Prognostic Value of C-Reactive Protein in Esophageal Cancer: a Meta-analysis

Background: The classical inflammatory biomarker, C-reactive protein (CRP), has been identified to be relatedto progression of esophageal cancer. Some research showed that elevated pretreatment serum CRP indicated apoor prognosis, but results have been inconsistent. Materials and
Methods: We searched the Medline, Embaseand the Cochrane Central Search Library for suitable studies and a meta–analysis of eleven (1,886 patients) wasconducted to examine the relationship between elevated serum CRP level and overall survival (OS) in esophagealcancer cases. Moreover, correlation analyses were conducted to assess links between pretreatment serum CRPlevel and tumor node metastasis (TNM) stage as well as T, N, M grade, respectively.
Results: The pooled analysisshowed that elevated pretreatment serum CRP level was significantly associated with poorer overall survival (HR2.09, 95%CI 1.52-2.87, p<0.01). Subgroup analyses were conducted by “country”, “cut-off value”, “treatment”and “number of patients”, and no single factor could alter the result. Elevated pretreatment serum CRP wassignificantly correlated with more advanced TNM stage and T, N, M grade respectively.
Conclusions: Elevatedpretreatment serum CRP levels are associated with poorer prognosis in esophageal cancer patients, and couldserve as a useful biomarker for outcome prediction.