Serum C-reactive protein levels predict survival in hepatocellular carcinoma
Article first published online: 15 AUG 2007
Volume 27, Issue 8, pages 1091–1097, October 2007
How to Cite
Nagaoka, S., Yoshida, T., Akiyoshi, J., Akiba, J., Torimura, T., Adachi, H., Kurogi, J., Tajiri, N., Inoue, K., Niizeki, T., Koga, H., Imaizumi, T., Kojiro, M. and Sata, M. (2007), Serum C-reactive protein levels predict survival in hepatocellular carcinoma. Liver International, 27: 1091–1097. doi: 10.1111/j.1478-3231.2007.01550.x
- Issue published online: 15 AUG 2007
- Article first published online: 15 AUG 2007
- Received 13 April 2007accepted 26 June 2007
- C-reactive protein;
- hepatocellular carcinoma;
Background/Aims: C-reactive protein (CRP) was recently identified as a prognostic factor for patients with hepatocellular carcinoma (HCC) after surgical resection. We investigated the relationship between the serum levels of high sensitivity CRP (H-CRP) and the prognosis of HCC patients.
Method: We conducted a cohort study of 90 HCC patients enrolled from 1997 to 1998. All patients were treated and followed for a mean period of 3.2 years. Clinical variables were compared between patients positive for H-CRP (serum H-CRP levels ≥3.0 mg/L, n=47) and those negative for H-CRP (serum H-CRP levels <3.0 mg/L, n=43). We also determined the relationship between serum H-CRP and prognosis in HCC patients.
Results: The survival rate of patients of the H-CRP-positive group was lower than that of H-CRP-negative patients. Tumour stage (stages 3 or 4), total bilirubin ≥1.2 mg/dL, albumin (Alb) <3.5 g/dL, des-γ-carboxy prothrombin ≥40 mAU/mL, positive H-CRP and initial treatment (transcatheter arterial chemoembolization, hepatic arterial infusion chemotherapy or best supportive care) were identified as significant poor prognostic factors by univariate analysis, while positive H-CRP [hazard ratio (HR), 1.58; P=0.048], Alb<3.5 g/dL (HR, 2.10; P=0.004), tumour stage (stages 3 or 4; HR, 3.05; P=0.001) and initial treatment (HR, 1.88; P=0.029) were considered to be significant determinants of poor prognosis by multivariate Cox proportional hazards analysis.
Conclusions: The prognosis of H-CRP-positive patients was poorer compared with H-CRP-negative patients. This study confirmed that H-CRP, like CRP, is a marker of poor prognosis in HCC patients.