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Slight elevation of high‐sensitivity C ‐reactive protein to predict recurrence and survival in patients with early stage hepatitis C ‐related hepatocellular carcinoma
Author(s) -
Fujiwara Naoto,
Tateishi Ryosuke,
Nakagawa Hayato,
Nakagomi Ryo,
Kondo Mayuko,
Minami Tatsuya,
Sato Masaya,
Uchino Koji,
Enooku Kenichiro,
Kondo Yuji,
Asaoka Yoshinari,
Shiina Shuichiro,
Yoshida Haruhiko,
Koike Kazuhiko
Publication year - 2015
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12398
Subject(s) - hepatocellular carcinoma , medicine , gastroenterology , hazard ratio , confidence interval , proportional hazards model , confounding , c reactive protein , stage (stratigraphy) , survival analysis , inflammation , paleontology , biology
Aim Hepatocellular carcinoma ( HCC ) is associated with chronic inflammation derived from various origins. We investigated whether high‐sensitivity C ‐reactive protein (hs CRP ) could predict recurrence and survival after curative treatment for early stage hepatitis C virus‐related HCC ( C ‐ HCC ). Methods We enrolled 387 patients with three or fewer C ‐ HCC nodules, none of which exceeded 3 cm, and of C hild– P ugh class A or B who underwent radiofrequency ablation. We divided the patients into high and low hs CRP groups based on the optimal cut‐off value for recurrence using a split‐sample method and maximally selected rank statistics. Differences in recurrence and survival rates were evaluated by the K aplan– M eier method and the log–rank test. Hazard ratios of hs CRP were adjusted with confounding factors using a multiple C ox regression model. We also assessed the correlations between hs CRP levels and clinical parameters.Results The optimal hs CRP cut‐off value was 0.08 mg/dL. The cumulative recurrence rates after 5 years in the high and low hs CRP groups were 90.0% and 82.2%, respectively ( P = 0.028), and the corresponding survival rates were 50.9% and 71.8%, respectively ( P < 0.001). Higher hs CRP was an independent predictor for recurrence (adjusted hazard ratio [a HR ], 1.32; 95% confidence interval [ CI ], 1.03–1.67; P = 0.026) and survival (a HR , 1.59; 95% CI , 1.14–2.22; P = 0.007). hs CRP was correlated with central obesity as well as tumor burden and liver dysfunction. Conclusion Slight elevation of the hs CRP level, even within the normal range, can predict recurrence and survival after curative treatment among patients with early stage C ‐ HCC .