Department of Urology, School of Medicine, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.
Mol Diagn Ther. 2010 Oct 1;14(5):295-303. doi: 10.1007/BF03256385.
Elevations in C-reactive protein (CRP) levels predict metastasis and mortality in a number of malignancies. However, the impact of non-malignant factors on CRP levels in patients with cancer remains unknown. To address this issue, we conducted an investigation of the National Social Life, Health, and Aging Project (NSHAP) cohort.
NSHAP participants with a history of malignancy were included. The 222-participant cohort was subdivided by CRP levels into low-risk (CRP <3 mg/L) and high-risk (CRP ≥3 mg/L) groups. Univariate and multivariate binary logistic regression analyses examined the impact of variables spanning social factors, demographic characteristics, and past medical history on high-risk CRP levels.
Of the cohort, 42.3% exhibited high-risk CRP levels. These participants were more likely to be unmarried (p = 0.013), to be a racial/ethnic minority (p = 0.012), to not use HMG-CoA reductase inhibitor (statin) medications (p = 0.032), and to be obese (p = 0.002). On multivariate logistic regression analysis, these variables were also significant predictors of high-risk CRP levels. For example, compared with participants who had a normal body mass index (BMI), obese participants were nearly 5 times more likely (odds ratio 5.725; 95% CI 1.848, 12.079; p = 0.001) to exhibit high-risk CRP levels.
CRP remains an important prognostic biomarker in the management of known malignancies. However, patients with a known history of cancer can also exhibit elevated CRP levels due to non-malignant factors such as race and ethnicity, statin use, marital status, and BMI. Consequently, further studies are needed to assess the predictive potential of CRP levels for cancer prognostication in the face of these social and biologic variables before use of this biomarker is widely adopted in clinical practice.
C 反应蛋白（CRP）水平升高可预测多种恶性肿瘤的转移和死亡。然而，非恶性因素对癌症患者 CRP 水平的影响尚不清楚。为了解决这个问题，我们对国家社会生活、健康和老龄化项目（NSHAP）队列进行了调查。
纳入有恶性肿瘤病史的 NSHAP 参与者。将 222 名参与者的队列按 CRP 水平分为低危（CRP<3mg/L）和高危（CRP≥3mg/L）组。单变量和多变量二项逻辑回归分析考察了社会因素、人口统计学特征和既往病史等变量对高危 CRP 水平的影响。
队列中有 42.3%的人 CRP 水平升高。这些参与者更有可能未婚（p=0.013）、属于少数族裔（p=0.012）、不使用 HMG-CoA 还原酶抑制剂（他汀类药物）（p=0.032）和肥胖（p=0.002）。多变量逻辑回归分析显示，这些变量也是高危 CRP 水平的显著预测因素。例如，与 BMI 正常的参与者相比，肥胖参与者出现高危 CRP 水平的可能性几乎高出 5 倍（比值比 5.725；95%置信区间 1.848，12.079；p=0.001）。
CRP 仍然是恶性肿瘤管理中重要的预后生物标志物。然而，有已知癌症病史的患者也可能由于种族和民族、他汀类药物使用、婚姻状况和 BMI 等非恶性因素而出现 CRP 水平升高。因此，在广泛采用这种生物标志物之前，需要进一步研究来评估 CRP 水平在面对这些社会和生物学变量时对癌症预后的预测潜力。
