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Elevated high-sensitivity C-reactive protein, a marker of advanced stage gastric cancer and postgastrectomy disease recurrence

Authors

  • Yanghee Woo MD,

    1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
    2. Robot and Minimally Invasive Surgery Center, Yonsei University College of Medicine, Seoul, Korea
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  • Woo Jin Hyung MD, PhD,

    Corresponding author
    1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
    2. Robot and Minimally Invasive Surgery Center, Yonsei University College of Medicine, Seoul, Korea
    3. Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
    • Department of Surgery, Yonsei University College of Medicine, 134 Shinchon-dong Seodaemun-gu, Seoul 120-752, Korea. Fax: +82-2-313-8289.
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  • Kazutaka Obama MD, PhD,

    1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
    2. Robot and Minimally Invasive Surgery Center, Yonsei University College of Medicine, Seoul, Korea
    3. Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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  • Hyoung-Il Kim MD,

    1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
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  • Kyung Ho Pak MD,

    1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
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  • Taeil Son MD,

    1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
    2. Robot and Minimally Invasive Surgery Center, Yonsei University College of Medicine, Seoul, Korea
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  • Sung Hoon Noh MD, PhD

    1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
    2. Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
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Abstract

Background and Objectives

Gastric cancer recurrence after curative surgery remains high. Although no preoperative marker of gastric cancer progression after radical gastrectomy exists, recent studies suggest that C-reactive protein (CRP) is associated with cancer progression. Our study evaluated the significance of preoperative high-sensitivity CRP (hs-CRP) levels as a marker of disease progression after radical gastrectomy.

Methods

The preoperative hs-CRP levels of 1,221 gastric cancer patients who underwent radical gastrectomies were analyzed for clinicopathologic significance. Patients with previous gastric cancer treatment, another primary cancer, active infection, or postoperative mortality were excluded.

Results

hs-CRP levels were significantly associated with increased tumor depth (P = 0.028), nodal status (P = 0.012), and stage (P = 0.045). Seventeen percent of patients had elevated hs-CRP levels at the cutoff value of >3.00 mg/L, whereas 6.6% and 6.1% of patients had CEA and CA-19-9 levels about the cutoffs of ≥5.00 ng/ml and ≥35.0 U/L, respectively. Hs-CRP levels >3.00 mg/L were an independent risk factor for recurrence-free survival along with stage.

Conclusion

Elevated preoperative hs-CRP levels in gastric cancer patients are clinically significant indicators of advanced stage and postoperative disease recurrence. J. Surg. Oncol. 2012;105:405–409. © 2011 Wiley Periodicals, Inc.

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