title: C-reactive protein as a prognostic factor for human osteosarcoma: a meta-analysis and literature review.
abstract: BACKGROUND
  Osteosarcoma is the most common primary bone cancer in growing adolescents and young adults. The prognostic role of C-reactive protein (CRP) in patients with osteosarcoma is not fully investigated. The purpose of this study is to perform a meta-analysis and literature review on the role of CRP in osteosarcoma and to assess the potential role of serum CRP as a prognostic factor for patients with osteosarcoma.
  
  
  METHODS
  A detailed literature search was made in Medline for related research publications written in English. Methodological quality of the studies was also evaluated. The data were extracted and assessed by two reviewers independently. Analysis of pooled data were performed, risk ratio (RR) and corresponding confidence intervals (CIs) were calculated and summarized respectively.
  
  
  RESULTS
  Final analysis of 397 patients from 2 eligible studies was performed. Combined RR of CRP expression suggested that the raised serum CRP level had an adverse prognostic effect on overall survival of patients with osteosarcoma (n = 397 in 2 studies; RR = 0.35; 95% CI: 0.18-0.68; p = 0.002). In the uni- and multivariate survival analysis, response rate and CRP levels were the only independent prognostic variables.
  
  
  CONCLUSIONS
  The results of this meta-analysis suggest that CRP expression confers a worse prognosis in patients with osteosarcoma. Large prospective studies are necessary to provide solid data to confirm the prognostic significance of CRP.
authors.affiliation: The Upper Limb Orthopedic Department of Huang Pu Award, The First Affiliated Hospital of Sun Yat-Sen University Guangzhou, China.
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Yi
authors.affiliation: The Upper Limb Orthopedic Department of Huang Pu Award, The First Affiliated Hospital of Sun Yat-Sen University Guangzhou, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Wang
authors.affiliation: The Upper Limb Orthopedic Department of Huang Pu Award, The First Affiliated Hospital of Sun Yat-Sen University Guangzhou, China.
authors.forename: Zhi-Yong
authors.initials: ZY
authors.lastname: Li
authors.affiliation: The Upper Limb Orthopedic Department of Huang Pu Award, The First Affiliated Hospital of Sun Yat-Sen University Guangzhou, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Hu
authors.affiliation: The Upper Limb Orthopedic Department of Huang Pu Award, The First Affiliated Hospital of Sun Yat-Sen University Guangzhou, China.
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Niu
authors.affiliation: The Upper Limb Orthopedic Department of Huang Pu Award, The First Affiliated Hospital of Sun Yat-Sen University Guangzhou, China.
authors.forename: Xiao-Lin
authors.initials: XL
authors.lastname: Liu
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D006801:Humans; D012516:Osteosarcoma / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein