title: Inflammatory biomarkers and cancer: CRP and suPAR as markers of incident cancer in patients with serious nonspecific symptoms and signs of cancer.
abstract: In Denmark, patients with serious nonspecific symptoms and signs of cancer (NSSC) are referred to the diagnostic outpatient clinics (DOCs) where an accelerated cancer diagnostic program is initiated. Various immunological and inflammatory biomarkers have been associated with cancer, including soluble urokinase plasminogen activator receptor (suPAR) and the pattern recognition receptors (PRRs) pentraxin-3, mannose-binding lectin, ficolin-1, ficolin-2 and ficolin-3. We aimed to evaluate these biomarkers and compare their diagnostic ability to classical biomarkers for diagnosing cancer in patients with NSSC. Patients were included from the DOC, Department of Infectious Diseases, Copenhagen University Hospital Hvidovre. Patients were given a final diagnosis based on the combined results from scans, blood work and physical examination. Weight loss, Charlson score and previous cancer were registered on admission, and plasma concentrations of biomarkers were measured. The primary outcome was incident cancer within 1 year. Out of 197 patients included, 39 patients (19.8%) were diagnosed with cancer. Patients with cancer were significantly older and had a higher burden of comorbidities and previous cancer diagnoses compared to patients who were not diagnosed with cancer. Previous cancer, C-reactive protein (CRP) and suPAR were significantly associated with newly diagnosed cancer during follow-up in multiple logistic regression analyses adjusted for age, sex and CRP. Neither any of the PRRs investigated nor self-reported weight loss was associated with cancer. In this study, previous cancer, CRP and suPAR were significantly associated with cancer diagnosis in patients with NSSC. Ficolin-1-3, MBL and pentraxin-3 were not associated with cancer.
authors.affiliation: Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: Line Jee Hartmann
authors.identifier: 0000-0001-6613-2469
authors.initials: LJH
authors.lastname: Rasmussen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev, Herlev, Denmark.
authors.forename: Martin
authors.initials: M
authors.lastname: Schultz
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Gaardsting
authors.affiliation: Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: Steen
authors.initials: S
authors.lastname: Ladelund
authors.affiliation: Laboratory of Molecular Medicine, Department of Clinical Immunology, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Garred
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Herlev, Herlev, Denmark.
authors.forename: Kasper
authors.initials: K
authors.lastname: Iversen
authors.affiliation: Clinical Research Centre, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: Jesper
authors.initials: J
authors.lastname: Eugen-Olsen
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: Morten
authors.initials: M
authors.lastname: Helms
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: Kim Peter
authors.initials: KP
authors.lastname: David
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet, Denmark.
authors.forename: Andreas
authors.initials: A
authors.lastname: Kjaer
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: Anne-Mette
authors.initials: AM
authors.lastname: Lebech
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.
authors.forename: Gitte
authors.initials: G
authors.lastname: Kronborg
mesh_terms: D000367:Age Factors; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D003718:Denmark; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000473:pathology; D037102:Lectins / Q000097:blood; D008297:Male; D037241:Mannose-Binding Lectins / Q000097:blood; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood* / Q000235:genetics / Q000473:pathology; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood*; D000683:Serum Amyloid P-Component / Q000378:metabolism; D012727:Sex Characteristics; D000097604:Ficolins; D000099153:Pentraxins
chemical_list: D014408:Biomarkers, Tumor; D002097:C-Reactive Protein; D037102:Lectins; D037241:Mannose-Binding Lectins; D055293:Receptors, Urokinase Plasminogen Activator; D000683:Serum Amyloid P-Component; D000097604:Ficolins; D000099153:Pentraxins
keywords: PTX3 protein; diagnosis; ficolin; mannose-binding lectin; neoplasms