High-sensitivity C-reactive protein as a predictor of locally advanced renal cell carcinoma

• Published in: Archivos españoles de urología Vol. 65; no. 6; pp. 601 - 607
• Main Authors: García-Marchiñena, Patricio, Billordo-Perés, Nicolas, Tobía-González, Ignacio, Jurado, Alberto, Damia, Oscar, Gueglio, Guillermo
• Format: Journal Article
• Language: English; Spanish
• Published: Spain 01-07-2012
• Subjects: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor - metabolism; C-Reactive Protein - metabolism; Carcinoma, Renal Cell - blood; Carcinoma, Renal Cell - diagnosis; Carcinoma, Renal Cell - pathology; Carcinoma, Renal Cell - surgery; Cross-Sectional Studies; Disease Progression; Female; Humans; Kidney Neoplasms - blood; Kidney Neoplasms - diagnosis; Kidney Neoplasms - pathology; Kidney Neoplasms - surgery; Logistic Models; Male; Middle Aged; Neoplasm Staging; Retrospective Studies; Smoking - adverse effects; Tomography, X-Ray Computed; Young Adult
• ISSN: 1576-8260

To determine if elevated levels of high-sensitivity C-reactive protein (CRP) in plasma are associated with locally advanced renal cell carcinoma (LARCC) after surgery.
Retrospective cross-sectional study conducted from May 2009 to January 2011. Altogether, 192 patients with non-disseminated disease and with preoperative quantitative determination of the CRP were evaluated. We evaluated the relation between age, gender, history of smoking, symptoms and CRP higher than 10 mg/L, with LARCC. The chi-square and Fisher's tests were used to compare categorical variables. For the multivariate analysis, we used logistic regression methods.
The median age was 62 years (r=23-85), 72.4% were males. The median CRP was 2.40 mg/L (r=0.1-173). Of all the patients, 43.2% had a history of smoking and 81.8% were asymptomatic. As for the tumors, 77.1%were clear cell carcinoma, 14.6% chromophobe, 4.7% papillary, 2.6% oncocytomas, and 1% other varieties of renal cell carcinoma. As for the TNM classification, 45.8% corresponded to stage pT1a, 27.6% pT1b, 13% pT2, and 13.5% pT3, pT4 was not found. In the multivariate analysis, the presence of symptoms (p=0.002, OR=3.1) and the presence of CRP higher than 10 mg/L (p=0.006, OR=4) remained as the only prognostic variables of LARCC.
Values of CRP higher than 10 mg/L increase 4 times the possibilities of finding LARCC in the pathological study of the surgical specimen. This variable should be taken into account when deciding what is the best surgical option.