Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website http://www.gastrores.org

Original Article

Volume 2, Number 2, April 2009, pages 104-109

Expression of C-Reactive Protein in Rectal Cancer

Figure 1. C-reactive protein immunoexpression in a sample of rectal adenocarcinoma. Positive cells display cytoplasmic brownish granulation stained by the DAB chromogen (ABC method; A: x 200; B: x 500).

Figure 2. Graphic representation of the positivity proportion of C-reactive protein in rectal tumours (n = 91) compared with controls (n = 22).

**Table 1.** Clinicopathological features of controls versus cases and of deceased cases versus survivors
Features	Controls (n=22)	Cases (n=91)	p value	Deaths (n=42)	Survivors (n=49)	p value
Data are presented as mean (SE: Standard error), medium (interquartile range: 25th-75th percentile), or counting (percentage).
Age (median, SE), years	49.1 (13.4)	60.6 (14.2)	<0.01	62.1 (15.3)	59.4 (13.3)	0.38
Male: Female	7:15	40:51	0.30	22:20	18:21	0.13
Location, from anal verge( mean, SE), cm		6.9 (3.4)	––	6.5 (3.1)	7.1 (3.6)	0.39
Differentiation, n (%)
well		9 (10)	––	1 (2)	8 (16)	<0.01
moderate		71 (78)		32 (76)	39 (80)
poor		11 (12)		9 (21)	2 (4)
Depth of invasion, n (%)
Submucosa		5 (6)	––	1 (2)	4 (8)	0.07
Muscularis propria		24 (26)		7 (17)	17 (35)
Adventitia		15 (17)		10 (24)	5 (10)
Surrounding tissues		47 (52)		24 (57)	23 (47)
Lymph-node positive cases, n (%)		48 (53)	––	31 (74)	17 (35)	<0.01
		n=89
Circumferential invasion, n (%)		7 (8)	––	6 (15)	1 (2)	0.04
Dukes–Turnbull
A		25 (28)	––	5 (12)	20 (41)	<0.01
B		17 (19)		5 (12)	12 (25)
C		34 (37)		22 (52)	12 (25)
D		15 (17)		10 (24)	5 (10)
Adjuvant therapy, n (%)		n=85
Radiotherapy (RT)		5 (6)	––	4 (10)	1 (2)	0.23
Chemotherapy (CT)		3 (4)		1 (3)	2 (4)
Combined CT + RT		14 (17)		4 (10)	10 (22)
No adjuvant therapy		63 (74)		30 (77)	33 (72)
CRP expression ≥ 10%, n (%)	22 (100)	65 (71)	<0.01	30 (71)	35 (71)	0.99

Table 1. Clinicopathological features of controls versus cases and of deceased cases versus survivors

Features

Controls (n=22)

Cases (n=91)

p value

Deaths (n=42)

Survivors (n=49)

p value

Data are presented as mean (SE: Standard error), medium (interquartile range: 25th-75th percentile), or counting (percentage).

Age (median, SE), years

49.1 (13.4)

60.6 (14.2)

<0.01

62.1 (15.3)

59.4 (13.3)

0.38

Male: Female

7:15

40:51

0.30

22:20

18:21

0.13

Location, from anal verge( mean, SE), cm

6.9 (3.4)

––

6.5 (3.1)

7.1 (3.6)

0.39

Differentiation, n (%)

well

9 (10)

––

1 (2)

8 (16)

<0.01

moderate

71 (78)

32 (76)

39 (80)

poor

11 (12)

9 (21)

2 (4)

Depth of invasion, n (%)

Submucosa

5 (6)

––

1 (2)

4 (8)

0.07

Muscularis propria

24 (26)

7 (17)

17 (35)

Adventitia

15 (17)

10 (24)

5 (10)

Surrounding tissues

47 (52)

24 (57)

23 (47)

Lymph-node positive cases, n (%)

48 (53)

––

31 (74)

17 (35)

<0.01

n=89

Circumferential invasion, n (%)

7 (8)

––

6 (15)

1 (2)

0.04

Dukes–Turnbull

25 (28)

––

5 (12)

20 (41)

<0.01

17 (19)

5 (12)

12 (25)

34 (37)

22 (52)

12 (25)

15 (17)

10 (24)

5 (10)

Adjuvant therapy, n (%)

n=85

Radiotherapy (RT)

5 (6)

––

4 (10)

1 (2)

0.23

Chemotherapy (CT)

3 (4)

1 (3)

2 (4)

Combined CT + RT

14 (17)

4 (10)

10 (22)

No adjuvant therapy

63 (74)

30 (77)

33 (72)

CRP expression ≥ 10%, n (%)

22 (100)

65 (71)

<0.01

30 (71)

35 (71)

0.99

**Table 2.** Relationship between clinicopathological features and death in patients with rectal tumours
Features (n)	Death	HR	CI 95%	p value
Data presented as counts and percentages. HR: hazard ratio by a multiple Cox model; CRP: Tumour expression of C-reactive protein as measured by percentage of positive cells; CI 95%: 95% confidence interval. *Cox model including only those subjects (n=81, events=37) with thorough observations.
CRP expression
≥ 10% (65)		30	46.2	1.31	0.58-2.94	0.51
< 10% (26)		12	46.2	1.00
Age
≥ 60 years (55)		27	49.1	1.32	0.66-2.64	0.43
< 60 years (36)		15	41.7	1.00
Circumferential wedge
Positive (7)		6	85.7	3.64	1.26-10.51	0.02
Negative (82)		34	41.5	1.00
Dukes-Turnbull
A (25)	25	5	20.0	1.00		0.01
B (17)	17	5	29.4	1.21	0.33-4.48	0.78
C (34)	34	22	64.7	4.59	1.72-12.27	0.01
D (15)	15	10	66.7	4.85	1.25-18.77	0.02

Table 2. Relationship between clinicopathological features and death in patients with rectal tumours

Features (n)

Death

CI 95%

p value

Data presented as counts and percentages. HR: hazard ratio by a multiple Cox model; CRP: Tumour expression of C-reactive protein as measured by percentage of positive cells; CI 95%: 95% confidence interval. *Cox model including only those subjects (n=81, events=37) with thorough observations.

CRP expression

≥ 10% (65)

46.2

1.31

0.58-2.94

0.51

< 10% (26)

46.2

1.00

Age

≥ 60 years (55)

49.1

1.32

0.66-2.64

0.43

< 60 years (36)

41.7

1.00

Circumferential wedge

Positive (7)

85.7

3.64

1.26-10.51

0.02

Negative (82)

41.5

1.00

Dukes-Turnbull

A (25)

20.0

1.00

0.01

B (17)

29.4

1.21

0.33-4.48

0.78

C (34)

64.7

4.59

1.72-12.27

0.01

D (15)

66.7

4.85

1.25-18.77

0.02