Wang Chia-Siu, Sun Chien-Feng
Department of General Surgery, Chang Gung Memorial Hospital, Chiayi, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Chang Gung Med J. 2009 Sep-Oct;32(5):471-82.
C-reactive protein (CRP) is a widely used systemic biomarker for diagnosing acute and chronic inflammation. During the past decade, serum CRP has been re-emphasized by extending its clinical use to the prediction or diagnosis of cardiovascular diseases and other conditions, particularly malignancies. Serum CRP has also been found to be elevated in patients with many malignancies, implying a close linkage between inflammation and malignancy. Prospective studies have shown a higher risk of developing cancer in those with elevated serum CRP. CRP is produced by hepatocytes in response to inflammatory cytokines, particularly, interleukin-6 from the tumor microenvironment. Preoperative CRP levels are parallel to the progression or pathological stages of malignancies, including gastric cancer in patients in our series. Elevated CRP is a determinant predictor of lower survival rates in patients with several cancers, including esophageal, colorectal, hepatocellular, pancreatic, urinary bladder, renal,ovarian and cervical cancer, after surgical resection. The measurement of serum CRP is simple, cheap, and available in daily practice. It can serve as an additional prognostic predictor for survival and post-treatment monitoring in cancer patients. In the future, CRP-lowering agents might offer a promising benefit in the prevention and therapy of many different types of cancer.
C反应蛋白（CRP）是一种广泛用于诊断急性和慢性炎症的全身性生物标志物。在过去十年中，血清CRP通过将其临床应用扩展到心血管疾病和其他病症（特别是恶性肿瘤）的预测或诊断而被重新重视。血清CRP在许多恶性肿瘤患者中也被发现升高，这意味着炎症与恶性肿瘤之间存在密切联系。前瞻性研究表明，血清CRP升高者患癌风险更高。CRP由肝细胞响应炎性细胞因子，特别是肿瘤微环境中的白细胞介素-6而产生。术前CRP水平与恶性肿瘤的进展或病理分期平行，包括我们系列中的胃癌患者。CRP升高是包括食管癌、结直肠癌、肝细胞癌、胰腺癌、膀胱癌、肾癌、卵巢癌和宫颈癌在内的几种癌症患者手术切除后生存率较低的决定性预测指标。血清CRP的检测简单、便宜，且在日常实践中即可进行。它可作为癌症患者生存和治疗后监测的额外预后预测指标。未来，降低CRP的药物可能在多种不同类型癌症的预防和治疗中带来有前景的益处。
