Baseline C Reactive Protein Level Predicts Survival of Early Stage Lung Cancer: Evidence from a Systematic Review and Meta Analysis
Purpose 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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