Clinical Value of C-reactive Protein and Erythrocyte Sedimentation Rate in Advanced Bladder Cancer

Abstract

Background: The identification of biomarkers would improve the management of advanced urinary bladder carcinoma. Aim: The current study assessed the potential prognostic role of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in advanced stage bladder cancer. Methods: Forty-six patients with advanced urinary bladder carcinoma were included in the study. After consent, CRP and ESR were measured before treatment, after 2 cycles of chemotherapy and at the end of treatment. The relation between CRP and ESR serum measurements and patients' characteristics and treatment response were assessed. Results: Both CRP and ESR were elevated in all included patients with mean values ± standard deviation: 35.43 ± 12.65 and 57.17 ± 18.15, respectively. The baseline CRP level was higher in patients with metastatic disease. ESR was significantly elevated in association with squamous cell carcinoma pathology and hydronephrosis and in patients who died within one year of diagnosis (p = 0.003, 0.001 and 0.03; respectively). Patients who experienced disease progression after 2 cycles of platinum-based chemotherapy had higher levels of CRP and ESR. Serial measurements during the course of treatment revealed that both CRP and ESR levels declined significantly during treatment mainly among responding patients (p = 0.001). Conclusion: CRP and ESR might be useful noninvasive biomarkers in advanced urinary bladder carcinoma.