Serum C‐reactive protein levels predict survival in hepatocellular carcinoma

Nagaoka, Sakae; Yoshida, Takafumi; Akiyoshi, Junji; Akiba, Jun; Torimura, Takuji; Adachi, Hisashi; Kurogi, Junichi; Tajiri, Nobuyoshi; Inoue, Kinya; Nishizaki, Takashi; Koga, Hironori; Imaizumi, Tsutomu; Kojiro, Masamichi; Sata, Michio

doi:10.1111/j.1478-3231.2007.01550.x

Cited by 87 publications

(72 citation statements)

References 30 publications

(32 reference statements)

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“…One patient received TACE with drug-eluting beads. The patients received a median number of three TACE cycles (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Second-line therapies after TACE included best supportive care (n ¼ 118), local-ablative intervention (radiofrequency ablation: n ¼ 13, percutaneous ethanol injection: n ¼ 1, radiation therapy: n ¼ 1), and medical treatment (sorafenib: n ¼ 7 and other therapies: n ¼ 9).…”

Section: Resultsmentioning

confidence: 99%

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Single determination of C-reactive protein at the time of diagnosis predicts long-term outcome of patients with hepatocellular carcinoma

et al. 2013

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We investigated the prognostic value of C-reactive protein (CRP) in patients with hepatocellular carcinoma (HCC) not amenable to surgery. A total of 615 patients diagnosed with HCC not amenable to surgery between April 1999 and December 2009 at the Department of Gastroenterology of the Medical Universities of Vienna and Innsbruck were included. We assessed the optimal CRP cutoff by regression spline analysis and tested its impact on median overall survival (OS) by the Kaplan-Meier method, univariate analysis (log-rank test), and multivariate analysis (Cox proportional hazard regression model) in a training cohort (n 5 466, Vienna) and an independent validation cohort (n 5 149, Innsbruck). We found a sigmoid-shaped association of CRP and the hazard ratio of death upon regression spline analysis and defined a CRP level <1/1 mg/dL as optimal cutoff for further survival assessments. Elevated CRP (1 mg/dL) at diagnosis was associated with poor OS (CRP-elevated versus CRP-normal; 4 versus 20 months; P < 0.001) and remained a significant negative predictor for OS upon multivariate analysis (hazard ratio, 1.7; P < 0.001), which was independent of age, Child-Pugh class, tumor characteristics, and treatment allocation. Analyses with respect to Barcelona Clinic Liver Cancer (BCLC) stage and Child-Pugh class supported the relevance of CRP (BCLC-stage C and Child-Pugh A: OS for CRP-elevated versus CRP-normal, 6 versus 14; P < 0.001; BCLC-stage C and Child-Pugh B: OS for CRP-elevated versus CRP-normal, 4 versus 15 months; P < 0.001). The prognostic significance of elevated CRP was reproducible at a second CRP determination timepoint and confirmed in the independent validation cohort. Conclusion: Elevated CRP is associated with a dismal prognosis in HCC patients and may become a useful marker for patient selection in HCC management.

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Section: Resultsmentioning

confidence: 99%

“…In fact, several studies have reported a prognostic value of elevated CRP levels in different types of cancer [8][9][10] including resectable HCC. [11][12][13] In this study we investigated the prognostic value of CRP levels in nonsurgical HCC patients with respect to the BCLC classification.…”

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confidence: 99%

Single determination of C-reactive protein at the time of diagnosis predicts long-term outcome of patients with hepatocellular carcinoma

et al. 2013

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“…Although the physiological role of CRP is unclear, it is considered as a potential predictive biomarker for several pathological conditions [29][30][31][32]. Recently studies have attempted to correlate the serum levels of CRP with the prognosis of HCC patients and the usefulness of CRP as a tumor marker in HCC patients is debatable [33,34]. In present study we observed the elevated level of CRP in the chronic patients in comparison to controls but without any correlation with viral loads of both HBV and HCV groups (Table 3; Figs.…”

Section: Discussionmentioning

confidence: 99%

Circulating Biomarkers and their Possible Role in Pathogenesis of Chronic Hepatitis B and C Viral Infections

et al. 2011

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The present study evaluated the plausible role of circulating biomarkers in immune pathogenesis of chronic hepatitis considered a priority in clinical hepatology. Total viral load of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) patients was quantified and correlation studies were performed with circulating levels of Th1/Th2 cytokines; C reactive protein and circulating nucleosomes; glutathione reductase (GR) and superoxide dismutase. To our knowledge, the study is first among its kind that validates strong positive correlation of viral load with IL-4, IL-6, GR in HBV and IL-6, IL-10, GR in HCV infections. Although, multi-centric studies including large cohorts are required for translating our findings to clinical practice, however, role of these biomarkers with potential diagnostic or prognostic significance might be helpful in clinical assessment of high-risk individuals, thereby, designing interventional strategies, towards development of personalized medicare. The results of our study also offer valuable insights of immune signaling mediators engaged in development of hepatocellular carcinoma.

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“…6 An association between elevated CRP and markers for cardiovascular risk was reported in children as well. [7][8][9][10] In addition, increased CRP has been associated with cancer 11,12 and has shown to be a prognostic marker in various malignancies in adults, [13][14][15] whereas data in children are scarce. Furthermore, elevated CRP levels are associated with an increased risk of type 2 diabetes in adults 16 and are correlated with insulin resistance in children.…”

Section: Introductionmentioning

confidence: 99%

C-reactive protein reference percentiles among pre-adolescent children in Europe based on the IDEFICS study population

et al. 2014

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on behalf of the IDEFICS consortium OBJECTIVES: C-reactive protein (CRP) is involved in a wide range of diseases. It is a powerful marker for inflammatory processes used for diagnostic and monitoring purposes. We aimed to establish reference values as data on the distribution of serum CRP levels in young European children are scarce. SUBJECTS: Reference values of high-sensitivity CRP concentrations were calculated for 9855 children aged 2.0-10.9 years, stratified by age and sex. The children were recruited during the population-based European IDEFICS study (Identification and prevention of Dietary-and lifestyle-induced health Effects in Children and infantS) with 18 745 participants recruited from 2007 to 2010. RESULTS: In 44.1 % of the children, CRP values were below or equal the detection limit of 0.2 mg/l. Median CRP concentrations showed a slight negative age trend in boys and girls, whereas serum CRP values were slightly higher in girls than in boys across all age groups. CONCLUSIONS: Our population-based reference values of CRP may guide paediatric practice as elevated values may require further investigation or treatment. Therefore, the presented reference values represent a basis for clinical evaluation and for future research on risk assessment of diseases associated with increased CRP levels among children.

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Serum C‐reactive protein levels predict survival in hepatocellular carcinoma

Abstract: The prognosis of H-CRP-positive patients was poorer compared with H-CRP-negative patients. This study confirmed that H-CRP, like CRP, is a marker of poor prognosis in HCC patients.

Cited by 87 publications

References 30 publications

Single determination of C-reactive protein at the time of diagnosis predicts long-term outcome of patients with hepatocellular carcinoma

Single determination of C-reactive protein at the time of diagnosis predicts long-term outcome of patients with hepatocellular carcinoma

Circulating Biomarkers and their Possible Role in Pathogenesis of Chronic Hepatitis B and C Viral Infections

C-reactive protein reference percentiles among pre-adolescent children in Europe based on the IDEFICS study population

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