title: Prognostic value of circulating C-reactive protein levels in patients with non-small cell lung cancer: a systematic review with meta-analysis.
abstract: BACKGROUND
  The clinical and prognostic significance of C-reactive protein (CRP) in nonsmall-cell lung cancer (NSCLC) remains inconsistent. To clarify a precise determinant of the clinical significance of CRP, we conducted a systematic review and meta-analysis to evaluate the overall risk of elevated CRP for survival in NSCLC.
  
  
  METHODS
  Related studies were identified and evaluated for quality through multiple search strategies. Data were collected from studies comparing overall survival in patients with elevated CRP levels and those having lower levels. The meta-analysis was performed by Review Manager version 5.2 (RevMan; the Cochrane Collaboration, Oxford, England). The pooled hazard ratios (HRs) and 95% confidence intervals (CI) were calculated employing fixed- or random-effects models depending on the heterogeneity of the included trials.
  
  
  RESULTS
  Eight eligible studies involved 1649 patients were ultimately identified. Combined HRs suggested that elevated CRP had an unfavorable impact on survival of patients with NSCLC. The HRs (95% CI) was 1.55 (1.19-2.01) overall, 1.78 (1.33-2.38) in Asian patients, 1.33 (1.00-1.77) in non-Asian patients, 1.78 (1.47-2.15) in primary resectable NSCLC, 1.28 (0.95-1.73) in primary unresectable NSCLC, 1.78 (1.33-2.38) in group of cut-off value <5 mg/L, 1.33 (1.00-1.77) in group of cut-off value ≥10 mg/L.
  
  
  CONCLUSIONS
  With the available evidence, CRP might serve as an efficient prognostic indicator in NSCLC. This marker should be taken into consideration in the development of new diagnostic and therapeutic program for NSCLC.
authors.forename: Ying
authors.initials: Y
authors.lastname: Jin
authors.forename: Yan
authors.initials: Y
authors.lastname: Sun
authors.forename: Xun
authors.initials: X
authors.lastname: Shi
authors.forename: Jun
authors.initials: J
authors.lastname: Zhao
authors.forename: Lei
authors.initials: L
authors.lastname: Shi
authors.affiliation: Department of Medical Oncology, Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Hangzhou 310022, China.
authors.forename: Xinmin
authors.initials: X
authors.lastname: Yu
mesh_terms: D002097:C-Reactive Protein / Q000378:metabolism*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000378:metabolism* / Q000473:pathology; D011379:Prognosis
chemical_list: D002097:C-Reactive Protein