Open AccessSerum C-reactive protein is an important and powerful prognostic biomarker in most adult solid tumors
Author(s) -
Shiva Shrotriya,
Declan Walsh,
Amy S. Nowacki,
Cliona Lorton,
Aynur Aktaş,
Barbara Hullihen,
Nabila Benanni-Baiti,
Katherine Hauser,
Serkan Ayvaz,
Bassam Estfan
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0202555
Subject(s) - medicine , cohort , categorical variable , continuous variable , biomarker , oncology , cancer , medical diagnosis , c reactive protein , cohort study , survival analysis , solid tumor , pathology , inflammation , statistics , biochemistry , chemistry , mathematics
Prognostication in cancer is challenging and inaccurate. C-Reactive Protein (CRP), a cheap and sensitive marker of inflammation may help. This study investigated the relationship between CRP and prognosis in a large cohort of solid tumors with mixed cancer diagnoses and stages. Methods Electronic medical records of 4931 adults with solid tumors who attended the Taussig Cancer Institute from 2006–2012 were reviewed. Demographic and clinical characteristics were recorded. Maximum CRP (mCRP) was identified for each individual. CRP was analysed as a time-dependent, continuous and categorical variable for association with survival. Results Two thirds of patients had a high mCRP. This was consistently associated with shorter survival, even after correction for time from diagnosis, and when analysed as a continuous or a categorical variable. When mCRP values above 10 mg/L were subcategorized, a higher mCRP was always worse. Even among those with normal values, statistically and clinically significant shorter survival was noted at mCRP levels >5 mg/L. Conclusions In a large representative cohort of consecutive solid tumor patients the risk of death was clinically and statistically significantly greater with a high mCRP. This was independent of other variables and regardless of statistical method from both dates of diagnosis and test. CRP appeared to be underutilized. Our results support the routine use of CRP as a universal cost-effective independent prognostic indicator in most solid tumors.