Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, School of Medicine, Padova, Italy
Surgery 1, S. Maria degli Angeli Hospital, Pordenone, Italy.
Anticancer Res. 2014 Dec;34(12):7263-6.
The molecular mechanism underlying the development of colorectal cancer (CRC) is not yet fully-understood, but there is evidence that inflammation plays a key role. Several circulating tumor and inflammatory markers can be useful for studying patients with CRC. It has been suggested that high serum levels of C-reactive protein (CRP) are associated with elevated risk of various malignancies and that CRP may affect survival of patients with CRC. We analyzed the relationship existing between the stage of the disease and baseline CRP serum levels in a group of 91 patients undergoing surgery for stage III (N=72, 79.1%) and IVa (N=19, 20.9%) CRC. There were 51 (56%) men and 40 (44%) women, with a median age of 66 years. Prior to surgery, all patients underwent quantitative serum CRP measurement. The overall 5-year survival was 37.1 ± 13.0 months. Patients with stage III disease and the sub-group with CRP<3 mg/l (N=43, 47.3%) had a longer survival (p<0.01) than patients with stage IVa and the sub-group with CRP ≥ 3 mg/l (N=48, 52.7%). No relationship between the age of the patients and CRP levels was found (R=-0.005, p=0.96), whilst there was a significant inverse relationship between survival and CRP level (R=-0.37, y=37.5343-0.5868x, p=0.0003). Using multivariate Cox model analysis (forward stepwise method), adjusted for age, CRP and CRC stage were independent parameters related to survival, with a relative risk of 3.5 (95% confidence interval=1.5-8.2) and 8.1 (95% confidence interval=3.0-21.3), respectively. In conclusion, CRP is a sensitive and easily detectable serum marker that can be useful in patients with CRC, allowing their better clinical stratification.
结直肠癌（CRC）发病机制尚不完全清楚，但有证据表明炎症起关键作用。几种循环肿瘤和炎症标志物可用于研究 CRC 患者。有研究表明，高血清 C 反应蛋白（CRP）水平与多种恶性肿瘤的风险增加有关，CRP 可能影响 CRC 患者的生存。我们分析了一组接受 III 期（N=72，79.1%）和 IVa 期（N=19，20.9%）CRC 手术治疗的 91 例患者疾病分期与基线 CRP 血清水平之间的关系。患者中 51 例（56%）为男性，40 例（44%）为女性，中位年龄为 66 岁。所有患者在手术前均进行了 CRP 血清定量检测。总体 5 年生存率为 37.1±13.0 个月。与 IVa 期和 CRP≥3mg/L 亚组（N=48，52.7%）患者相比，III 期疾病和 CRP<3mg/L 亚组（N=43，47.3%）患者的生存时间更长（p<0.01）。患者年龄与 CRP 水平之间无相关性（R=-0.005，p=0.96），而生存时间与 CRP 水平呈显著负相关（R=-0.37，y=37.5343-0.5868x，p=0.0003）。采用多变量 Cox 模型分析（向前逐步法），校正年龄后，CRP 和 CRC 分期是与生存相关的独立参数，相对危险度分别为 3.5（95%置信区间为 1.5-8.2）和 8.1（95%置信区间为 3.0-21.3）。总之，CRP 是一种敏感且易于检测的血清标志物，对 CRC 患者有一定的临床分层作用。
