Elevated high-sensitivity C-reactive protein, a marker of advanced stage gastric cancer and postgastrectomy disease recurrence

Abstract

BACKGROUND AND OBJECTIVES: Gastric cancer recurrence after curative surgery remains high. Although no preoperative marker of gastric cancer progression after radical gastrectomy exists, recent studies suggest that C-reactive protein (CRP) is associated with cancer progression. Our study evaluated the significance of preoperative high-sensitivity CRP (hs-CRP) levels as a marker of disease progression after radical gastrectomy.

METHODS: The preoperative hs-CRP levels of 1,221 gastric cancer patients who underwent radical gastrectomies were analyzed for clinicopathologic significance. Patients with previous gastric cancer treatment, another primary cancer, active infection, or postoperative mortality were excluded.

RESULTS: hs-CRP levels were significantly associated with increased tumor depth (P = 0.028), nodal status (P = 0.012), and stage (P = 0.045). Seventeen percent of patients had elevated hs-CRP levels at the cutoff value of >3.00 mg/L, whereas 6.6% and 6.1% of patients had CEA and CA-19-9 levels about the cutoffs of ≥5.00 ng/ml and ≥35.0 U/L, respectively. Hs-CRP levels >3.00 mg/L were an independent risk factor for recurrence-free survival along with stage.

CONCLUSION: Elevated preoperative hs-CRP levels in gastric cancer patients are clinically significant indicators of advanced stage and postoperative disease recurrence.