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.