Evaluation of Preoperative Elevation of Serum C-Reactive Protein as an Indicator for Prognosis in Colorectal Cancer

The c-reactive protein (crp) is a product synthesized in hepatocytesand has been reported to be up-regulated by such proinflammatory cytokines asinterleukin-1 (il-1), interleukin-6 (il-6), and tumor necrosis factor (tnf).the significance of a preoperative serum elevation in crp as a predictive indicatorfor the malignant potential and prognosis in colorectal cancer has not beenelucidated.method: forty consecutive patients with colorectal cancer, whose local lesions wereresected in our department, plus forty volunteer healthy persons, were selected.any patient with inflammatory diseases such as infection or collagen disease wasexcluded from the current study. then preoperative serum crp level weremeasured, and also from the control group. the relationships between the serumelevation of crp and both the clinicopathologic factors and prognosis of thepatients was investigated.results: the rate of patients with elevated serum crp level was significantly higherin colorectal cancer patients in comparison with the control group (55% versus 2.5%). furthermore the incidence of liver metastasis, peritoneal carcinomatosis,histopathologic lymph nodes metastasis, and tumor invasion in colorectal cancerpatients with a preoperatively elevated serum crp level were significantly morefrequent than in those with a negative serum crp level. the survival rates ofcolorectal cancer patients without a preoperative elevation of serum crp proved tobe significantly more favourable than what in colorectal cancer patients with suchan elevation (94. 4% versus 59. 1%; p<0. 001).conclusions: a preoperative serum elevation of crp was thus found to be anindicator of malignant potential of the tumor as well as a predictor for theprognosis of patients with colorectal cancer.