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      C-Reactive Protein as a Prognostic Biomarker for Gynecologic Cancers: A Meta-Analysis

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          Abstract

          Background

          The prognostic role of CRP (C-reactive protein) in gynecological tumors has been previously reported in individual studies, but whether CRP can be used as a separate potential prognostic factor has not been systematically reviewed. The purpose of this research is to determine if there is a link between CRP levels and the prognosis of gynecological cancer patients.

          Methods

          A systematic search was carried out to find the literature evaluating the predictive role of CRP in the prognosis of gynecological cancer patients. For the purpose of determining the relationship between CRP and clinicopathological characteristics, the pooled odds ratio (OR) was calculated. A hazard ratio (HR) with a 95% confidence interval (CI) was used to determine differences in overall survival (OS), disease-free survival (DFS), or progression-free survival (PFS) between patients with low and high CRP levels.

          Results

          A total of 19 studies, including 4062 patients, were analyzed retrospectively. The FIGO stage was related to the CRP level (OR = 0.43, 95% CI: 0.19–1.00). Age, lymph node metastasis, and histological grade were not associated with CRP level (OR = 0.93, 95% CI: 0.69–1.25; OR = 0.91, 95% CI: 0.65–1.28; OR = 0.74, 95% CI: 0.52–1.05). Worse OS (HR = 1.40, 95% CI: 1.23–1.57), DFS (HR = 1.20, 95% CI: 1.12–1.28), and PFS (HR = 1.57, 95%CI: 1.23–1.91) were associated with elevated CRP levels, as shown by the pooled results. Subgroup analysis was performed according to cancer type (endometrial cancer: HR = 1.15, 95% CI: 1.02–1.28; ovarian cancer: HR = 1.67, 95% CI: 1.03–2.31; cervical cancer: HR = 1.42, 95% CI: 1.19–1.64), multivariate value (HR = 1.22, 95% CI: 1.10–1.33), and age (HR = 1.50, 95% CI: 1.28–1.72). Significant correlations were observed between CRP and OS.

          Conclusions

          CRP may be utilized as a prognostic indicator for a variety of gynecologic malignancies, including cervical cancer, ovarian cancer, endometrial cancer, and vulvar cancer.

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          Cancer statistics in China, 2015.

          Wanqing Chen, Rongshou Zheng, Peter D Baade … (2016)
          With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. Because of China's massive population (1.37 billion), previous national incidence and mortality estimates have been limited to small samples of the population using data from the 1990s or based on a specific year. With high-quality data from an additional number of population-based registries now available through the National Central Cancer Registry of China, the authors analyzed data from 72 local, population-based cancer registries (2009-2011), representing 6.5% of the population, to estimate the number of new cases and cancer deaths for 2015. Data from 22 registries were used for trend analyses (2000-2011). The results indicated that an estimated 4292,000 new cancer cases and 2814,000 cancer deaths would occur in China in 2015, with lung cancer being the most common incident cancer and the leading cause of cancer death. Stomach, esophageal, and liver cancers were also commonly diagnosed and were identified as leading causes of cancer death. Residents of rural areas had significantly higher age-standardized (Segi population) incidence and mortality rates for all cancers combined than urban residents (213.6 per 100,000 vs 191.5 per 100,000 for incidence; 149.0 per 100,000 vs 109.5 per 100,000 for mortality, respectively). For all cancers combined, the incidence rates were stable during 2000 through 2011 for males (+0.2% per year; P = .1), whereas they increased significantly (+2.2% per year; P < .05) among females. In contrast, the mortality rates since 2006 have decreased significantly for both males (-1.4% per year; P < .05) and females (-1.1% per year; P < .05). Many of the estimated cancer cases and deaths can be prevented through reducing the prevalence of risk factors, while increasing the effectiveness of clinical care delivery, particularly for those living in rural areas and in disadvantaged populations.
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            Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2).

            Claudia Allemani, Hannah K Weir, Helena Carreira … (2015)
            Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control.
            Article 0 comments Cited 489 times – based on 0 reviews     Review now
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              Chronic inflammation and cancer.

              Emily Shacter, Sigmund Weitzman (2002)
              A substantial body of evidence supports the conclusion that chronic inflammation can predispose an individual to cancer, as demonstrated by the association between chronic inflammatory bowel diseases and the increased risk of colon carcinoma. Chronic inflammation is caused by a variety of factors, including bacterial, viral, and parasitic infections, chemical irritants, and nondigestible particles. The longer the inflammation persists, the higher the risk of associated carcinogenesis. This review describes some of the underlying causes of the association between chronic inflammation and cancer. Inflammatory mediators contribute to neoplasia by inducing proneoplastic mutations, adaptive responses, resistance to apoptosis, and environmental changes such as stimulation of angiogenesis. All these changes confer a survival advantage to a susceptible cell. In this article, we discuss the contribution of reactive oxygen and nitrogen intermediates, prostaglandins, and inflammatory cytokines to carcinogenesis. A thorough understanding of the molecular basis of inflammation-associated neoplasia and progression can lead to novel approaches to the prevention and treatment of cancer.
              Article 0 comments Cited 210 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Qingling Ren:
                ORCID: https://orcid.org/0000-0002-7383-9873
                Journal
                Journal ID (nlm-ta): Comput Intell Neurosci
                Journal ID (iso-abbrev): Comput Intell Neurosci
                Journal ID (publisher-id): cin
                Title: Computational Intelligence and Neuroscience
                Publisher: Hindawi
                ISSN (Print): 1687-5265
                ISSN (Electronic): 1687-5273
                Publication date Collection: 2022
                Publication date (Electronic): 11 October 2022
                Volume: 2022
                Electronic Location Identifier: 6833078
                Affiliations
                1Department of Gynaecology, Affliated Hospital of Nanjing University of Chinese Medicine, No. 155, Hanzhong Street, Nanjing 210029, Jiangsu, China
                2Department of Gastroenterology, Affliated Hospital of Nanjing University of Chinese Medicine, No. 155, Hanzhong Street, Nanjing 210029, Jiangsu, China
                3Nursing Institute of Nanjing Medical University, No. 818, Tianyuan Street, Nanjing 210029, Jiangsu, China
                Author notes

                Academic Editor: D. Plewczynski

                Author information
                https://orcid.org/0000-0002-7383-9873
                Article
                DOI: 10.1155/2022/6833078
                PMC ID: 9578838
                PubMed ID: 36268143
                SO-VID: cdaf7114-860e-4179-bbd2-251e04ee5576
                Copyright © Copyright © 2022 Yingying Yang et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 23 July 2022
                Date revision received : 3 September 2022
                Date accepted : 14 September 2022
                Funding
                Funded by: National Natural Science Foundation of China
                Award ID: 82074478
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Neurosciences
                Data availability:
                ScienceOpen disciplines: Neurosciences

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