Higher serum C-reactive protein concentration and hypoalbuminemia are poor prognostic indicators in patients with esophageal cancer undergoing radiotherapy.
OBJECTIVE
We evaluate if C-reactive protein (CRP) is an objective biomarker of esophageal cancer in patients undergoing radiotherapy.


METHODS
Between November 2002 and July 2007, 123 patients undergoing radiotherapy for newly diagnosed esophageal cancer were enrolled. Serum CRP concentration was measured before the initiation of treatment. The relationship between serum CRP levels and other relevant variables such as body mass index, white blood cell count, platelet count, bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), cholesterol, hemoglobin, and albumin levels was also analyzed.


RESULTS
Eighty-one patients of the 123 patients enrolled (65.9%) had elevated CRP levels (5mg/L). The 2-year survival for patients with CRP 5mg/L was 7.8% compared to 78.4% for patients with CRP <5mg/L. Hypoalbuminemia (albumin <3.5g/dL) was also related to shorter survival using univariate analysis. Multivariate analysis demonstrated that only higher serum CRP concentration and hypoalbuminemia were independent prognostic indicators for survival of patients with esophageal cancer.


CONCLUSIONS
Pretreatment serum levels of CRP and albumin are objective, easily measurable biomarkers which can be used in combination with conventional staging to accurately predict survival in patients with esophageal cancer treated with radiotherapy.
Wang
Chang-Yu
CY
National Kaohsiung University of Applied Sciences, Taiwan. cywang@adm.cgmh.org.tw
Hsieh
Ming-Jang
MJ
Chiu
Yi-Chun
YC
Li
Shau-Hsuan
SH
Huang
Hurng-Wern
HW
Fang
Fu-Min
FM
Huang
Yu-Jie
YJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D034141:Hypoalbuminemia / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D015996:Survival Rate
D014408:Biomarkers, Tumor; D002097:C-Reactive Protein