title: Clinical significance of preoperative C-reactive protein and squamous cell carcinoma antigen levels in patients with penile squamous cell carcinoma.
abstract: To evaluate the relevance of C-reactive protein (CRP) and squamous cell carcinoma antigen (SCC-Ag) levels in relation to clinicopathological factors and prognosis in penile cancer.
  
  
  
  A total of 124 Chinese patients with penile squamous cell carcinoma (SCC), treated between November 2007 and October 2014, were analysed retrospectively. Receiver-operating characteristic curves were used to identify the combination of markers with the best sensitivity and specificity for prognosis prediction. Statistical data analysis was performed using a non-parametric method, and survival analysis was performed using the log-rank test and Cox proportional hazard model.
  
  
  
  Levels of CRP ≥4.5 mg/L and SCC-Ag ≥1.4 ng/mL were both significantly associated with lymph node metastasis (LNM) laterality (chi-squared trend test, P = 0.041), extranodal extension (chi-squared trend test, P < 0.001), pelvic LNM (chi-squared trend test, P = 0.024), pathological tumour status (chi-squared trend test, P = 0.002), pathological nodal status (chi-squared trend test, P < 0.001), and disease-specific survival (DSS; log-rank test, P < 0.001). Moreover, the influence of CRP and SCC-Ag levels on DSS (P = 0.033, hazard ratio 3.390, 95% confidence interval 1.104-10.411) remained after adjusting for smoking history, phimosis, tumour status, tumour cell differentiation and nodal status.
  
  
  
  The present study shows that the combined measurement of preoperative CRP and SCC-Ag levels may serve as an independent biomarker for LNM, advanced tumour stage and DSS in patients with penile SCC.
authors.affiliation: Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in Southern China, Guangzhou, China.|Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
authors.forename: Zai-Shang
authors.initials: ZS
authors.lastname: Li
authors.affiliation: Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in Southern China, Guangzhou, China.|Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Yao
authors.affiliation: Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in Southern China, Guangzhou, China.|Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
authors.forename: Yong-Hong
authors.initials: YH
authors.lastname: Li
authors.affiliation: Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in Southern China, Guangzhou, China.|Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
authors.forename: Jie-Ping
authors.initials: JP
authors.lastname: Chen
authors.affiliation: Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in Southern China, Guangzhou, China.|Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
authors.forename: Chuang-Zhong
authors.initials: CZ
authors.lastname: Deng
authors.affiliation: School of Life Science, Sun Yat-sen University, Guangzhou, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: Department of Urology, Affiliated Tumor Hospital of Xinjiang Medical University, Urumchi, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Chen
authors.affiliation: Department of Urology, Cancer Center of Guangzhou Medical University, Guangzhou, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Urology, Dong Guan People's Hospital, Guang Dong, China.
authors.forename: Qi-Wu
authors.initials: QW
authors.lastname: Mi
authors.affiliation: Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in Southern China, Guangzhou, China.|Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
authors.forename: Zhuo-Wei
authors.initials: ZW
authors.lastname: Liu
authors.affiliation: Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in Southern China, Guangzhou, China.|Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
authors.forename: Zi-Ke
authors.initials: ZK
authors.lastname: Qin
authors.affiliation: Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in Southern China, Guangzhou, China.|Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Han
authors.affiliation: Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in Southern China, Guangzhou, China.|Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
authors.forename: Fang-Jian
authors.initials: FJ
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000097:blood* / Q000401:mortality; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D015843:Serpins / Q000097:blood*; D015996:Survival Rate
chemical_list: D000951:Antigens, Neoplasm; D015843:Serpins; C051072:squamous cell carcinoma-related antigen; D002097:C-Reactive Protein
keywords: lymph node excision; lymph node metastasis; penile neoplasm; prognosis; staging system