Prognostic role of C reactive protein in breast cancer an updated systematic review and meta analysis
The C reactive protein (CRP) an inflammatory biomarker, has been identified to be related to progression of breast cancer. However, the results remain controversial. A meta analysis of epidemiologic studies was therefore conducted to address this issue. Data were collected from studies comparing overall, cancer specific, and diseasefree survival (OS, CSS, and DFS) in patients with per natural log unit change in CRP. Study specific risk estimates were pooled using a random effects model. Sixteen studies involving a total of 15,545 breast cancer cases were included in this meta analysis. The pooled results showed that per natural log unit change in CRP was significantly associated with poor OS (HR 1.28, 95% CI 1.13 1.44) and DFS (HR 1.18, 95% CI 1.04 1.34) For CSS, the pooled HR was 1.38 (95% CI 1.15 1.66) which could strongly predict poorer survival in breast cancer patients. Similar results were also observed in the stratified analyses by number of patients, treatment, max follow up and CRP marker. The meta analysis indicated that elevated CRP levels has a critical prognostic value in patients with breast cancer as an inflammation biomarker.