Preoperative C-reactive protein levels are associated with tumor size and lymphovascular invasion in resected non-small cell lung cancer

Abstract

This study focused on the association between preoperative serum C-reactive protein (CRP) levels and pathologic parameters in patients with resected non-small cell lung cancer (NSCLC). Our primary objective was to find pathologic factors that may explain poor prognosis in patients with preoperative serum CRP elevation. The records of 102 patients who had undergone pulmonary resection of NSCLC were reviewed. The association between preoperative serum CRP levels and variables that had p-values of less than 0.05 in t-test or one-way ANOVA was examined using multiple linear regression analysis. Mean serum CRP level prior to surgery was 3.8+/-4.9 (range, 0.1-19.8) mg/dL. The Pearson correlation coefficient indicated that serum CRP level and pathologic tumor diameter are positively correlated (r=0.487, p<0.001). Serum CRP levels were associated with sex (male vs. female, p=0.003), smoking status (smoker vs. never smoker, p=0.007), histology (squamous vs. non-squamous, p=0.001), tumor size (size>3 cm vs. size< or =3, p<0.001), tumor necrosis (yes vs. no, p<0.001), lymphovascular invasion (yes vs. no, p<0.001), and pleural invasion (P0 vs. P1 vs. P2 vs. P3, p=0.013), but not with age (age>64.5 vs. age< or =64.5, p=0.508), atelectasis or obstructive pneumonia (yes vs. no, p=0.119), location of tumor (peripheral vs. central, p=0.474), and lymph node involvement (N0 vs. N1 vs. N2 vs. N3, p=0.558). Multiple linear regression analysis indicated that pathologic tumor size (beta=0.583, p=0.005) and lymphovascular invasion (beta=3.002, p=0.009) were associated with preoperative serum CRP level. Our results indicate that lymphovascular invasion and pathologic tumor size are associated with preoperative serum CRP level, which may be considered a prognostic factor in patients with NSCLC. This additional information might serve as a basis to explain poor prognosis in patients with preoperative serum CRP elevation.