| Objective:The aim of this study was to determine whether baseline serum C-reactive protein(CRP)levels were associated with overall survival in patients with metastatic prostate cancer(PCa)in the Chinese population,and to explore the value of CRP in the prediction of PCa in the Chinese population.Methods:A total of 205 patients with metastatic prostate cancer were retrospectively analyzed from January 2010 to May 2014.Total 70 patients were removed due to the missing information of PSA results or follow-up information.Therefore 135 patients with metastatic prostate cancer were retrospectively reviewed.The patients were divided into two parts according to serum CRP level(CRP?10 mg/L and CRP<10 mg/L),Gleason score(Gleason score>8 and Gleason score<8),age(?65year and<65year),prostate specific antigen(PSA)level(PSA?80 ng/mL and CRP<80 ng/ml)and visceral metastases(positive and negative)respectively,and four groups(1.2.3.and 4)according to clinical stage.Fisher's exact test was used to compare relationships between baseline serum CRP values and clinicopathological characters.Kaplan-Meier product-limit methods and the log-rank test were used to estimate overall survival distribution and test the difference.A multivariate survival analysis of the group variables was performed using the Cox proportional hazard model to validate the prognostic role of baseline serum CRP values on overall survival by adjusting for baseline factors,and the corresponding P value had to be>0.10 when removing a variable from the model.A two-tailed P value less than 0.05 was considered statistically significant and was determined using STATA 12.0 software.Results:(1)Among the 135 patients with metastatic prostate cancer,51(37.8%)patients had higher CRP levels ?10 mg/L,83(61.5%)patients were older than 65 years,83(61.5%)patients had higher PSA levels ?80 ng/mL,81(60%)had higher Gleason score>8,and 86(63.7%)had visceral metastases.(2)No significant association between clinical characteristics of PCa patients and CRP levels.(3)Kaplan-Meier product-limit method and log-rank test showed that patients with high serum CRP level(?10 mg/L)had significantly worse overall survival than those patients with normal serum CRP level(<10 mg/L)(P<0.001).(4)Patients with high Gleason scores(?8)had significantly worse overall survival than those patients with normal Gleason scores(<8)(P<0.001).(5)Multivariable analysis by Cox regression model further showed that the high serum CRP level(?10 mg/L)was a significantly independent predictor of overall survival(hazard ratio(HR)=2.39;95%confidence interval(95%CI)1.56-2.39,P<0.001).In addition,a high Gleason score(?8)also was an independent predictor of overall survival(HR=1.80;95%CI 1.16-2.79,P=0.008).However,the other factors were not associated with the overall survival in patients with metastatic prostate cancer.The other factors including age(HR=1.24;95%CI=0.81-1.88,P=0.312),PSA levels(HR=1.41;95%CI=0.92-2.17,P=0.12),cancer stage(HR=1.23;95%CI=0.97-1.55,P=0.09),and visceral metastases(HR=1.34;95%CI=0.88-2.04,P=0.17)had no association with the overall survival time of patients with metastatic prostate cancer.Conclusions:In conclusion,serum CRP level is useful to predict the prognosis of metastatic prostate cancer patients,and high serum CRP level is a significantly independent predictor of worse overall survival.In addition,Gleason score is also an independent predictor of overall survival of metastatic prostate cancer patients.These results have a very important role in choosing treatment methods,improving the life quality of patient,and extending survival of metastatic prostate cancer patients. |
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