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C-reactive protein as a biomarker for urological cancers

Nature Reviews Urology volume 8, pages 659–666 (2011)Cite this article

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Abstract

Systemic inflammation has been linked with the progression of cancer, and, in patients with urological cancers, the presence of a systemic inflammatory response is thought to be indicative of poor prognosis. C-reactive protein (CRP) is an acute-phase reactant, the levels of which can be objectively measured using standardized reliable assays, and a useful marker of systemic inflammation. CRP levels have been shown to predict survival in patients with urological cancers, including renal cell carcinoma, upper urinary tract and bladder cancers, and prostate cancer, and the incorporation of CRP into prognostic models for urological cancers improves the models' predictive accuracy. Furthermore, the kinetics of CRP release and the analysis of dynamic changes in CRP concentrations over time, could predict tumor aggressiveness and potential treatment efficacy. For instance, in long-term survivors of testicular cancer, CRP is associated with the risk of late complications, such as cardiovascular disease, and with the development of second non-germ-cell cancer. CRP could, therefore, be an important biomarker for urological cancers.

Key Points

  • The presence of a systemic inflammatory response, as evidenced by elevation of C-reactive protein (CRP) concentration, has been associated with poor prognosis in various malignancies including urological cancers

  • An increasing number of studies have shown that CRP is an important prognostic factor for renal cell carcinoma (RCC), upper urinary tract and bladder cancer, and prostate cancer

  • CRP has been incorporated into some prognostic algorithms for urological cancers (RCC and bladder cancer); this improves the predictive accuracy of the algorithms

  • The observation of dynamic changes in CRP concentration—CRP kinetics—contributes useful information for evaluating the risk of progression and mortality in RCC

  • In patients with testicular cancer, CRP is of prognostic importance in terms of predicting late complications, such as cardiovascular disease and second non-germ-cell cancer in long-term survivors who received systemic therapy

  • CRP meets the NIH criteria to be considered as a biomarker and could, therefore, be useful when assessing patients with urological cancers

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Figure 1: Inflammatory stimuli in the tumor microenvironment can elevate serum CRP levels.

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  1. Department of Urology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Kazutaka Saito & Kazunori Kihara

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K. Saito researched and wrote the article. Both K. Saito and K. Kihara made equal contributions to discussion of content, and reviewing and editing the manuscript before submission.

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Saito, K., Kihara, K. C-reactive protein as a biomarker for urological cancers. Nat Rev Urol 8, 659–666 (2011). https://doi.org/10.1038/nrurol.2011.145

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