 53 patients with a serum CRP level of ≥ 1.0 mg/dl were classified as the high CRP individuals. The association between the preoperative serum CRP level and survival was retrospectively assessed. RESULTS The cancer-specific survival of the patients with a high CRP level was significantly worse than that of the patients with a low CRP level. A multivariate analysis indicated that the curability (non-curative surgery), the number of organs with metastasis (more than one organ), the tumor diameter (≥ 5 cm), lymphatic involvement, histological differentiation (non-differentiated) and a high CRP level (≥ 1.0 mg/dl) were independent risk factors for a poor survival. CONCLUSIONS A high preoperative serum CRP level is a convenient biomarker for identifying patients with a poor prognosis for stage IV colorectal cancer.
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Chen XL, Liao YQ, Liu JR. Genotype CC of rs1800947 in the C-Reactive Protein Gene May Increase Susceptibility to Colorectal Cancer: a Meta-Analysis. Asian Pac J Cancer Prev 2014; 15:2663-7. [DOI: 10.7314/apjcp.2014.15.6.2663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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