Cancer Management and Research (Feb 2023)

The Role of Perioperative C-Reactive Protein in Predicting the Prognosis of Epithelial Ovarian Carcinoma

  • Pan Q,
  • Wei M,
  • Lu M,
  • Xu Y,
  • Xie X,
  • Li X

Journal volume & issue
Vol. Volume 15
pp. 233 – 243

Abstract

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Qianqian Pan,1,2 Mingjing Wei,1,3,4 Mengyi Lu,5 Yaping Xu,6 Xing Xie,1,3,4 Xiao Li1,3,4 1Department of Gynecologic Oncology, Women’s Hospital, School of Medicine Zhejiang University, Hangzhou, Zhejiang, 310006, People’s Republic of China; 2Zhejiang Financial College, Hangzhou, Zhejiang, People’s Republic of China; 3Zhejiang Provincial Key Laboratory of Precision Diagnosis and Therapy for Major Gynecological Diseases, Hangzhou, Zhejiang, 310006, People’s Republic of China; 4Zhejiang University Cancer Center, Hangzhou, Zhejiang, 310058, People’s Republic of China; 5Wenzhou Central Hospital, Wenzhou, Zhejiang, People’s Republic of China; 6Hangzhou Red Cross Hospital, Hangzhou, Zhejiang, 310003, People’s Republic of ChinaCorrespondence: Xiao Li, Women’s Hospital, Zhejiang University School of Medicine, No. 1 Xueshi Road, Hangzhou, Zhejiang, People’s Republic of China, 310006, Tel +86-0571-89998891, Fax +86-0571-89998891, Email [email protected]: Increasing epidemiological evidence supported that chronic inflammatory factors might be involved in the carcinogenesis and progression of various cancers. The present study tried to investigate the prognostic value of perioperative C-reactive protein (CRP) in prognosis of patients with epithelial ovarian carcinoma (EOC) from a tertiary university teaching hospital.Methods: The cutoff value of CRP was calculated according to receiver operating characteristic (ROC) curve. Variables were compared using Chi-square test. Progress-free survival (PFS) and overall survival (OS) time were assessed by Kaplan–Meier (KM) survival analysis and Log rank test based on serum CRP level. Univariate and multivariate Cox regression analyses were applied for assessing the relationship between clinicopathological parameters and survival.Results: Higher perioperative CRP levels (preoperative ≥ 5.15 mg/L and postoperative ≥ 72.45 mg/L) were significantly associated with serous tumor, high-grade, advanced stage, elevated preoperative CA125, suboptimal surgery, chemotherapy resistance, recurrence and death in EOC (P < 0.01). KM analysis suggested patients with elevated preoperative, postoperative and perioperative CRP had shorter survival (P < 0.01). Elevated perioperative CRP was an independent risk factor for PFS (HR 1.510, 95% CI 1.124– 2.028; P = 0.006) and OS (HR 1.580, 95% CI 1.109– 2.251; P = 0.011). Similar results were obtained for elevated preoperative CRP. Subgroup analysis further suggested that elevated perioperative CRP was also an independent risk factor for prognosis in advanced stage and serous EOC.Conclusion: Elevated perioperative CRP was an independent risk factor for poorer prognosis of EOC, particularly in advanced stage and serous patients.Keywords: epithelial ovarian carcinoma, perioperative C-reactive protein, prognosis

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