Abstract

Objective To evaluate the association between C-reactive protein (CRP) blood levels and specific survival time of non-small cell lung cancer (NSCLC) patients treated with chemotherapy. Methods Data from 96 advanced (stage ⅢB/Ⅳ) NSCLC patients were analyzed. All patients were divided into two groups based on the enrolled time as follows the initial treatment group (48 cases) and retreatment group (48 cases). According to 0.6 mg/L and 7.3 mg/L of CRP which were the 1/3 and 2/3 of CRP concentrations, respectively, the 96 patients were divided into low, intermediate and high groups. Kaplan-Meier and Cox proportional-hazard models were used to evaluate the relationship between the CRP level and survival time. Results After adjusting for age, sex, smoking history, histological type and stage of lung cancer, a significant relationship between CRP and survival time was observed (P<0.05). Such significant differences of survival time were also observed in both of the adenocarcinoma (P<0.001) and squamous with poorly differentiated (P=0.032) subtypes. On stratification analysis by chemotherapy status, the circulating CRP level in retreatment group was correlated well with survival time (P<0.001). However, the influence of circulating CRP levels on survival time in initial group did not reach statistical significance (P=0.296). For all patients, the hazard ratio with high CRP levels for NSCLC-specific survival was 1.15(95 % CI 0.82-1.61) compared with that of low CRP levels. The hazard ratio for the initial treatment group and retreatment group were 0.52 (95 % CI 0.16-1.74) and 1.77 (95 % CI 0.73-4.26), respectively. Patients with high circulating CRP level also responded poorly to chemotherapy. Conclusion A high level of circulating CRP is associated with an inferior response and survival outcome in NSCLC patients treated with chemotherapy. Key words: Carcinoma, non-small-cell lung cancer; C-reactive protein; Survival time; Drug therapy

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