The prognostic value of serum C-reactive protein-bound serum amyloid A in early-stage lung cancer.
- Author:
Xue-Yan ZHANG
1
;
Ge ZHANG
2
;
Ying JIANG
3
;
Dan LIU
4
;
Man-Zhi LI
5
;
Qian ZHONG
6
;
Shan-Qi ZENG
7
;
Wan-Li LIU
8
;
Mu-Sheng ZENG
9
Author Information
- Publication Type:Journal Article
- MeSH: Biomarkers; C-Reactive Protein; Enzyme-Linked Immunosorbent Assay; Humans; Lung Neoplasms; Multivariate Analysis; Prognosis; Prospective Studies; Proteomics; Retrospective Studies; Serum Amyloid A Protein
- From:Chinese Journal of Cancer 2015;34(8):335-349
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDElevated levels of serum C-reactive protein (CRP) have been reported to have prognostic significance in lung cancer patients. This study aimed to further identify CRP-bound components as prognostic markers for lung cancer and validate their prognostic value.
METHODSCRP-bound components obtained from the serum samples from lung cancer patients or healthy controls were analyzed by differential proteomics analysis. CRP-bound serum amyloid A (CRP-SAA) was evaluated by co-immunoprecipitation (IP). Serum samples from two independent cohorts with lung cancer (retrospective cohort, 242 patients; prospective cohort, 222 patients) and healthy controls (159 subjects) were used to evaluate the prognostic value of CRP-SAA by enzyme-linked immunosorbent assay.
RESULTSCRP-SAA was identified specifically in serum samples from lung cancer patients by proteomic analysis. CRP binding to SAA was confirmed by co-IP in serum samples from lung cancer patients and cell culture media. The level of CRP-SAA was significantly higher in patients than in healthy controls (0.37 ± 0.58 vs. 0.03 ± 0.04, P < 0.001). Elevated CRP-SAA levels were significantly associated with severe clinical features of lung cancer. The elevation of CRP-SAA was associated with lower survival rates for both the retrospective (hazard ration [HR] = 2.181, 95% confidence interval [CI] = 1.641-2.897, P < 0.001) and the prospective cohorts (HR = 2.744, 95% CI = 1.810-4.161, P < 0.001). Multivariate Cox analysis showed that CRP-SAA was an independent prognostic marker for lung cancer. Remarkably, in stages I-II patients, only CRP-SAA, not total SAA or CRP, showed significant association with overall survival in two cohorts. Moreover, univariate and multivariate Cox analyses also showed that only CRP-SAA could be used as an independent prognostic marker for early-stage lung cancer patients.
CONCLUSIONCRP-SAA could be a better prognostic marker for lung cancer than total SAA or CRP, especially in early-stage patients.
