The acute phase response in breast carcinoma.
BACKGROUND
The acute phase response follows tissue injury, trauma or infection and maintains homeostasis. It may also be activated in patients with malignancy and studies have suggested that it is associated with a poor prognosis. This study examined C-reactive protein (CRP) and serum amyloid A (SAA) in patients with breast carcinoma, both at presentation and during follow-up, to assess the value of the acute phase proteins in patient management.


METHODS
CRP and SAA were measured in 92 patients with breast carcinoma at presentation and 31 patients with benign breast disease. Serial levels were also measured in 14 patients who developed metastatic disease and 16 patients without evidence of disease progression.


RESULTS
The levels of CRP and SAA were significantly higher in patients with Stage 4 disease compared with controls (CRP 47.6(275) vs 4.5(3.5) mg/L; p < 0.001): SAA 271.1(174.8) vs 37.6 (14.7) mg/L; p < 0.01; results as mean (SEM)). The highest levels of both CRP and SAA were seen in patients with T4 ulcerating tumours (CRP 86.7(38.6) mg/L; SAA 507.3 (276.5) mg/L). During follow-up only CRP levels were elevated at the time of recurrence and neither CRP nor SAA measurement were of benefit in predicting recurrence.


CONCLUSIONS
The highest levels of CRP and SAA were seen in ulcerating T4 tumours. This has implications for the postulated role of acute phase proteins as prognostic factors in other tumours. Serial levels of acute phase proteins were of no benefit in predicting recurrence.
O'Hanlon
Deirdre M
DM
National Breast Cancer Research Institute, University College Hospital, Galway, Ireland. deirdreohanlon@hotmail.com
Lynch
Jennifer
J
Cormican
Martin
M
Given
H Fred
HF
D000210:Acute-Phase Reaction / Q000097:blood*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001053:Apolipoproteins / Q000097:blood; D001859:Bone Neoplasms / Q000097:blood / Q000556:secondary; D001943:Breast Neoplasms / Q000097:blood / Q000473:pathology*; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000556:secondary; D008875:Middle Aged; D009367:Neoplasm Staging; D000685:Serum Amyloid A Protein
D001053:Apolipoproteins; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein