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Prognostic Significance of C-reactive Protein in Urological Cancers: a Systematic Review and Meta-analysis

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单位: [1]Huazhong Univ Sci & Technol,Tongji Med Coll,Tongji Hosp,Dept Urol,Wuhan 430074,Peoples R China [2]Huazhong Univ Sci & Technol,Tongji Med Coll,Tongji Hosp,Inst Urol,Wuhan 430074,Peoples R China [3]Peoples Hosp Guangxi Zhuang Autonomous Reg, Dept Urol, Nanning, Peoples R China [4]Beijing Hosp, Dept Urol, Beijing, Peoples R China
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关键词: C-reactive protein prognosis urological cancer meta-analysis

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Background: 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. Materials and Methods: 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. Results: 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. Conclusions: 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.

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大类 | 4 区 医学
小类 | 4 区 肿瘤学
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Q4 ONCOLOGY
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第一作者单位: [1]Huazhong Univ Sci & Technol,Tongji Med Coll,Tongji Hosp,Dept Urol,Wuhan 430074,Peoples R China [2]Huazhong Univ Sci & Technol,Tongji Med Coll,Tongji Hosp,Inst Urol,Wuhan 430074,Peoples R China
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通讯机构: [1]Huazhong Univ Sci & Technol,Tongji Med Coll,Tongji Hosp,Dept Urol,Wuhan 430074,Peoples R China [2]Huazhong Univ Sci & Technol,Tongji Med Coll,Tongji Hosp,Inst Urol,Wuhan 430074,Peoples R China
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