Evaluation of increased preoperative serum high sensitive C-reactive protein and procalcitonin levels on grade and stage of clear cell renal cell carcinoma.
OBJECTIVES
To evaluate the relationship between preoperative high sensitive C-reactive protein (hs-CRP) and procalcitonin (PCT) levels with the two important prognostic factors, tumor stage and tumor grade, in patients with clear cell renal cell carcinoma (RCC).


METHODS
We evaluated 116 clear cell RCC patients who had undergone either radical or partial nephrectomy at Ankara University, Department of Urology between November 2011 and June 2014. Comparison of hs-CRP and PCT levels between the subgroups of pathological stage and nuclear grade were evaluated. The cut off value for hs-CRP and PCT was determined by receiver- operating characteristic (ROC) analysis.


RESULTS
Median levels of hs-CRP and PCT levels of the patients were 0.818 mg/L and 0.0825 ng/mL, respectively. Hs-CRP levels of pT1 stage patients was found to be lower compared to the pT3-4 group (p = 0.016). Median hs-CRP levels of the grade 1 - 2 group was found to be significantly lower compared to the grade 3 - 4 group (p = 0.0001). The difference of median PCT levels between stage pT1 vs. pT2 (p = 0.003) and stage pT1 vs. pT3-4 (p = 0.0001) were statistically significant. Regarding Fuhrman grade, median PCT levels of Fuhrman grade 1 - 2 patients were significantly lower compared to grade 3 - 4 patients (p = 0.001). To predict higher Fuhrman grade of the tumor (grade 3 - 4), ROC analysis was performed and cut off values of 0.645 mg/L and 0.087 ng/mL were detected for hs-CRP and PCT, respectively.


CONCLUSION
High preoperative serum hs-CRP and PCT values may play a role in the prognostic stratification of localized clear cell RCC patients. Further prospective validation is required prior to recommendation regarding suitability as biomarkers for RCC clinical prediction.