Prognostic value of C-reactive protein in esophageal cancer: a meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational prognostic cohort studies
PubMed 25338987 · doi:10.7314/apjcp.2014.15.19.8075
What was done
The authors searched Medline, Embase, and the Cochrane Central Search Library to perform a meta-analysis evaluating the association between pretreatment serum C-reactive protein (CRP) and overall survival in esophageal cancer across 11 studies totaling 1,886 patients. They also evaluated correlations between CRP and tumor node metastasis (TNM) stage as well as individual T, N, and M classifications, performing subgroup analyses by country, cut-off value, treatment modality, and sample size.
What was found
Elevated pretreatment serum CRP was significantly associated with poorer overall survival (HR 2.09, 95% CI 1.52-2.87, p<0.01). Subgroup analyses by country, cut-off value, treatment, and patient count did not alter the result. Elevated CRP was also significantly correlated with more advanced TNM stage and T, N, M grades, although specific numerical correlation coefficients or effect sizes for stage were not reported in the abstract.
Why it matters
Pretreatment serum CRP may serve as an accessible, cost-effective inflammatory biomarker to assist in risk stratification and outcome prediction for patients with esophageal cancer.
Limits
The evidence base is composed entirely of observational studies susceptible to residual confounding and publication bias. The abstract does not report specific cut-off values used to define elevated CRP, histopathological subtypes (e.g., squamous cell carcinoma versus adenocarcinoma), or quantitative estimates for the tumor stage correlations.
Cited by
- supports Diets high in added sugars chronically elevate C-reactive protein (CRP), an inflammatory marker correlated with tumor progression and metastasis.