Jia Mi Yu1, Mei Yang1, Hong Xia Xu2, Wei Li3, Zhen Ming Fu4, Yuan Lin5, Ying Ying Shi6, Chun Hua Song7, Han Ping Shi8, Zeng Qing Guo1. 1. a Department of Medical Oncology , Fujian Cancer Hospital, Fujian Medical University Cancer Hospital , Fuzhou , Fujian , China. 2. b Department of Nutrition , Daping Hospital & Research Institute of Surgery, Third Military Medical University , Chongqing , China. 3. c Cancer Center of the First Hospital of Jilin University , Changchun , Jilin , China. 4. d Cancer Center, Renmin Hospital of Wuhan University , Wuhan , Hubei , China. 5. e Department of Gastrointestinal Surgery , Affiliated Tumor Hospital of Guangxi Medical University , Nanning , Guangxi , China. 6. f Department of Surgery , The First Affiliated Hospital of SunYat-sen University , Guangzhou , Guangdong , China. 7. g Department of Epidemiology , College of Public Health, Zhengzhou University , Zhengzhou , Henan , China. 8. h Department of Gastrointestinal Surgery/Clinical Nutrition , Beijing Shijitan Hospital, Capital Medical University , Haidian District , Beijing , China.
Abstract
BACKGROUND: The level of the systemic inflammatory marker C-reactive protein (CRP) is elevated in many patients with malignant disease and may be related to nutritional status. OBJECTIVE: To analyze the association between serum CRP levels in patients with malignant tumors and their nutritional status. METHOD: A total of 3,692 cases were analyzed and the serum CRP levels were determined using an immunometric assay. Nutritional status was assessed by using patient-generated subjective global assessment (PG-SGA). The biochemical evaluation of prealbumin (PA), albumin (ALB), cholesterol (CHOL), and triglycerides (TG) were assayed within 48 h admission to the hospital. The association between serum CRP concentration and the nutritional status, the stage of the tumor and other factors was analyzed by univariate and multivariate logistic regression analysis. RESULT: Elevated serum CRP was observed in 47.6% (1,548/3,269) of patients compared with the reference value, and the median CRP concentration was 18.29 mg/l. Patient serum CRP concentrations in the malnourished group (PG-SGA B + C) were higher than in the well-nourished (PG-SGA A) patients (P < 0.05). The serum CRP level was related to the patients' age, gender, tumor stage, and was affected by hepatitis, liver cirrhosis, diabetes, but it has no effect on hypertension. The CRP high patients had lower PA and ALB levels, lower Karnofsky performance status scores, and higher PG-SGA scores (P < 0.05), and there was no relationship with CHOL and TG levels. Weight loss in the previous 1 mo was seen with CRP positive patients (P < 0.05). CONCLUSION: Almost 50% of malignant tumor patients had elevated serum CRP levels indicating a systemic inflammatory state. The nutritional status was worse in cancer patients with higher concentrations of serum CRP. The level of CRP was associated with the tumor stage, and, as stage is a prognostic factor, so can CRP be used as a prognostic maker in malignant tumors patients.
BACKGROUND: The level of the systemic inflammatory marker C-reactive protein (CRP) is elevated in many patients with malignant disease and may be related to nutritional status. OBJECTIVE: To analyze the association between serum CRP levels in patients with malignant tumors and their nutritional status. METHOD: A total of 3,692 cases were analyzed and the serum CRP levels were determined using an immunometric assay. Nutritional status was assessed by using patient-generated subjective global assessment (PG-SGA). The biochemical evaluation of prealbumin (PA), albumin (ALB), cholesterol (CHOL), and triglycerides (TG) were assayed within 48 h admission to the hospital. The association between serum CRP concentration and the nutritional status, the stage of the tumor and other factors was analyzed by univariate and multivariate logistic regression analysis. RESULT: Elevated serum CRP was observed in 47.6% (1,548/3,269) of patients compared with the reference value, and the median CRP concentration was 18.29 mg/l. Patient serum CRP concentrations in the malnourished group (PG-SGA B + C) were higher than in the well-nourished (PG-SGA A) patients (P < 0.05). The serum CRP level was related to the patients' age, gender, tumor stage, and was affected by hepatitis, liver cirrhosis, diabetes, but it has no effect on hypertension. The CRP high patients had lower PA and ALB levels, lower Karnofsky performance status scores, and higher PG-SGA scores (P < 0.05), and there was no relationship with CHOL and TG levels. Weight loss in the previous 1 mo was seen with CRP positive patients (P < 0.05). CONCLUSION: Almost 50% of malignant tumorpatients had elevated serum CRP levels indicating a systemic inflammatory state. The nutritional status was worse in cancerpatients with higher concentrations of serum CRP. The level of CRP was associated with the tumor stage, and, as stage is a prognostic factor, so can CRP be used as a prognostic maker in malignant tumorspatients.