title: Serum C-reactive protein (CRP) as a simple and independent prognostic factor in extranodal natural killer/T-cell lymphoma, nasal type.
abstract: BACKGROUND
  C-reactive protein (CRP) is a biomarker of the inflammatory response, and it shows significant prognostic value for several types of solid tumors. The prognostic significance of CRP for lymphoma has not been fully examined. We evaluated the prognostic role of baseline serum CRP levels in patients with extranodal natural killer (NK)/T-cell lymphoma (ENKTL).
  
  
  METHODS
  We retrospectively analyzed 185 patients with newly diagnosed ENKTL. The prognostic value of the serum CRP level was evaluated for the low-CRP group (CRP≤10 mg/L) versus the high-CRP group (CRP>10 mg/L). The prognostic value of the International Prognostic Index (IPI) and the Korean Prognostic Index (KPI) were evaluated and compared with the newly developed prognostic model.
  
  
  RESULTS
  Patients in the high-CRP group tended to display increased adverse clinical characteristics, lower rates of complete remission (P<0.001), inferior progression-free survival (PFS, P = 0.001), and inferior overall survival (OS, P<0.001). Multivariate analysis demonstrated that elevated serum CRP levels, age >60 years, hypoalbuminemia, and elevated lactate dehydrogenase levels were independent adverse predictors of OS. Based on these four independent predictors, we constructed a new prognostic model that identified 4 groups with varying OS: group 1, no adverse factors; group 2, 1 factor; group 3, 2 factors; and group 4, 3 or 4 factors (P<0.001). The novel prognostic model was found to be superior to both the IPI in discriminating patients with different outcomes in the IPI low-risk group and the KPI in distinguishing between the low- and intermediate-low-risk groups, the intermediate-low- and high-intermediate-risk groups, and the high-intermediate- and high-risk groups.
  
  
  CONCLUSIONS
  Our results suggest that pretreatment serum CRP levels represent an independent predictor of clinical outcome for patients with ENKTL. The prognostic value of the new prognostic model is superior to both IPI and KPI.
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, China.
authors.forename: Ya-Jun
authors.initials: YJ
authors.lastname: Li
authors.forename: Zhi-Ming
authors.initials: ZM
authors.lastname: Li
authors.forename: Yi
authors.initials: Y
authors.lastname: Xia
authors.forename: Jia-Jia
authors.initials: JJ
authors.lastname: Huang
authors.forename: Hui-Qiang
authors.initials: HQ
authors.lastname: Huang
authors.forename: Zhong-Jun
authors.initials: ZJ
authors.lastname: Xia
authors.forename: Tong-Yu
authors.initials: TY
authors.lastname: Lin
authors.forename: Su
authors.initials: S
authors.lastname: Li
authors.forename: Xiu-Yu
authors.initials: XY
authors.lastname: Cai
authors.forename: Zhi-Jun
authors.initials: ZJ
authors.lastname: Wu-Xiao
authors.forename: Wen-Qi
authors.initials: WQ
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D054391:Lymphoma, Extranodal NK-T-Cell / Q000097:blood* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D056910:Republic of Korea; D012307:Risk Factors; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein