Utility of C - reactive protein as a Novel Prognostic Marker in Patients with Carcinoma Prostate Undergoing Androgen Deprivation Therapy
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 3
Abstract
Introduction and objectives: There is increasing recognition that systemic inflammation is associated with progression and reduced survival of prostate cancer patients. C-reactive protein (CRP) is an inflammatory marker that has been evaluated as a reflection of the same. Our aim was to study the prognostic implications of pre-treatment CRP values with regard to PSA response, disease progression and short term survival in patients with carcinoma prostate undergoing androgen deprivation therapy (ADT). Patients and methods: 86 patients with prostate cancer were subjected to measurement of CRP levels at time of diagnosis.PSA levels, Gleason score, haemoglobin, S.albumin were determined for all patients. Patients were grouped according to age, Gleason grade, PSA levels and presence of bone metastatic disease. They were followed up prospectively at preset regular intervals post ADT with relevant investigations for 12 months. Results: CRP values were significantly elevated in patients with higher PSA (1.78 vs 9.81 for PSA />20ng/dl), bone metastases (18.68 vs 6.06 for no mets), and higher gleason grade.Quartiles of CRP were: 0–2.0, 2.1–6.9, 7.0–15.5, and15.6–78 mg/L On follow up, CRP was a predictive of PSA response ( achieved in > 80% for patients with lowest CRP quartile compared to response in < 25% in highest quartile). In the cohort of patients with metastatic disease- CRP, low albumin levels, gleason score were prognostic factors for short term survival at 1 year. On regression analysis CRP remained an independent prognostic factor HR 1.49 inCRP (p = 0.023). Conclusion: We have found that rise in CRP level is significantly associated with an aggressive tumor phenotype at the time of diagnosis.CRP can be predictive of PSA response to therapy. Also, CRP is a costeffective test that can be used as one of the markers to risk-stratify men with advanced prostate cancer.
Authors and Affiliations
Dineshan K M, Aditya Shenoy, Felix Cardoza
Keywords
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- EP ID EP592490
- DOI 10.9790/0853-1603020713
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