A systematic review of the association between circulating concentrations of C reactive protein and cancer

Abstract

The objective of this study was to review and summarise the published evidence for an association between circulating concentrations of C reactive protein (CRP) and cancer through a systematic review. 90 discrete studies were identified. 81 (90%) were prevalent case-control or cross-sectional studies, and only 9 studies had a prospective design. In most prevalent studies, CRP concentrations were found to be higher in patients with cancer than in healthy controls or controls with benign conditions. Of the nine large prospective studies identified in this review, four reported no relationship between circulating CRP levels and breast, prostate or colorectal cancers, and five studies found that CRP was associated with colorectal or lung cancers. Most of the studies evaluating CRP as a diagnostic marker of cancer did not present relevant statistical analyses. Furthermore, any association reported in the prevalent studies might reflect reverse causation, survival bias or confounding. The prospective studies provided no strong evidence for a causal role of CRP in cancer. Instead of further prevalent studies, more large prospective studies and CRP gene-cancer association studies would be valuable in investigating the role of CRP in cancer.

Prognostic Role of C-reactive Protein in Gastric Cancer: A Meta-analysis

“…On the other hand, with the progression of cancer, the tumor itself can also trigger regional inflammatory response and release proinflammatory cytokines, which results in the formation of an inflammatory microenvironment (Balkwill et al, 2001;Coussens et al, 2002;Mantovani et al, 2008). Several studies pointed out that the elevated inflammatory response was associated with poor local immune response to the tumor and contributed to the lymph node spread and metastasis through a series of steps, including recruitment of the regulatory T lymphocytes and chemokine, activation of cytokines interleukin-6 and tumor necrosis factor-alpha, induction of neutrophilia, and secretion of CRP (Ulich et al, 1987;Ulich et al, 1989;Heikkila et al, 2007;Crumley et al, 2010).…”

Inflammatory Marker Changes in a Yearlong Randomized Exercise Intervention Trial among Postmenopausal Women

“…To date, most etiologic research surrounding preexisting, low-grade inflammation, and cancer incidence has focused on lung and colon cancers (5). Although the body of epidemiologic evidence relating inflammation specifically to postmenopausal breast cancer risk is more limited (6)(7)(8), the association is plausible given that postmenopausal breast cancer risk is increased with body fatness (9) and decreased with physical activity (9,10), which are 2 factors often related to low-grade inflammation (11).…”

“…Interleukin-6 (IL-6), TNF-a, and C-reactive protein (CRP) are biomarkers of inflammation that have been measured extensively in cardiovascular disease research but only more recently in relation to cancer (5,7,8). CRP is an acute phase protein, primarily hepatocyte derived, that is widely accepted as a sensitive and reliable biomarker of systemic inflammation (13,14), whereas IL-6 and TNF-a are inflammationresponsive and proinflammatory cytokines, respectively, that influence CRP production (1,14).…”

Pre-operative serum C-reactive protein as independent prognostic factor for survival but not infection in patients with high-grade osteosarcoma

“…Thus, the measurement of circulating serum CRP is an important monitor of inflammatory disease in clinical routine [13]. Moreover, there is a rapidly increasing body of evidence that CRP levels can also be elevated in patients with chronic infections, artherosclerosis or malignant disease when compared to healthy controls [14][15][16][17][18]. Additionally, it has been shown that in many cancer types overall survival is strongly linked to and can reliably be predicted by pre-operative serum CRP levels [19].…”