Inflammatory biomarkers and cancer: CRP and suPAR as markers of incident cancer in patients with serious non-specific symptoms and signs of cancer

Abstract

In Denmark, patients with serious non-specific symptoms and signs of cancer (NSSC) are referred to the diagnostic outpatient clinics (DOCs) where an accelerated cancer diagnostic program is initiated. Various immunological and inflammatory biomarkers have been associated with cancer, including soluble urokinase plasminogen activator receptor (suPAR) and the pattern recognition receptors (PRRs) pentraxin-3, mannose-binding lectin, ficolin-1, ficolin-2, and ficolin-3. We aimed to evaluate these biomarkers and compare their diagnostic ability to classical biomarkers for diagnosing cancer in patients with NSSC.

Patients were included from the DOC, Department of Infectious Diseases, Copenhagen University Hospital Hvidovre. Patients were given a final diagnosis based on the combined results from scans, blood work, and physical examination. Weight loss, Charlson score, and previous cancer were registered on admission, and plasma concentrations of biomarkers were measured. The primary outcome was incident cancer within 1 year.

Out of 197 patients included, 39 patients (19.8%) were diagnosed with cancer. Patients with cancer were significantly older and had a higher burden of comorbidities and previous cancer diagnoses compared with patients who were not diagnosed with cancer. Previous cancer, C-reactive protein (CRP), and suPAR were significantly associated with newly diagnosed cancer during follow-up in multiple logistic regression analyses adjusted for age, sex, and CRP. Neither any of the PRRs investigated nor self-reported weight loss were associated with cancer.

In this study, previous cancer, CRP, and suPAR were significantly associated with cancer diagnosis in patients with NSSC. Ficolin-1-3, MBL, and pentraxin-3 were not associated with cancer. This article is protected by copyright. All rights reserved.

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