C-Reactive Protein as a Prognostic Biomarker for Gynecologic Cancers: A Meta-Analysis

Abstract

Background. The prognostic role of CRP (C-reactive protein) in gynecological tumors has been previously reported in individual studies, but whether CRP can be used as a separate potential prognostic factor has not been systematically reviewed. The purpose of this research is to determine if there is a link between CRP levels and the prognosis of gynecological cancer patients. Methods. A systematic search was carried out to find the literature evaluating the predictive role of CRP in the prognosis of gynecological cancer patients. For the purpose of determining the relationship between CRP and clinicopathological characteristics, the pooled odds ratio (OR) was calculated. A hazard ratio (HR) with a 95% confidence interval (CI) was used to determine differences in overall survival (OS), disease-free survival (DFS), or progression-free survival (PFS) between patients with low and high CRP levels. Results. A total of 19 studies, including 4062 patients, were analyzed retrospectively. The FIGO stage was related to the CRP level (OR = 0.43, 95% CI: 0.19–1.00). Age, lymph node metastasis, and histological grade were not associated with CRP level (OR = 0.93, 95% CI: 0.69–1.25; OR = 0.91, 95% CI: 0.65–1.28; OR = 0.74, 95% CI: 0.52–1.05). Worse OS (HR = 1.40, 95% CI: 1.23–1.57), DFS (HR = 1.20, 95% CI: 1.12–1.28), and PFS (HR = 1.57, 95%CI: 1.23–1.91) were associated with elevated CRP levels, as shown by the pooled results. Subgroup analysis was performed according to cancer type (endometrial cancer: HR = 1.15, 95% CI: 1.02–1.28; ovarian cancer: HR = 1.67, 95% CI: 1.03–2.31; cervical cancer: HR = 1.42, 95% CI: 1.19–1.64), multivariate value (HR = 1.22, 95% CI: 1.10–1.33), and age (HR = 1.50, 95% CI: 1.28–1.72). Significant correlations were observed between CRP and OS. Conclusions. CRP may be utilized as a prognostic indicator for a variety of gynecologic malignancies, including cervical cancer, ovarian cancer, endometrial cancer, and vulvar cancer.

Prognostic value of baseline C-reactive protein in diffuse large B-cell lymphoma: a systematic review and meta-analysis

“…CRP testing is noninvasive, easy to detect, inexpensive, repeatable, and can track tumor status in real time, making it a hot topic in the emerging field of noninvasive tumor markers. Various meta-analyses have shown that CRP has significant prognostic value for solid tumors, including gynecological tumors ( 24 ), urinary tract tumors ( 25 ), lung cancer ( 26 ), and colorectal cancer ( 27 ). Additionally, CRP is associated with low OS in various tumors, consistent with the results of this meta-analysis, which showed that CRP was associated with low OS in DLBCL.…”

C-Reactive Protein: Pathophysiology, Diagnosis, False Test Results and a Novel Diagnostic Algorithm for Clinicians

“…A recent meta-analysis found that CRP can be used as a possible prognostic indicator for a variety of gynecologic malignancies, such as cervical cancer, ovarian cancer, endometrial cancer, and vulvar cancer [ 839 ]. Yet, a study found that CRP combined with other markers could be beneficial to distinguish leiomyosarcoma from especially degenerated or atypical leiomyoma [ 840 ].…”

Chasing Uterine Cancer with NK Cell-Based Immunotherapies

“…The uterine immune cell number changes cyclically with the menstrual cycle and inflammatory insult. Chronic inflammation without resolution may induce cancer, including endometrial cancer (EC), and systemic inflammatory markers, including C-reactive protein (CRP), serve as prognostic markers [99][100][101]. Hence, systemic and local inflammation may affect predisposition to the EC and its severity.…”