EVALUATION OF PREOPERATIVE ELEVATION OF SERUM C-REACTIVE PROTEIN AS AN INDICATOR FOR PROGNOSIS OF COLORECTAL CANCER

Background: Cancer has not been elucidated in colerectal site. C-reactive protein (CRP) is a product synthesized in hepatocytes and has been reported to be up-regulated by such proinflammatory cytokines as interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor (TNF). The significance of a preoperative serum elevation was evaluated using CRP as a predictive indicator for the malignant potential and prognosis. Methods: Forty consecutive patient with colorectal cancer whose local lesions were resected in our department, plus forty healthy volunteers, were selected. Any patient with inflammatory diseases such as infection or collagen disease was excluded from the current study. The preoperative serum CRP level and the control group were measured. The relationships between the serum elevation of CRP and both the clinicopathologic factors and prognosis of the patients was investigated. Results: The rate of patients with elevated serum CRP level was significantly higher in the colorectal cancer patients in comparison to the control group (55% versus 2.5%). Furthermores the incidence of liver metastasis, peritoneal carcinomatosis, histopathologic lymph nodes metastasis, and tumor invasion in colorectal cancer patients with a preoperatively elevated serum CRP level were significantly more frequent than in those with a negative serum CRP level. The survival rates of the colorectal cancer patients without a preoperative elevation of the serum CRP proved to be significantly more favorable than that of the colorectal cancer patients with such an elevation (94.4% versus 59.1%; P<0.001). Conclusion: Apreoperative serum elevation of CRP was thus found to be an indicator of the malignant potential of the tumor as well as prognostic factor for patients with colorectal cancer.