The level of C-reactive protein (CRP) expressed in the tumor specimens of patients with renal cell carcinoma (RCC) may serve as a widely available biomarker for postoperative prognosis of localized disease, according to researchers from Emory University in Atlanta, Georgia.
Johnson, et al reported in The Journal of Urology
that patients with high-risk levels of CRP experienced a 27-fold increase in their risk of mortality compared with those whose levels were rated as low risk (2011;186(4):1213-1217). By contrast, the preoperative CRP level measured in serum was not a significant predictive factor in overall survival.
Serum CRP, which measures systemic inflammatory response, has emerged in recent years as a predictive marker for patients with metastatic RCC. Investigators at Emory, however, noted that the prognostic value of intratumor CRP is not yet clear.
The research team examined postoperative surgical specimens through immunohistochemistry from 95 patients with resected, localized clear cell RCC. Patients were categorized as low risk (staining 0-1), intermediate risk (staining 2) and high risk (staining 3).
At follow-up of up to 46 months, 49.3% of tumors were classified as low risk, 25.3% as intermediate risk, and 25.3% as high risk. Patients with the highest levels of CRP had the highest risk, particularly when compared with those whose tumors were in the low-risk category (hazard ratio 27.767, 95% confidence interval 1.488-518.182).