Elevation of preoperative serum C‐reactive protein level is related to poor prognosis in esophageal squamous cell carcinoma

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Abstract
Background and Objectives An increased serum C‐reactive protein (CRP) level was found in patients with various malignant tumors and was associated with poor prognosis. The aim of this study was to analyze the clinicopathological significance and the prognostic value of preoperative CRP levels in patients with esophageal squamous cell carcinomas. Patients and Methods The preoperative CRP level was measured by enzyme‐linked immunosorbent assay (ELISA) in 150 patients with primary esophageal squamous cell carcinomas. All patients underwent radical surgery without any preoperative therapy. The patients were divided into two groups using a cut‐off value of 1.0 mg/dl. The pathological classifications of the tumor were examined according to the TNM/UICC classification. The associations between the clinicopathological factors and CRP level were determined. The prognostic value of CRP was determined using Cox's proportional hazards model. Results Thirty‐five patients (23%) showed high CRP levels (more than 1.0 mg/dl). Statistically significant differences in CRP levels were observed depending on tumor depth (P = 0.022) and TNM/UICC stage (P = 0.001). A high CRP level was associated with poor survival (P = 0.005) and was confirmed by multivariate analysis. Conclusions A high CRP level is associated with tumor progression and poor survival in patients with esophageal squamous cell carcinoma. J. Surg. Oncol. 2003;83:248–252.