title: Prognostic value of C-reactive protein in esophageal cancer: a meta-analysis.
abstract: BACKGROUND
  The classical inflammatory biomarker, C-reactive protein (CRP), has been identified to be related to progression of esophageal cancer. Some research showed that elevated pretreatment serum CRP indicated a poor prognosis, but results have been inconsistent.
  
  
  METHODS
  We searched the Medline, Embase and the Cochrane Central Search Library for suitable studies and a meta-analysis of eleven (1,886 patients) was conducted to examine the relationship between elevated serum CRP level and overall survival (OS) in esophageal cancer cases. Moreover, correlation analyses were conducted to assess links between pretreatment serum CRP level and tumor node metastasis (TNM) stage as well as T, N, M grade, respectively.
  
  
  RESULTS
  The pooled analysis showed that elevated pretreatment serum CRP level was significantly associated with poorer overall survival (HR 2.09, 95%CI 1.52-2.87, p<0.01). Subgroup analyses were conducted by "country", "cut-off value", "treatment" and "number of patients", and no single factor could alter the result. Elevated pretreatment serum CRP was significantly correlated with more advanced TNM stage and T, N, M grade respectively.
  
  
  CONCLUSIONS
  Elevated pretreatment serum CRP levels are associated with poorer prognosis in esophageal cancer patients, and could serve as a useful biomarker for outcome prediction.
authors.affiliation: Department of Thoracic Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China E-mail : zzuzhaosong@yahoo.com.
authors.forename: Tian-Liang
authors.initials: TL
authors.lastname: Zheng
authors.forename: Ke
authors.initials: K
authors.lastname: Cao
authors.forename: Cui
authors.initials: C
authors.lastname: Liang
authors.forename: Kai
authors.initials: K
authors.lastname: Zhang
authors.forename: Hai-Zhou
authors.initials: HZ
authors.lastname: Guo
authors.forename: De-Ping
authors.initials: DP
authors.lastname: Li
authors.forename: Song
authors.initials: S
authors.lastname: Zhao
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein