C-reactive protein levels: A prognostic marker for patients with head-and-neck cancer

Background: C-reactive protein (CRP) is a nonglycosylated pentameric polypeptide comprising 206 amino acid residues. CRP causes activation of the classical complement pathway by binding to various autologous and extrinsic ligands exposed on membranes of injured, necrotic, or cells undergoing apoptosis. There is evolving evidence which strongly suggests that CRP is an inflammatory marker and is significantly elevated in patients diagnosed with tumors such as hepatocellular, pulmonary, and breast carcinomas. In addition, serum CRP level has been shown to be associated with size of tumor (T), clinic-pathological characteristics, and metastasis to lymph nodes. Aim: The aim of this study was to compare serum CRP levels in potentially malignant disorders and oral malignancies. Materials and Methods: This cross-sectional prospective study was designed to study serum CRP levels in patients with oral potentially malignant disorders (leukoplakia and oral submucous fibrosis), patients with oral squamous cell carcinoma, and normal controls. Study participants were divided into four groups: (1) Group I comprising 40 patients with leukoplakia, (2) Group II comprising 40 patients with oral submucous fibrosis, (3) Group III comprising 40 patients with oral squamous cell carcinoma, and (4) Group IV comprising 40 controls. Five milliliters of venous blood was collected after venipuncture from the antecubital vein followed by centrifugation, and serum was separated. This separated serum was analyzed for CRP levels using SPINREACT kit and semi-automated biochemical analyzer (Kyoto, Japan). All obtained data were entered into Microsoft Excel Worksheet 2007, and tabulations were performed using SPSS 16 (Statistical Package for the Social Sciences) software (IBM Corporation, Chicago, IL, USA). P < 0.05 was considered statistically significant. Results: Mean ± standard deviation values derived were 5.5 ± 4.8 mg/dl (Group I), 6.1 ± 4.9 mg/dl (Group II), 10.5 ± 2.4 mg/dl (Group III), and 2.1 ± 1.6 mg/dl (Group IV), respectively. On applying one-way analysis of variance for comparison of three groups, P < 0.003 was obtained. The results implied that an extremely significant statistical correlation existed between all studied groups when serum CRP levels were compared. Conclusion: Serum CRP levels are prognostic markers in oral potentially malignant disorders and oral malignancies.