Prognostic Significance Of C-reactive Protein Research Articles

Comment on, "Creactive protein levels, the prognostic nutritional index, and the lactate dehydrogenasetolymphocyte ratio are important prognostic factors in primary central nervous system lymphoma: a singlecenter study of 223 patients".

This study by Zuo et al. (2024) investigates the prognostic significance of C-reactive protein (CRP) levels, the prognostic nutritional index (PNI), and the lactate dehydrogenase-to-lymphocyte ratio (LLR) in primary central nervous system lymphoma (PCNSL) using data from 223 patients. The research demonstrates that these markers are critical in predicting patient outcomes, offering novel insights beyond traditional prognostic models like the MSKCC and IELSG scores. Despite its strengths, the study's retrospective design and lack of validation cohort limit its generalizability. Future research should focus on validating these findings in diverse, multicenter settings and integrating these markers with existing prognostic models to improve clinical decision-making. Longitudinal studies and advanced statistical methods are recommended to further explore the interactions between these factors and their impact on patient outcomes, potentially leading to the development of targeted therapies for PCNSL.

Role of C-reactive Protein and Procalcitonin in Early Diagnostic Accuracy and Their Prognostic Significance in Sepsis.

Sepsis is a serious condition that often results in high fatality rates, particularly in intensive care units (ICUs). Its nonspecific clinical characteristics makes early diagnosis and therapy difficult, despite how critical they are. The use of biomarkers like procalcitonin (PCT) and C-reactive protein (CRP) in the diagnosis and prognosis of sepsis has demonstrated encouraging results. In contrast to PCT, which is highly selective for bacterial infections, CRP is an acute-phase protein that reflects systemic inflammation. This study aimed to assess the diagnostic accuracy and prognostic significance of CRP and PCT in early sepsis detection and outcome prediction. This study was a retrospective cohort study that involved 90 patients in the ICU who met the criteria for sepsis-3. CRP and PCT levels, clinical data, and outcomes were obtained from electronic medical records. The diagnostic accuracy was tested using receiver operating characteristic (ROC) curves, while the prognostic relevance was analyzed by Kaplan-Meier survival analysis and Cox proportional hazards regression. The mean CRP level was 102.3 mg/L and PCT level was 5.4 ng/mL. ROC analysis revealed an area under the curve (AUC) of 0.78 for CRP and 0.82 for PCT, indicating better diagnostic performance for PCT. High levels of CRP and PCT were associated with poorer survival, with median survival times of 18 and 15 days, respectively, for high-level groups. Cox regression identified CRP and PCT as significant predictors of mortality, with hazard ratios of 1.50 and 1.68, respectively. Both CRP and PCT are valuable biomarkers for diagnosing and prognosticating sepsis. PCT, with its higher specificity for bacterial infections, demonstrates superior diagnostic accuracy compared to CRP. Elevated levels of both biomarkers are associated with increased mortality risk, highlighting their potential role in early sepsis management and outcome prediction.

Prognostic significance of C-reactive protein in unresectable hepatocellular carcinoma treated with atezolizumab and bevacizumab.

C-reactive protein (CRP) is both an inflammatory and prognostic marker in various cancers. This study aimed to elucidate the characteristics of CRP and the prognostic factors in patients who were administered with atezolizumab plus bevacizumab (ATZ+BEV) for unresectable hepatocellular carcinoma (HCC). A total of 213 patients who received ATZ+BEV for HCC from November 2020 to March 2023 at 15 hospitals were enrolled in this retrospective study. The prognosis was analyzed by subdividing the patients based on baseline characteristics, radiologic response, and treatment lines. Accuracy of survival prediction was assessed using CRP, alpha fetoprotein (AFP), C-reactive protein and alpha fetoprotein in immunotherapy (CRAFITY), and Glasgow Prognostic Score. Compared with patients with baseline CRP <1mg/dL, those with baseline CRP ≥1mg/dL (n=45) had a significantly higher baseline albumin-bilirubin score and AFP levels, significantly lower disease control rate (62.2%), and significantly shorter median overall survival (hazards ratios 2.292; 95% confidence interval 1.313-5.107; log-rank test, p<0.001). Multivariate analysis identified CRP ≥1mg/dL, AFP ≥100ng/mL, and modified albumin-bilirubin grade as the significant prognostic factors. The baseline CRP, AFP, CRAFITY, and Glasgow Prognostic Score demonstrated higher discrimination for 1-year survival prediction after first-line ATZ+BEV administration, compared with beyond second line, with area under the receiver operating characteristic curves of 0.759, 0.761, 0.805, and 0.717, respectively. CRP was a significant biomarker in patients treated with ATZ+BEV for HCC. Elevated CRP levels may indicate aggressive cancer progression and potential resistance to ATZ+BEV therapy.

ДИАГНОСТИЧЕСКИЙ ПОТЕНЦИАЛ С-РЕАКТИВНОГО БЕЛКА ПРИ СЕПСИСЕ У ОНКОГЕМАТОЛОГИЧЕСКИХ БОЛЬНЫХ

The study aims to analyze the dynamics, diagnostic, and prognostic significance of C-reactive protein (CRP) in sepsis in oncohematological patients. The CRP levels were compared in 30 patients with lymphoproliferative diseases using two designs. The first design included patients who received cytostatic therapy (groups 1 and 3 with and without complications, respectively), as well as patients who received autologous hematopoietic stem cell transplantation after cytostatic therapy (groups 2 and 4 with and without complications, respectively). The second design consisted of two groups of patients: the first with sepsis (n = 15) and the second without any complications (n = 15). In statistical analysis, the Mann–Whitney U test or Student’s t-test (at p &lt; 0.05) were used to compare quantitative indicators according to the distribution type, and the ROC curve (AUC) was used to assess the diagnostic significance of CRP in predicting a specific outcome. Statistically significant differences were found in the level of CRP in both groups with sepsis compared to the corresponding groups without sepsis (p1–3 &lt; 0.001, p2–4 &lt; 0.001), the level of CRP depending on the outcome (recovery/death) in both study designs (p &lt; 0.05), and the dynamics of CRP when comparing groups with sepsis. When assessing the diagnostic significance of CRP, AUC = 0.862 ± 0.029 with 95 % CI: 0.806–0.918, sensitivity (Se) was 85.7 % and specificity (Sp) was 69.7 %. When predicting 10-day mortality, AUC = 0.756 ± 0.069 with 95 % CI: 0.621–0.892, Se was 57.9 % and Sp was 89.2 %, the model was statistically significant (p &lt; 0.001) in both cases. As an available marker, CRP has good diagnostic value in the comprehensive sepsis diagnosis, in particular in hematological oncology patients.

Prognostic Significance of C-Reactive Protein and Neutrophil- Lymphocyte Ratio in Lung Adenocarcinoma Patients

Prognostic Significance of C-Reactive Protein and Neutrophil- Lymphocyte Ratio in Lung Adenocarcinoma Patients

Clinical and prognostic significance of C-reactive protein in the conditions of stable angina pectoris in combination with chronic obstructive pulmonary disease stage II–III

The aim of the study: to evaluate the clinical and prognostic value of the altered C-reactive protein expression level in functional class II–III stable angina pectoris combined with chronic obstructive pulmonary disease (COPD) stage II–III. Materials and methods. In accordance with the goal of the study, 122 individuals were examined being assigned to 4 clinical groups: Group 1 – 30 patients with ischemic heart disease (IHD, functional class II–III stable angina pectoris, mean age 56.93 ± 1.25 years; male / female ratio 86.67 % / 13.33 %); Group 2 – 30 patients with COPD stage II–III (mean age 57.99 ± 1.12 years; male / female ratio 80.0 % / 20.0%); Group 3 – 40 patients with IHD + COPD (mean age 56.48 ± 1.16 years; male / female ratio 76.92 / 23.08 %) and Group 4 – 22 apparently healthy individuals (mean age 54.37 ± 1.84 years old, male / female ratio 77.50 % / 22.50 %). Results. Significant correlations have been found between the level of C-reactive protein (CRP) and troponin I (r = +0.71 and r = +0.82, p &lt; 0.01 for both pairs) in IHD and IHD + COPD groups. When the level of CRP expression was elevated, a clear increase in the level of cardiospecific proteins (troponin I) was seen, which could indicate a damage to the myocardium. A positive association was found between the CRP level and the CAT scale score in COPD and IHD+COPD groups (r = +0.65 and r = +0.73, respectively, p &lt; 0.05) indicating a significant association between the processes of systemic inflammation and the dynamics of a patient’s subjective condition, caused mainly by the severity of ventilatory and respiratory disorders and pulmonary obstruction. The relative risk for cardiorespiratory fitness impairment (according to 6MWD) in patients with a high level of CRP (&gt;6 mg/L) was almost 13 times higher (EER 80.0 % CER 6.25 %, RR = 12.8 at 95 % CI, which was 1.87–87.56, р &lt; 0.001), while the odds ratio was 60 (OR = 60.0 with CI 4.69–767.85, р &lt; 0.001), compared to patients with a CRP level &lt;6 mg/L, indicating systemic inflammatory process progression in the development of a negative prognosis of IHD combined with COPD. Conclusions. The study and examination of the CRP level is necessary as a prognostic predictor for assessing the risk for developing cardiovascular complications in ІHD combined with COPD.

Prognostic Significance of C-reactive Protein in Patients With Non-metastatic Papillary Renal Cell Carcinoma: Results from the INternational Marker Consortium for Renal Cancer (INMARC) Cohort.

C-reactive protein is a useful biomarker for screening renal cell carcinoma (RCC); however, its significance in papillary RCC is unclear. We assessed the prognostic effect of serum C-reactive protein levels in patients with surgically treated non-metastatic papillary RCC. We established an international multi-institutional database (the INternational Marker Consortium for Renal Cancer) of 3799 patients with surgically treated RCC. Among these, data of 400 patients with non-metastatic papillary RCC were analyzed. An elevated pretreatment serum C-reactive protein level was defined as > 10 mg/L. Associations of clinical covariates with recurrence-free survival were investigated. Among the patients, 174 were African Americans, 155 were European-Americans, 50 were Asians, and 21 were of other races. Pathological T stages were 1, 2, 3, and 4 in 313, 46, 32, and 3 patients, respectively. The median pretreatment C-reactive protein level was 1.0 mg/L; 48 patients exhibited an elevated C-reactive protein level. During follow-up (median 18 months), 30 patients presented recurrence. The 1-, 3-, and 5-year recurrence-free rates were 95%, 91%, and 87%, respectively. Multivariate analysis revealed a significant association of the elevated pretreatment C-reactive protein level with poor recurrence-free survival (hazard ratio 2.47, 95% confidence interval 1.03-5.48; P=.043). The 5-year recurrence-free survival was significantly worse for patients with elevated C-reactive protein levels (67% vs. 90%; P=.001). C-reactive protein is a significant prognostic factor for patients with non-metastatic papillary RCC and can serve as a useful adjunct biomarker for screening patients with a high risk of recurrence.

The Prognostic Significance of C-Reactive Protein to Albumin Ratio in Patients With Severe Fever With Thrombocytopenia Syndrome.

BackgroundSevere fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with the high case-fatality rate, lacking effective therapies and vaccines. Inflammation-based indexes have been widely used to predict the prognosis of patients with cancers and some inflammatory diseases. In our study, we aim to explore the predictive value of the inflammation-based indexes in SFTS patients.MethodsWe retrospectively analyzed 82 patients diagnosed with SFTS. The inflammation-based indexes, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), aggregate index of systemic inflammation (AISI) and C-reactive protein to albumin ratio (CAR), were compared between the survival and death patients. Receiver operating characteristic (ROC) curves were used to compare the predictive ability of MLR, AISI, and CAR. The survival analysis was based on the Kaplan–Meier (KM) method. Multivariate logistic regression analysis was used to analyze the independent risk factors of poor prognosis in patients with SFTS.ResultsThe CAR is higher in the death group while MLR and AISI were higher in the survival group. The ROC curve analysis indicated CAR exhibited more predictive value than the other indexes and the optimal cut-off value of CAR was equal to or greater than 0.14. KM survival curve showed that higher CAR was significantly correlated to the lower overall survival in SFTS patients. Multivariate logistic regression analysis indicated that CAR was an independent risk factor for poor prognosis in patients with SFTS.ConclusionThe CAR is an independent risk factor for death in patients with SFTS and could predict the poor prognosis of SFTS patients. It could be used as a biomarker to help physicians to monitor and treat patients more aggressively to improve clinical prognosis.

The C-reactive protein to albumin ratio is a prognostic factor for stage I non-small cell lung cancer in elderly patients: JACS1303.

To establish the prognostic significance of C-reactive protein (CRP) and albumin in octogenarians with non-small cell lung cancer (NSCLC) based on the study of the Japanese Association for Chest Surgery (JACS 1303). A total of 618 octogenarians with pathological stage I NSCLC, who underwent pulmonary resection, were included in the analysis. We conducted multivariable Cox regression analysis to evaluate the CRP to albumin ratio (CAR) as a potential prognostic factor. Other clinicopathological factors were also evaluated. The median age was 82years. Operations included lobectomy (n = 388; 62.8%) segmentectomy (n = 95; 15%), and wedge resection (n = 135; 22%). Pathological stage IA was diagnosed in 380 (61.5%) patients. The 3-year (OS) and cancer-specific survival (CS) rates were 86.7% and 94.6%, respectively. OS was significantly higher for patients with low CAR (< 0.106) than for those with high CAR (≥ 0.106) (hazard ratio = 3.13, 95% confidence interval: 1.99-4.93, p < 0.0001). Univariate analysis identified sex, poor performance status, smoking status, comorbidity, solid tumor, histology, high Glasgow prognostic scale, and high CAR as significant prognostic factors. Multivariate analysis identified only the CAR as a significant prognostic factor for both OS and CS. Our analysis of the nationwide data demonstrated that the CAR is a useful prognostic factor for elderly patients with stage I NSCLC.

Clinical and prognostic significance of C-reactive protein to albumin ratio in hospitalized coronavirus disease 2019 (COVID-19) patients : Data on 2309patients from atertiary center and validation in an independent cohort.

C‑reactive protein (CRP) and albumin are inflammation sensitive parameters that are regulated by interleukin‑6 inflammatory pathways. The CRP to albumin ratio (CAR) integrates these two into a potent clinical parameter whose clinical and prognostic association in the context of coronavirus disease 2019 (COVID-19) have not been well defined. We aimed to investigate the clinical and prognostic significance of CAR in the context of COVID-19 infection.We retrospectively analyzed 2309 consecutive COVID-19 patients hospitalized at a tertiary level hospital in the period from March 2020 to March 2021 who had baseline data for a CAR assessment. Findings were validated in an independent cohort of 1155 patients hospitalized from March 2021 to June 2021.The majority of patients (85.8%) had severe or critical COVID-19 on admission. Median CRP, albumin and CAR levels were 91 mg/L, 32 g/L and 2.92, respectively. Higher CAR was associated with a tendency for respiratory deterioration during hospitalization, increased requirement of high-flow oxygen treatment and mechanical ventilation, higher occurrence of bacteriemia, higher occurrence of deep venous thrombosis, lower occurrence of myocardial infarction, higher 30-day mortality and higher postdischarge mortality rates. We defined and validated four CAR prognostic categories (< 1.0, 1.0–2.9, 3.0–5.9 and ≥ 6.0) with distinct 30-day survival. In the series of multivariate Cox regression models we could demonstrate robust prognostic properties of CAR that was associated with inferior 30-day survival independently of COVID-19 severity, age and comorbidities and additionally independently of COVID-19 severity, CURB-65 and VACO index in both development and validation cohorts.The CAR seems to have a good potential to improve prognostication of hospitalized COVID-19 patients.Supplementary InformationThe online version of this article (10.1007/s00508-021-01999-5) contains supplementary material, which is available to authorized users.

The Prognostic Significance of C-Reactive Protein to Albumin Ratio in Newly Diagnosed Acute Myeloid Leukaemia Patients.

BackgroundThe ratio of C-reactive protein to albumin (CAR) is an inflammatory marker that has been demonstrated to be a simple and reliable prognostic factor in several solid tumours and chronic lymphocytic leukaemia (CLL). However, no studies have investigated the prognostic value of the CAR in patients with acute myeloid leukaemia (AML).Objectives and MethodsWe retrospectively analysed 212 newly diagnosed non-M3 AML patients. Using the receiver operating characteristic curve (ROC) method, the optimal cut-off value for CAR was determined. We investigated the correlations of the pretreatment CAR levels with clinical characteristics, treatment response of induction chemotherapy, overall survival (OS) and event-free survival (EFS). We also assessed the prognostic value of the CAR compared with other inflammation-based prognostic parameters by the area under the curve (AUC).ResultsAccording to the ROC curve, the optimal cut-off value of CAR was 1.015. CAR was associated with age, C-reactive protein (CRP) levels, albumin levels, ferritin levels, bone marrow blast percentage, French-American-British (FAB) classification, immunophenotype and 2017 European Leukemia Net (2017 ELN) risk stratification. Importantly, we found that high CAR was a powerful indicator of a lower complete remission (CR) rate (p<0.001), worse OS (p<0.001) and worse EFS (p<0.001). Subgroup analysis showed that a high CAR was associated with shorter OS and EFS in patients with intermediate risk stratification or those aged ≤65 years or those without haematopoietic stem cell transplantation (HSCT). In the multivariate analysis, the CAR was an independent prognostic factor for OS and EFS. Furthermore, the predictive value of CAR for OS is superior to that of CRP, albumin and GPS in de novo AML patients aged ≤65 years old.ConclusionCAR is a simple and effective prognostic marker in patients with AML. It could be an additional prognostic factor that help further precise the current risk stratification of non-M3 AML, particularly for patients in intermediate risk stratification and those aged ≤65 years and those who did not undergo HSCT.

Prognostic Value of C-Reactive Protein, Glasgow Prognostic Score, and C-Reactive Protein-to-Albumin Ratio in Colorectal Cancer.

Background: Emerging evidence suggests that inflammatory response biomarkers are predictive factors that can improve the accuracy of colorectal cancer (CRC) prognoses. We aimed to evaluate the prognostic significance of C-reactive protein (CRP), the Glasgow Prognostic Score (GPS), and the CRP-to-albumin ratio (CAR) in CRC.Methods: Overall, 307 stage I–III CRC patients and 72 colorectal liver metastases (CRLM) patients were enrolled between October 2013 and September 2019. We investigated the correlation between the pretreatment CRP, GPS, and CAR and the clinicopathological characteristics. The Cox proportional hazards model was used for univariate or multivariate analysis to assess potential prognostic factors. A receiver operating characteristic (ROC) curve was constructed to evaluate the predictive value of each prognostic score. We established CRC survival nomograms based on the prognostic scores of inflammation.Results: The optimal cutoff levels for the CAR for overall survival (OS) in all CRC patients, stage I–III CRC patients, and CRLM patients were 0.16, 0.14, and 0.25, respectively. Kaplan–Meier analysis and log-rank tests demonstrated that patients with high CRP, CAR, and GPS had poorer OS in CRC, both in the cohorts of stage I–III patients and CRLM patients. In the different cohorts of CRC patients, the area under the ROC curve (AUC) of these three markers were all high. Multivariate analysis indicated that the location of the primary tumor, pathological differentiation, and pretreatment carcinoembryonic antigen (CEA), CRP, GPS, and CAR were independent prognostic factors for OS in stage I–III patients and that CRP, GPS, and CAR were independent prognostic factors for OS in CRLM patients. The predictors in the prediction nomograms included the pretreatment CRP, GPS, and CAR.Conclusions: CRP, GPS, and CAR have independent prognostic values in patients with CRC. Furthermore, the survival nomograms based on CRP, GPS, and CAR can provide more valuable clinical significance.

Clinical Significance of C-Reactive Protein to Albumin Ratio in Patients with Hepatocellular Carcinoma: A Meta-Analysis.

Aim To evaluate the prognostic significance of C-reactive protein to albumin ratio (CAR) for clinical outcomes in hepatocellular carcinoma (HCC) patients. Material and Methods. Eligible studies were searched by PubMed, MedLine, the Cochrane Library, from January 1, 2000, to June 30, 2019, investigating the prognostic value of CAR in patients with HCC. Primary endpoint was OS. Hazard ratio (HR) with 95% confidence interval (CI) was used to determine the effect size. Results 7 records including 2208 patients published since 2014 were enrolled into our meta-analysis. Clinicopathological characteristics were also correlated with the level of CAR. The pooled HR for the OS rate between low and high CAR groups was 2.13 (95% CI 1.70~2.68, P < 0.00001) using a random model, but sensitivity analysis showed that the pooled HR for the OS rates did not change substantially after removal of any included study. As for patients receiving surgery, the pooled HR for the OS rate between low and high CAR groups was 2.04 (95% CI 1.59~2.61, P < 0.00001). Subgroup analysis showed that CAR could be a prognostic biomarker for HCC patients regardless of regions (China, HR = 1.75, 95% CI 1.51~2.02; Japan, HR = 3.36, 95% CI 2.07~5.45; Korea, HR = 2.26, 95% CI 1.47~4.47; respectively), the cut-off value (<0.1, HR = 2.84, 95% CI 1.90~4.24; >0.1, HR = 1.99, 95% CI 1.52~2.61; respectively), and sample size (<200, HR = 2.85, 95% CI 2.01~4.03; >200, HR = 1.75, 95% CI 1.52~2.02; respectively). Conclusion With the current data, we clearly concluded that CAR was closely correlated with prognosis of patients with HCC. Multicenter, prospective randomized trials are warranted to confirm the conclusion.

Prognostic significance of C-reactive protein to albumin ratio in colorectal cancer patients: a meta-analysis.

Inconsistent results on the prognostic significance of C-reactive protein to albumin ratio (CAR) in colorectal cancer patients have been reported. This meta-analysis sought to assess the prognostic value of pretreatment CAR for survival outcomes in colorectal cancer patients. We conducted a systematic literature search of PubMed and Embase databases until February 16, 2019. Observational studies investigating the prognostic role of pretreatment CAR for survival outcome in patients with colorectal cancer were included. Outcome measures included overall survival (OS), disease-free survival (DFS), or progression-free survival (PFS). Pooled hazard ratio (HR) with 95% confidence interval (CI) was utilized to summarize the prognostic significance of CAR for patient survival. Nine retrospective studies involving 2492 colorectal cancer patients were identified. A fixed-effect model meta-analysis showed that high pretreatment CAR was an independent predictor of poor OS (HR 2.25; 95% CI 1.84-2.76) and DFS (HR 2.49; 95% CI 1.43-4.33). On the other hand, no significant association was observed between high CAR and PFS (HR 1.71; 95% CI 0.44-6.60). The predictive values of OS with high pretreatment CAR caused no significant changes in different sample sizes, countries, cut-off values of CAR, treatment methods, and study quality of subgroups. This meta-analysis suggests that CAR may be a powerful prognostic indicator for colorectal cancer prognosis. High pretreatment CAR is associated with poor OS and DFS in patients with colorectal cancer.

Prognostic significance of C-Reactive protein and its correlation with predictors of outcome in stable and unstable patients of COPD

Aim- The aim of the study was to find out value of CRP in COPD patients and its correlation with the predictors of outcome. Method- We studied 100 COPD patients (80 stable and 20 unstable) with spirometry, body mass index, MMRDC dyspnoea scale, 6-minute walk distance and BODE index. The CRP values were measured in these patients and compared with 50 sex and age matched controls. CRP was subjected to evaluation for any correlation with the predictors of outcomes in COPD patients. Results- Serum CRP levels were significantly higher in COPD patients than in healthy subjects (Mean 13.55+10.83 vs.2.07+ 0.82 mg/lit, p&lt;0.001). CRP levels were significantly higher in unstable than stable patients (mean 33.78+7.74 mg/lit vs. 8.50+1.81 mg/lit, p&lt;0.001). Severity of dyspnoea as measured by MMRC dyspnoea scale was significantly higher in unstable patients than in stable patients (mean 3.60+0.5 vs. 1.84+0.86, p&lt;0.001). The exercise capacity of the patients as measured by 6 MWD was significantly lower in un stable patients than in stable patients (mean 180.5+53.26m vs. 219.58+67m, p=0.017). The BODE index was found to be significantly higher among unstable patients than stable patients (mean 7.30+1.66 vs. 4.94+1.94, p&lt;0.001). A significant negative correlation was found between CRP and FEV1 (r=-0.284, p=0.004) and FEV1/FVC (r=-0.305, p=0.002). CRP levels were independent of FVC (r=-0.162, p=0.107). A significant positive correlation was found bet ween CRP and severity of dyspnoea according to MMRC dyspnoea scale (r=0.638, p&lt;0.001). The CRP levels negatively correlated with the exercise capacity of the patient (6MWD) which was statistically significant (r= -0.364, p&lt;0.001). A significant positive correlation was foun d between CRP with BODE index (r=0.780, p&lt;0.001) and BODE stage (r=0.726, p&lt;0.001). Conclusion- We conclude that systemic inflammation is present in COPD patients and CRP is important biomarker in COPD in means of reflecting severity of disease and prognosis of patients.

Is C-reactive protein useful in prognostication for colorectal cancer? A systematic review.

With the advent of several different therapeutic strategies to manage the different stages of colorectal cancer, it would be beneficial to allow substratification of patients into groups who are most likely to benefit from costly interventions. The purpose of this review is to analyse the evidence from several retrospective studies examining the prognostic significance of C-reactive protein (CRP). A literature search was performed using PubMed, Embase, Cochrane Library, CINAHL and Google Scholar databases to identify studies that analysed CRP and its prognostic significance in all stages of operable colorectal cancer. The primary end-points of interest were overall survival and disease-free survival. In all, 205 studies were identified by the search. Twelve involving 1705 patients fulfilled the inclusion criteria and were included. Three of the included studies including 305 patients considered Stage IV colorectal cancer and the impact of CRP on survival. Overall survival and disease-free survival were shorter in the presence of an elevated preoperative CRP in local and advanced colorectal cancer. CRP may be useful for prognosis in patients with primary and metastatic colorectal cancer, but currently there is insufficient evidence to justify its routine use. Further well-designed prospective studies are needed to validate its role in substratification of patients for consideration of (neo)adjuvant therapies.

Prognostic significance of C-reactive protein in patients with intermediate-risk metastatic renal cell carcinoma treated with molecular targeted therapy.

The present study aimed to investigate the impact of pre-treatment C-reactive protein (CRP) levels on the prediction of prognosis in patients with metastatic renal cell carcinoma (mRCC), who were classified as intermediate-risk patients using the Memorial Sloan Kettering Cancer Center (MSKCC) risk classification and who received molecular targeted therapy. The oncological outcome of 140 patients with mRCC who underwent molecular targeted therapy was analyzed. Patients were divided into favorable-, intermediate- and poor-risk groups (groups F, I and P, respectively) based on the MSKCC risk classification. The patients in group I were then further classified into two groups based on pre-treatment serum CRP levels. The overall survival (OS) rates of the patients in these groups were then assessed. The OS rate of the patients in group I with normal pre-treatment CRP levels was found to be significantly increased compared with that of patients with high pre-treatment CRP levels (P<0.0001), while there was no significant difference in the OS rate in the patients with normal pre-treatment CRP levels in group I compared with those in group F. Multivariate analyses revealed that high pre-treatment CRP levels were an independent prognostic factor for OS in the patients in group I (P<0.0001; hazard ratio, 3.898). Thus, pre-treatment CRP levels may be a candidate predictor for OS in patients with intermediate-risk mRCC.

Prognostic significance of C-reactive protein in urological cancers: a systematic review and meta-analysis.

C-reactive protein (CRP), considered as a prototypical inflammatory cytokine, has been proposed to be involved in tumor progression through inflammation. Recent studies have indicated CRP as a progostic predictor for urological cancers, but the results remain controversial. A systematic search of Medline, Scopus and the Cochrane Library was performed to identify eligible studies published between Jan 1, 2001 and Sep 1, 2013. Outcomes of interest were collected from studies comparing overall survival (OS), cancer-specific survival (CSS) and relapse-free survival (RFS) in patients with elevated CRP levels and those having lower levels. Studies were pooled, and combined hazard ratio (HR) of CRP with its 95% confidence interval (CI) for survival were used for the effect size estimate. A total of 43 studies (7,490 patients) were included in this meta-analysis (25 for RCC, 10 for UC, and 8 for PC). Our pooled results showed that elevated serum CRP level was associated with poor OS (HR: 1.26, 95%CI: 1.22-1.30) and RFS (HR: 1.38 95%CI: 1.29-1.47), respectively. For CSS the pooled HR (HR: 1.33, 95%CI: 1.28-1.39) for higher CRP expression could strongly predict poorer survival in urological cancers. Simultaneously, elevated serum CRP was also significantly associated with poor prognosis in the subgroup analysis. Our pooled results demonstrate that a high serum level of CRP as an inflammation biomarker denotes a poor prognosis of patients with urological cancers. Further large prospective studies should be performed to confirm whether CRP, as a biomarker of inflammation, has a prognostic role in urological cancer progression.

Prognostic value of circulating C-reactive protein levels in patients with non-small cell lung cancer: a systematic review with meta-analysis.

The clinical and prognostic significance of C-reactive protein (CRP) in nonsmall-cell lung cancer (NSCLC) remains inconsistent. To clarify a precise determinant of the clinical significance of CRP, we conducted a systematic review and meta-analysis to evaluate the overall risk of elevated CRP for survival in NSCLC. Related studies were identified and evaluated for quality through multiple search strategies. Data were collected from studies comparing overall survival in patients with elevated CRP levels and those having lower levels. The meta-analysis was performed by Review Manager version 5.2 (RevMan; the Cochrane Collaboration, Oxford, England). The pooled hazard ratios (HRs) and 95% confidence intervals (CI) were calculated employing fixed- or random-effects models depending on the heterogeneity of the included trials. Eight eligible studies involved 1649 patients were ultimately identified. Combined HRs suggested that elevated CRP had an unfavorable impact on survival of patients with NSCLC. The HRs (95% CI) was 1.55 (1.19-2.01) overall, 1.78 (1.33-2.38) in Asian patients, 1.33 (1.00-1.77) in non-Asian patients, 1.78 (1.47-2.15) in primary resectable NSCLC, 1.28 (0.95-1.73) in primary unresectable NSCLC, 1.78 (1.33-2.38) in group of cut-off value <5 mg/L, 1.33 (1.00-1.77) in group of cut-off value ≥10 mg/L. With the available evidence, CRP might serve as an efficient prognostic indicator in NSCLC. This marker should be taken into consideration in the development of new diagnostic and therapeutic program for NSCLC.

Changes in C-reactive Protein (CRP) in Patients with Acute Heart Failure

In patients with chronic heart failure, the prognostic significance of C-reactive protein (CRP) has been reported recently. On the other hand, the prognostic role of CRP in acute heart failure has not been elucidated. Our purpose is to investigate the relationship between CRP concentrations and prognosis.