title: Relationship Between Chronic Inflammation and the Stage and Histopathological Size of Colorectal Carcinoma.
abstract: OBJECTIVE
  The association of inflammatory reactions with almost all types of cancer supports the concept that inflammation is a critical component of tumor progression. The present study aimed to evaluate the relationship of serum markers of chronic inflammation with the stage of and histopathological size of colorectal carcinoma (CRC).
  
  
  METHODS
  This cross-sectional study included 90 patients of both sexes, mean age 66.2 (range 47-78) years, with clinically and histologically confirmed CRC, who were admitted to the Clinic for abdominal surgery UCCS for surgical treatment of CRC. The patients according to the stage of disease were divided into three groups (stage II-IV). The control group consisted of 30 subjects with no signs of malignancy and acute inflammatory diseases. Staging of CRC was done according to the TNM classification. In each patient, the preoperative blood samples were taken for determination of the parameters of inflammation: the erythrocyte sedimentation rate, white blood cells, C-reactive protein (CRP), fibrinogen and alpha 2 globulins.
  
  
  RESULTS
  It was confirmed that increasing markers of inflammation followed increasing stages of colorectal cancer, depth of tumor invasion and the occurrence of metastatic disease. CRP is a biomarker that consistently and significantly increases from the second to the fourth stage of colorectal cancer (7.2 (2.3-14.6) mg/L vs. 21.85 (12.3-41) mg/L vs. 38.6 (21.5-79) mg/L; p<0.01) and significantly correlates positively with the stage of CRC (r= 0.783, p<0.001), and the tumor size (r=0.249, p<0.05).
  
  
  CONCLUSIONS
  The study results point to an increase in the degree of chronic inflammation throughout the progression of colorectal cancer. The most consistent marker of chronic inflammation that accompanies the progression of colorectal carcinoma is CRP.
authors.affiliation: Clinic for Abdominal Surgery, Clinical Center of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors.forename: Ismar
authors.initials: I
authors.lastname: Rasic
authors.affiliation: Department of Pathology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors.forename: Svjetlana
authors.initials: S
authors.lastname: Radovic
authors.affiliation: Clinic for Abdominal Surgery, Clinical Center of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina.
authors.forename: Goran
authors.initials: G
authors.lastname: Aksamija
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism*; D002277:Carcinoma / Q000378:metabolism / Q000473:pathology*; D003092:Colitis / Q000378:metabolism / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000378:metabolism / Q000473:pathology*; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging
chemical_list: D014408:Biomarkers, Tumor; D005340:Fibrinogen; D002097:C-Reactive Protein
keywords: chronic inflammation; colorectal cancer