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ECPB 2017, 77(1): 5–12
Research articles

Highly Sensitive C reactive Protein (hs-CRP) as marker in Oral & Oropharyngeal malignancy

ADARSH K.*, PREETHI B.L.**, PONNI ARUL ***
Abstract

High-sensitivity C-reactive protein (hsCRP) an acute phase inflammatory reactant protein, it has been used to predict the risk of cardiovascular disease in healthy individuals and to monitor treatment responses. Epidemiological evidence also points to link between inflammation and development of cancer, i.e. long-term inflammation and dysplasia. Worldwide ~ 15 % of the cancer incidence is associated with microbial infection. NSAIDs have been used for cancer prevention in familial adenomatous polyposis. The objective of study is to evaluate the association between hs-CRP and head and neck cancer (SCCHN).

Methods: Prospective, cross sectional case-control study was under taken involving 36 SCCHN (cases) and 36 normal volunteers age matched (controls). Cases staged as per UICC TNM. The study subjects 4ml clotted blood, centrifuged, serum stored at -20 °C. hsCRP (mg/L) determined using Quantitative Immunoturbidimetric method. Statistical analysis was performed using SPSS. Results: Evaluable subjects = 72, Cases (Cancer patients) = 36 & Control = 36. Age group range 18 to 80 yrs. Mean Age Cases 59.5+9.9 v/s Control 59+9.6 yrs. M: F Cases - 25:9 v/s Control 27:9. In Cases Oral Ca – 22 (61.1 %) & Oropharynx - 14 (38.9 %). T4 – 20 (55.6 %), T3 - 8 (22.2 %) & T2 - 8 (22.2 %). N3 - 3 (8.3 %), N2 - 14 (38.9 %), N1 - 5 (13.9 %) & N0 - 14 (38.9 %). The hsCRP of Control group v/s Cancer Case group = 3.03 ± 2.61 v/s19.23 ± 19.003 respectively (P < 0.0001). hsCRP for Oral Cancer – 15.07 + 7.66 & OPX – 25.77 + 28.31. In the case group, the mean hsCRP levels with tumour size T2 was 119.36 ± 7.0, T3 was 21.32 ± 23.27, T4 was 18.3350 ± 21.0915 and with Node size N0 - 20.3 ± 35.07, N1 - 13.8 ± 5.37, N2 - 21.6 ± 25.022, N3 - 122.1 ± 1.7.

Conclusions: Inflammatory responses play decisive roles at different stages of tumor development, initiation, promotion, malignant conversion, invasion, and metastasis. This study shows serum hsCRP levels were significantly elevated in SCCHN cases compared to age matched normal control subjects. hsCRP Can be used as a surrogate marker of SCCHN. Measuring and charting hsCRP values can prove useful in determining disease progress or the effectiveness of treatments, Furthers studies are contemplated.

Received 20/11/2016

Keywords: hsCRP, CRP, Inflammation, Cancer, Head & Neck cancer, Oral cancer

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