High Expression of C-reactive Protein Increases the Risk of Poor Prognosis in Patients with Gastric Cancer: A Meta-analysis

Objective: To investigate the correlation between the expression level of C-reactive protein (CRP) and the prognosis of patients with gastric cancer, and its dose-response relationship. Methods: A computer-based online search was performed by using China National Knowledge Infrastructure, Wanfang, PubMed, Embase, and Web of Science database. The cohort studies on the relationship between CRP and the risk of poor prognosis in patients with gastric cancer were selected according to the inclusion and exclusion criteria, and the data were extracted and evaluated. Then Meta-analysis was performed by using STATA 11.0 software. The pooled hazard ratio (HR) and its 95% confidence interval (CI) were calculated. Furthermore, the subgroup analysis, multivariate analysis, sensitivity analysis and publication bias test were performed, respectively. Results: A total of eighteen cohort studies were included, involving 3 656 patients with gastric cancer. Meta-analysis showed a significant association between the expression of CRP and prognosis in patients with gastric cancer (HR = 1.50, 95% CI: 1.24-1.81, P 10 mg/L. Subgroup analysis showed no significant difference when the included studies were divided by the number of samples, follow-up time, TNM staging, and treatment methods (all P > 0.05). According to multivariate analysis, the peritoneal metastasis and recurrence were the independent factors associated with poor prognosis of patients with gastric cancer (both P > 0.05). Conclusion: The level of CRP was significantly associated with the prognosis of patients with gastric cancer in different clinical stages, and the risk of poor prognosis was significantly increased when CRP level > 10mg/L. DOI:10.3781/j.issn.1000-7431.2016.33.662