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Disorders of the Pleura |

Diagnostic Value and Prognostic Significance of Pleural C-Reactive Protein in Lung Cancer Patients With Malignant Pleural Effusions

Ki Eun Hwang*, MD; Eun Taik Jung, MD; Hak Ryul Kim, MD
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Wonkwang University Hospital, Iksan City, Republic of Korea


Chest. 2012;142(4_MeetingAbstracts):495A. doi:10.1378/chest.1389636
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Abstract

SESSION TYPE: Pleural Biomarkers

PRESENTED ON: Monday, October 22, 2012 at 04:00 PM - 05:30 PM

PURPOSE: C-reactive protein (CRP), an acute-phase protein, has been implicated in various inflammatory and advanced malignant states. Increased serum CRP (s-CRP) levels have been shown to be associated with independent prognostic factors for survival in patients with advanced lung cancer. However, only few studies have focused on the role of CRP in pleural effusions. This study aimed to evaluate the diagnostic and prognostic value of pleural CRP (p-CRP) in lung cancer patients with malignant pleural effusion (MPE).

METHODS: Pleural effusion (PE) samples were collected from patients with MPE (68 lung cancers; 12 extrathoracic tumors), and from 68 patients with various benign conditions (31 with pneumonia; 37 with tuberculosis). Concentrations of p- and s-CRP were measured by enzyme-linked immunosorbent assay. The expression profile of CRP in pleural fluid and its association with survival were investigated.

RESULTS: p-CRP levels correlated with s-CRP levels (r = 0.82, P < 0.0001). The area under the receiver operating characteristic curve, representing diagnostic accuracy in differentiating lung cancer with MPE from benign pleural effusion, was greater for p-CRP (0.86) than for s-CRP (0.77). High p-CRP expression significantly correlated with shorter overall survival (P = 0.006). In a multivariate Cox regression analysis, p-CRP was independent prognostic factor significantly associated with overall survival (P = 0.0001). The relative risk of overall survival for lung cancer patients with high p-CRP levels was 3.909 (95% confidence interval, 2.000-7.639).

CONCLUSIONS: In conclusion, p-CRP is superior to s-CRP in determining pleural fluid etiology.

CLINICAL IMPLICATIONS: Quantitative measurement of p-CRP might be a useful complementary diagnostic and prognostic test for lung cancer patients with MPE.

DISCLOSURE: The following authors have nothing to disclose: Ki Eun Hwang, Eun Taik Jung, Hak ryul Kim

No Product/Research Disclosure Information

Wonkwang University Hospital, Iksan City, Republic of Korea

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