The prognostic impact of baseline C-reactive protein (CRP) in non-small-cell
lung cancer (NSCLC) is debated. To evaluate this issue, we performed a
systematic review and meta-analysis to explore the role of CRP value in
predicting early-stage NSCLC survival.
Methods
Ten articles on early-stage NSCLC were eligible and included in our study. We
performed a random-effects meta-analysis and assessed heterogeneity and
publication bias. We pooled hazard ratio (HR) estimates and their 95%
confidence intervals (CIs) on mortality for the comparison between the
study-specific highest category of CRP level versus the lowest one.
Results
In overall analysis, elevated pretreatment CRP values were significantly
associated with poor overall survival (HR 1.60, 95% CI 1.30-1.97,
p<0.001, I2 = 71.9%). Similar results were observed across
considered strata. However, higher mortality risk was reported in studies in
which CRP was combined with other factors (HR 1.96, 95% CI 1.58-2.45) and in
those using a cutoff value of 3 mg/L (HR 1.89, 95% CI 1.52-2.35).
Conclusions
Based on our analysis, baseline high CRP level is significantly associated
with poor prognosis in early-stage NSCLC. Further prospective controlled
studies are needed to confirm these data.
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