Abstract P6-08-06: C-Reactive Protein Expression and Its Association with Disease Specific Survival and Disease Recurrence in ER Negative Breast Cancer Patients

Abstract

Abstract Background: The systemic inflammatory response, as evidenced by elevated serum C-reactive protein (CRP) has been reported to be predictive of poor survival, independent of tumour stage, in a variety of solid tumours (1). Previous studies suggest that systemic elevated serum CRP did not predict relapse-free, cancer-specific (DSS) nor overall survival (2). Aim of this study was to examine the relationship between expression of CRP within ER negative breast cancers and patients’ clinical outcome. Methods: Tissue microarray technology was employed to analyse tissue taken from 171 ER negative breast cancer patients at time of surgery. Immunohistochemistry was performed using an antibody to CRP. Expression was assessed using the weighted histoscore method by two independent scorers. Results: Cohort's median age was 56 years and tumour size was 20mm, 22% were pathologically graded G2 and 74% G3 and 46% were lymph node positive. 60% underwent a mastectomy, 56% received radiotherapy and 67% chemotherapy. 33% had recurrence after a median time of 5.6 years. 47/171 patient were deceased at time of analysis. There was a definitive trend noticed between high nuclear and cytoplasmic CRP expression and DSS (p=0.078 and p=0.173, figure 1a and 1b) and recurrence (p=0.133, p=0.253, figure 2a and 2b). There was a significant association seen with high CRP expression in the surrounding tumoural stroma and DSS (p=0.007) as well as recurrence (p=0.016). Conclusion: Due to small patient numbers only trends indicating that high CRP expression within and surrounding the tumour play an important role in ER negative patients regards poorer survival and earlier recurrence. We are currently expanding our cohort further.