title: Higher serum C-reactive protein concentration and hypoalbuminemia are poor prognostic indicators in patients with esophageal cancer undergoing radiotherapy.
abstract: 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.
authors.affiliation: National Kaohsiung University of Applied Sciences, Taiwan. cywang@adm.cgmh.org.tw
authors.forename: Chang-Yu
authors.initials: CY
authors.lastname: Wang
authors.forename: Ming-Jang
authors.initials: MJ
authors.lastname: Hsieh
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Chiu
authors.forename: Shau-Hsuan
authors.initials: SH
authors.lastname: Li
authors.forename: Hurng-Wern
authors.initials: HW
authors.lastname: Huang
authors.forename: Fu-Min
authors.initials: FM
authors.lastname: Fang
authors.forename: Yu-Jie
authors.initials: YJ
authors.lastname: Huang
mesh_terms: 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
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein