Department of Urology, Emory University, Atlanta, Georgia, USA.
Mol Diagn Ther. 2010 Jun 1;14(3):191-3. doi: 10.1007/BF03256373.
C-reactive protein (CRP) is an acute-phase reactant that can increase dramatically in response to a variety of pathologic states. Elevated pre- and postoperative CRP levels have been associated with an increased tumor burden and metastasis in kidney cancer. We report on a case that serves to highlight a potentially novel use for CRP monitoring in the postoperative management of renal cell carcinoma. Recently, we treated a patient who presented with a localized renal cell carcinoma and an elevated preoperative CRP level. Surgical pathology demonstrated negative surgical margins and absence of nodal metastasis. Postoperatively, the patient's serum CRP levels remained relatively low, consistent with his continued negative staging on CT scans. However, at 6 months postoperatively, the patient's CRP level increased 13-fold. His subsequent CT scan revealed "multiple pulmonary nodules consistent with progression of metastatic disease." This case demonstrates the potential for monitoring CRP in addition to, or instead of, standard restaging imaging.
C-反应蛋白（CRP）是一种急性时相反应物，可在多种病理状态下显著增加。术前和术后 CRP 水平升高与肾癌的肿瘤负荷增加和转移有关。我们报告了一个病例，该病例突出了 CRP 监测在肾细胞癌术后管理中的潜在新用途。最近，我们治疗了一位患有局限性肾细胞癌和术前 CRP 水平升高的患者。手术病理学显示无手术切缘阳性和淋巴结转移。术后，患者的血清 CRP 水平仍然相对较低，与他的 CT 扫描持续阴性分期一致。然而，在术后 6 个月时，患者的 CRP 水平增加了 13 倍。他随后的 CT 扫描显示“多个肺结节，提示转移性疾病进展”。该病例表明，CRP 监测可作为标准重新分期影像学检查的补充，甚至替代。
