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Identification of prognostic inflammatory factors in colorectal liver metastases.

Hamilton TD, Leugner D, Kopciuk K, Dixon E, Sutherland FR, Bathe OF - BMC Cancer (2014)

Bottom Line: The inflammatory state associated with elevated CRP was comprised of raised IL-1β, IL-6, IL-12 and IL-15.In addition, elevated IL-8 and PDGF-AB/BB and decreased eotaxin and IP-10 were associated with worse disease-free and overall survival.Elevated CRP is associated with a proinflammatory state.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of Calgary, Calgary, AB, Canada. bathe@ucalgary.ca.

ABSTRACT

Background: The modified Glasgow Prognostic Score (mGPS) has been reported to be an important prognostic indicator in a number of tumor types, including colorectal cancer (CRC). The features of the inflammatory state thought to accompany elevated C-reactive protein (CRP), a key feature of mGPS, were characterized in patients with colorectal liver metastases. Additional inflammatory mediators that contribute to prognosis were explored.

Methods: In sera from 69 patients with colorectal liver metastases, a panel of 42 inflammatory mediators were quantified as a function of CRP levels, and as a function of disease-free survival. Multivariate statistical methods were used to determine association of each mediator with elevated CRP and truncated disease-free survival.

Results: Elevated CRP was confirmed to be a strong predictor of survival (HR 4.00, p = 0.001) and recurrence (HR 3.30, p = 0.002). The inflammatory state associated with elevated CRP was comprised of raised IL-1β, IL-6, IL-12 and IL-15. In addition, elevated IL-8 and PDGF-AB/BB and decreased eotaxin and IP-10 were associated with worse disease-free and overall survival.

Conclusions: Elevated CRP is associated with a proinflammatory state. The inflammatory state is an important prognostic indicator in CRC liver metastases. The individual contributions of tumor biology and the host to this inflammatory response will require further investigation.

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Related in: MedlinePlus

Kaplan-Meier curves depicting survival as a function of CRP levels. A. Overall survival as a function of serum CRP levels. B. Disease-free survival as a function of serum CRP levels. Groups with elevated and normal CRP levels were compared by log rank test.
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Fig1: Kaplan-Meier curves depicting survival as a function of CRP levels. A. Overall survival as a function of serum CRP levels. B. Disease-free survival as a function of serum CRP levels. Groups with elevated and normal CRP levels were compared by log rank test.

Mentions: Median follow-up for patients still alive was 20 months (range 1–49 months). During follow-up, 15 patients (28%) died, and 31 patients (58%) developed recurrent disease. The median overall survival in patients with normal and elevated CRP was 79 months and 41 months, respectively (Figure 1A). However, this difference was not statistically significant by log rank test. The median disease-free survival in patients with normal CRP was 23 months and, in patients with elevated CRP, was 13 months (Figure 1B). Again, this was not statistically significant by log rank test, due to the small sample size. However, when CRP was analyzed as a continuous variable (as opposed to a binary variable), it was found to be a strong predictor of overall survival (hazard ratio 4.00; Table 3) and disease-free survival (hazard ratio 3.30, Table 4).Figure 1


Identification of prognostic inflammatory factors in colorectal liver metastases.

Hamilton TD, Leugner D, Kopciuk K, Dixon E, Sutherland FR, Bathe OF - BMC Cancer (2014)

Kaplan-Meier curves depicting survival as a function of CRP levels. A. Overall survival as a function of serum CRP levels. B. Disease-free survival as a function of serum CRP levels. Groups with elevated and normal CRP levels were compared by log rank test.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4125702&req=5

Fig1: Kaplan-Meier curves depicting survival as a function of CRP levels. A. Overall survival as a function of serum CRP levels. B. Disease-free survival as a function of serum CRP levels. Groups with elevated and normal CRP levels were compared by log rank test.
Mentions: Median follow-up for patients still alive was 20 months (range 1–49 months). During follow-up, 15 patients (28%) died, and 31 patients (58%) developed recurrent disease. The median overall survival in patients with normal and elevated CRP was 79 months and 41 months, respectively (Figure 1A). However, this difference was not statistically significant by log rank test. The median disease-free survival in patients with normal CRP was 23 months and, in patients with elevated CRP, was 13 months (Figure 1B). Again, this was not statistically significant by log rank test, due to the small sample size. However, when CRP was analyzed as a continuous variable (as opposed to a binary variable), it was found to be a strong predictor of overall survival (hazard ratio 4.00; Table 3) and disease-free survival (hazard ratio 3.30, Table 4).Figure 1

Bottom Line: The inflammatory state associated with elevated CRP was comprised of raised IL-1β, IL-6, IL-12 and IL-15.In addition, elevated IL-8 and PDGF-AB/BB and decreased eotaxin and IP-10 were associated with worse disease-free and overall survival.Elevated CRP is associated with a proinflammatory state.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, University of Calgary, Calgary, AB, Canada. bathe@ucalgary.ca.

ABSTRACT

Background: The modified Glasgow Prognostic Score (mGPS) has been reported to be an important prognostic indicator in a number of tumor types, including colorectal cancer (CRC). The features of the inflammatory state thought to accompany elevated C-reactive protein (CRP), a key feature of mGPS, were characterized in patients with colorectal liver metastases. Additional inflammatory mediators that contribute to prognosis were explored.

Methods: In sera from 69 patients with colorectal liver metastases, a panel of 42 inflammatory mediators were quantified as a function of CRP levels, and as a function of disease-free survival. Multivariate statistical methods were used to determine association of each mediator with elevated CRP and truncated disease-free survival.

Results: Elevated CRP was confirmed to be a strong predictor of survival (HR 4.00, p = 0.001) and recurrence (HR 3.30, p = 0.002). The inflammatory state associated with elevated CRP was comprised of raised IL-1β, IL-6, IL-12 and IL-15. In addition, elevated IL-8 and PDGF-AB/BB and decreased eotaxin and IP-10 were associated with worse disease-free and overall survival.

Conclusions: Elevated CRP is associated with a proinflammatory state. The inflammatory state is an important prognostic indicator in CRC liver metastases. The individual contributions of tumor biology and the host to this inflammatory response will require further investigation.

Show MeSH
Related in: MedlinePlus