Serum C-reactive protein levels predict survival in hepatocellular carcinoma.

Background/Aims: C- reactive protein (CRP) was recently identified as a prognostic factor for patients with hepatocellular carcinoma (HCC) after surgical resection. We investigated the relationship between the serum levels of high sensitivity CRP (H-CRP) and the prognosis of HCC patients. Method: We conducted a cohort study of 90 HCC patients enrolled from 1997 to 1998. All patients were treated and followed for a mean period of 3.2 years. Clinical variables were compared between patients positive for H-CRP ( serum H-CRP levels >= 3.0mg/L, n= 47) and those negative for H-CRP ( serum H-CRP levels < 3.0mg/ L,n = 43). We also determined the relationship between serum H-CRP and prognosis in HCC patients. Results: The survival rate of patients of the H-CRP-positive group was lower than that of H-CRP-negative patients. Tumour stage ( stages 3 or 4), total bilirubin >= 1.2mg/dL, albumin ( Alb) < 3.5 g/dL, des-gamma-carboxy prothrombin >= 40mAU/mL, positive H-CRP and initial treatment (transcatheter arterial chemoembolization, hepatic arterial infusion chemotherapy or best supportive care) were identified as significant poor prognostic factors by univariate analysis, while positive H-CRP [ hazard ratio (HR), 1.58; P= 0.048], Alb < 3.5 g/dL ( HR, 2.10; P= 0.004), tumour stage ( stages 3 or 4; HR, 3.05; P= 0.001) and initial treatment ( HR, 1.88; P= 0.029) were considered to be significant determinants of poor prognosis by multivariate Cox proportional hazards analysis. Conclusions: The prognosis of H-CRP-positive patients was poorer compared with H-CRP-negative patients. This study confirmed that H-CRP, like CRP, is a marker of poor prognosis in HCC patients.