Prognostic Significance of Pre-treatment Serum C-Reactive Protein Level in Patients with Adenocarcinoma of the Uterine Cervix

Abstract

Cervical cancer is the third most common cancer in women worldwide, with peak incidence in the 40-to 45-year age group (1). Adenocarcinoma of the uterine cervix is a rare histological subtype, representing up to 20% of cervical carcinoma. International Federation of Gynaecology and Obstetrics (FIGO) stage, histological grade, tumour size, lymphovascular space invasion and lymph node metastasis are major prognostic factors reported in literature (1-3). Nevertheless, additional information guiding the patient's management would be helpful. There is much interest in prognostic factors to permit more accurate patient stratification, that will improve clinical decision-making and may contribute to more rational treatment options. Current guidelines for cervical cancer recommend the same treatment regardless of histological subtype, although lower survival rates were reported for the adenocarcinoma subtype (4). Therefore increasing efforts should focus on prognosticators in adenocarcinoma of the uterine cervix.C-Reactive protein (CRP) is widely used in clinical routine as the most important acute-phase serum protein for monitoring infection. CRP has also been shown to be elevated in patients with a variety of cancer types and an association with prognosis was found. Several studies have shown that patients with cancer have a higher level of circulating CRP than healthy controls prior to clinical diagnosis (5-8). In addition, an increase in serum CRP has been reported to be associated with poor prognosis in oesophageal, liver, colon and lung cancer (9-12). Elevated serum CRP levels have also been linked to impaired survival in patients with different gynaecological malignancies, including cervical, ovarian and endometrial cancer (13-15). However, only few studies reported on the prognostic role of CRP expression in cervical carcinoma (14, 16), with no data investigating exclusively the histological subtype adenocarcinoma of the uterine cervix.The aim of the present study was to evaluate whether the pre-treatment serum CRP level might be used as a prognostic parameter in patients with adenocarcinoma of the uterine cervix and to investigate a possible correlation between the serum CRP level and various clinicopathological parameters. 4691

Prognostic value of C-reactive protein/albumin ratio in predicting overall survival of Chinese cervical cancer patients overall survival: comparison among various inflammation based factors

“…Barbara analysed prognostic value of serum CRP in rare histological subtype adenocarcinoma of the uterine cervix. They find that CRP level can be seen as an additional independent prognostic parameter in patients with the rare histological subtype adenocarcinoma of the uterine cervix 11 . CRP/Alb was convenient for testing in clinical laboratories 18 , and it was a sensitive, reliable convenient and a low-cost prognostic marker in cervical cancer.…”

“…C-reactive protein albumin (CRP) test is great significance in the early diagnosis, differential diagnosis and observation of curative effects. Suyang Guo et al aslo confirmed the role of CRP in the early diagnosis of cervical cancer recurrence 11 . Several nutrition-based and (or) inflammatory factors have been applied to predict the survival time in many cancers, such as neutrophil/lymphocyte ratio (NLR) 12 , platelet/ lymphocyte ratio (PLR) 16 , C-reactive protein albumin (CRP/Alb) ratio 13 , modified Glasgow prognostic score (mGPS) 14 , prognostic index (PI) 12 and prognostic nutritional index (PNI) 15 .…”

Increased bone marrow SUVmax on 18F-FDG PET is associated with higher pelvic treatment failure in patients with cervical cancer treated by chemoradiotherapy and brachytherapy

“…Several studies have revealed that tumor microenvironment with bone marrow derived proinflammatory cells, such as neutrophils, can promote cancer progression through an increased expression of inflammatory cytokines and growth factors, but also adversely affect response to therapy. [17][18][19] As many studies have found, neutrophil to lymphocyte ratio (NLR), 20 albumin level, 21 c-reactive protein (CRP) level 22 and Glasgow prognostic score (GPS) 23 may also predict the outcome for LACC patients who receive CRT plus IGABT. Additionally, the current hypothesis is that radiotherapy failure is related to increased levels of myeloid-derived suppressor cells.…”

S100A16 Regulates HeLa Cell through the Phosphatidylinositol 3 Kinase (PI3K)/AKT Signaling Pathway

“…The diagnosis and prognosis marker became the main research tendency due to the recurrence rate of cervical cancer. Serum levels of vascular endothelial growth factor [19], C-reactive protein [20], the ratio of serum angiopoietin-1 to angiopoietin-2 [21], and serum protein TKT, human fibrinogen FGA, metabolism-related protein [22], all of these can be a reliable marker for clinical treatment. Similarly, Lon peptidase 2 can be a potential therapeutic target, regulating oxidative damage and peroxidosome homeostasis, changing the proliferation and invasion of cancer cells [23].…”