Abstract
ObjectiveScarce information exists on the pathogenesis of thymic epithelial tumors (TETs), comprising thymomas, thymic carcinomas (TCs) and neuroendocrine tumors. C-reactive protein (CRP) increases during certain malignancies. We aimed to investigate the clinical relevance of CRP in patients with TETs.ResultsPretreatment CRP serum concentrations were significantly elevated in patients with TETs, particularly TCs and metastatic TETs. After complete tumor resection CRP serum concentrations were decreased (p = 0.135) but increased significantly in case of tumor recurrence (p = 0.001). High pretreatment CRP was associated with significantly worse 5- and 10-year freedom-from recurrence (FFR) (p = 0.010) and was a negative prognostic factor for FFR (HR 3.30; p = 0.015). IL-6 (not IL-1β) serum concentrations were significantly elevated in patients with TETs but we did not detect CRP tissue expression in TETs.Materials and MethodsPretreatment CRP serum concentrations were retrospectively analyzed from 128 surgical patients (1990–2015). In a subset of 68 patients longitudinal analysis of CRP was performed. Additionally, immunohistochemical tumor CRP expression and serum concentrations of interleukin (IL)-6 and IL-1β were measured.ConclusionsHence, diagnostic measurement of serum CRP might be useful to indicate highly aggressive TETs and to make doctors consider tumor recurrences during oncological follow-up.
Highlights
Thymic epithelial tumors (TETs) are rare malignancies that originate from thymic epithelial cells
Elevated C-reactive protein (CRP) serum concentrations in patients with TETs compared to controls Pretreatment CRP serum concentrations were significantly elevated in patients with TETs (n = 128) compared to sex- and age-matched controls (n = 64) (TETs 1.03 ± 0.3 mg/dL vs. controls 0.16 ± 0.03 mg/dL; p < 0.001; Figure 1A)
Post hoc comparisons revealed significant differences for thymic carcinoma (TC) compared to thymomas (p = 0.001) and TCs compared to controls (p < 0.001; Figure 1B)
Summary
Pretreatment CRP serum concentrations were significantly elevated in patients with TETs, TCs and metastatic TETs. After complete tumor resection CRP serum concentrations were decreased (p = 0.135) but increased significantly in case of tumor recurrence (p = 0.001). High pretreatment CRP was associated with significantly worse 5- and 10-year freedom-from recurrence (FFR) (p = 0.010) and was a negative prognostic factor for FFR (HR 3.30; p = 0.015). IL-6 (not IL-1β) serum concentrations were significantly elevated in patients with TETs but we did not detect CRP tissue expression in TETs
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