Association between serum C-reactive protein value and prognosis of patients with non-small cell lung cancer: a meta-analysis.

OBJECTIVE: C-reactive protein (CRP) has been reported, with controversy, to be associated with poor survival of patients with non-small cell lung cancer (NSCLC). This meta-analysis aimed to evaluate the prognostic role of CRP in NSCLC. METHODS: We searched PubMed, EMBASE and CNKI databases for published studies that evaluated the prognostic role of CRP in NSCLC up to March 1, 2014. The data were analyzed using STATA software (Version 12.0; Stata Corporation). Hazard ratios (HRs) with a 95% CI and 5-year survival rates were calculated to evaluate the relationships between CRP levels and the prognosis of NSCLC patients. RESULTS: Eight studies were included, totaling 1668 NSCLC patients. The results revealed that elevated CRP values might predict poor 5-year overall survival rates (RR=2.15, 95% CI: 1.78-2.59) and poor 5-year disease-specific survival rates (RR=2.12, 95% CI: 1.56-2.88). The pooled HR between stage I/II and stage III/IV patients was 0.98 (95% CI: 0.26-3.63, P=0.976), which indicated that the difference between the survival rates of the patients with elevated CRP and those with undetectable CRP was not significant. In our survival analysis, the results of Egger's testing did not demonstrate evidence of publication bias (P=0.099). CONCLUSION: Elevated CRP level is relevant to poorer survival of NSCLC patients and might be used as a prognostic biomarker for NSCLC.