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Volume 16, Issue 3 (May 2014) 16, 467–471; 10.4103/1008-682X.123686

Prognostic role of C-reactive protein in prostate cancer: a systematic review and meta-analysis

Zhu-Qing Liu*, Li Chu*, Jue-Min Fang, Xi Zhang, Hua-Xin Zhao, Yi-Jing Chen, Qing Xu

Department of Medical Oncology, Shanghai Tenth People’s Hospital, Tongji University, School of Medicine, Shanghai 200072, China
*These authors contributed equally to this work.

Correspondence: Dr. Q Xu (qingxumed@163.com)

Received: 27 August 2013; Revised: 03 October 2013; Accepted: 02 November 2013


Several studies have reported that C-reactive protein, an inflammation biomarker, may be associated with the prognosis of prostate cancer. The objective of this systematic review is to summarize the predictive role of C-reactive protein for survival in prostate cancer as reported in previous studies. Related studies were identified, and evaluated for quality through multiple search strategies. Data was collected from studies comparing overall and cancer-specific survival in patients with elevated C-reactive protein levels and those having lower levels. However, for progression-free survival, data were collected according to the log of C-reactive protein. The hazard ratio and its 95% confidence interval were used to assess the strength of associations. A total of 9 studies (n= 1,497) were evaluated in this meta-analysis (5 for overall survival, 4 for cancer-specific survival, and 2 for progression-free survival). For overall and progression-free survival, the pooled hazard ratio of C-reactive protein was statistically significant at 1.51 (95% confidence interval, 1.28–1.79) and 1.50 (95% confidence interval, 1.25–1.81), respectively. For cancer-specific survival, the pooled hazard ratio was 1.91 (95% confidence interval, 1.36-2.69) with higher C-reactive protein expression in prostate cancer, which strongly indicates poorer survival in prostate cancer. This study demonstrates that C-reactive protein may have a critical prognostic value in patients with prostatic cancer.

Keywords: C‑reactive protein; meta‑analysis; prognosis; prostate cancer

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