Prognostic importance of serum CRP, prealbumin, and transferrin levels in patients with advanced stage esophageal cancer

Abstract

Amac: Bu calismada stent takilarak tedavi edilen ileri evre ozofagus kanserli hastalarda serum C-reaktif protein (CRP), prealbumin ve transferrin duzeylerinin prognostik degeri arastirildi. Ca­lis­ma­ pla­ni:­ Temmuz 2007 ve Aralik 2008 tarihleri arasinda gerceklestirilen prospektif randomize bir calismada lokal olarak ilerlemis hastalik veya uzak organ metastazi nedeniyle stent takilarak tedavi edilen ardisik 61 hastada, stent takilmadan 1-3 gun once serum CRP, prealbumin ve transferrin duzeyleri calisildi. Tum hastalar olunceye kadar takip edildi. Bul gu lar: Stent tum hastalarda basari ile takilarak oral alim tekrar saglandi. Isleme bagli mortalite gozlenmedi. Hastalarin ortalama sagkalim suresi 164.3±120.3 gun (dagilim 15-450 gun) idi. Serum CRP seviyesi ≥10 mg/L olan hastalarda (n=38) ortalama sagkalim 103.2±82.3 gun iken serum CRP seviyesi <10 mg/L olan hastalarda (n=23) ortalama sagkalim 265.4±121.2 gun idi. Serum prealbumin seviyesi ≥15 mg/L olan hastalarda (n=28) ortalama sagkalim 237.5±132.7 gun iken serum prealbumin seviyesi <15 mg/L olan hastalarda (n=33) ortalama sagkalim 102.3±79.6 gun idi. Serum transferrin seviyesi ≥200 mg/L olan hastalarda (n=25) ortalama sagkalim 211.6±130.2 gun iken serum transferrin seviyesi <200 mg/L olan hastalarda (n=36) ortalama sagkalim 131.5±113.8 gun idi. Referans serum CRP, prealbumin ve transferrin seviyelerinin sagkalimla iliskisi istatistiksel olarak anlamli idi (sirasiyla p<0.001, p<0.001 ve p=0.003). So­nuc:­ Ileri evre ozofagus kanserli hastalarda ozofageal stent uygulamasindan once serum CRP, prealbumin ve transferrin duzeyleri kolaylikla saptanabilir ve hastalarin prognozlari hakkinda fikir elde edilebilir. Anah tar soz cuk ler: C-reaktif protein; ozofagus kanseri; prealbumin; sagkalim; transferrin. Background:­ This study investigated the prognostic value of serum C-reactive protein (CRP), prealbumin, and transferrin levels in patients with advanced stage esophageal cancers treated with stent placement. Methods: In a prospective, randomized study conducted between July 2007 and December 2008, serum CRP, prealbumin, and transferrin levels were determined 1-3 days prior to stent placement in 61 consecutive patients who underwent stent placement due to locally advanced disease or distant organ metastasis. All patients were followed until death. Results:­The stent was successfully placed in all patients and oral intake was restored. There was no procedure-related mortality. The mean survival period of the patients was 164.3±120.3 days (range 15 to 450 days). Whereas the mean survival period was 103.2±82.3 days in patients with a serum CRP level ≥10 mg/L (n=38), it was 265.4±121.2 days in patients with a serum CRP level <10 mg/L (n=23). While the mean survival period was 237.5±132.7 days in patients with a serum prealbumin level ≥15 mg/L (n=28), the mean survival period was 102.3±79.6 days in patients with a serum prealbumin level <15 mg/L (n=33). The mean survival period was 211.6±130.2 days in patients with a serum transferrin level ≥200 mg/L (n=25) while the mean survival period was 131.5±113.8 days in patients with a serum transferrin level <200 mg/L (n=36). The relationship between serum CRP, prealbumin, and transferrin levels in reference to survival was statistically significant (p<0.001, p<0.001, and p=0.003, respectively). Conclusion:­Serum CRP, prealbumin, and transferrin levels can easily be measured prior to esophageal stent placement in patients with advanced stage esophageal cancer and the results may give an idea on the prognosis of the patients.