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C-reactive protein in bladder cancer: where do we stand?

Nature Reviews Urology volume 10, page 182 (2013)Cite this article

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In their Review, Saito and Kihara provided an in-depth discussion of the status of the prognostic role of serum C-reactive protein (CRP) in various urological cancers (C-reactive protein as a biomarker for urological cancers. Nat. Rev. Urol. 8, 659–666; 2011).1 We agree that, given CRP might indicate cancer-specific outcomes, its role in different cancer entities for which immunogenic factors might be involved is a relevant issue for prognosis. CRP is released by hepatocytes to activate the complement system in response to IL-6 secretion, which is produced by immune cells to facilitate cancer cell detection and opsonization.2 This process is integral to the immune-mediated response to the cancer microenvironment,3 which itself resembles a state of chronic inflammation with the aim of infiltrating the blood and lymphatic systems to form distant metastases. A variety of cytokines (such as IL-6) and growth factors are released to promote cytological crosstalk between the humoral and cytotoxic immune pathways to enhance the elimination of cancer cells.

Consequently, investigating the prognostic role of CRP in patients with cancer is a promising avenue for research. Essentially, serum CRP is a sensitive serological biomarker of acute or chronic inflammation that can be routinely assessed at low cost. Although CRP is mostly known in the medical community as a sensitive inflammatory marker indicating systemic response to pathogens, its prognostic potential as a tumour marker has been recently investigated in a subset of nonurological malignancies, including pancreatic, gastric, lung and ovarian cancer.

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  1. Department of Urology, University Hospital Tübingen, Eberhard-Karls University, Hoppe-Seyler Strasse 3, Tübingen, D-72076, Germany

    Georgios Gakis & Arnulf Stenzl

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  1. Georgios Gakis
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  2. Arnulf Stenzl
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Correspondence to Georgios Gakis.

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Gakis, G., Stenzl, A. C-reactive protein in bladder cancer: where do we stand?. Nat Rev Urol 10, 182 (2013). https://doi.org/10.1038/nrurol.2011.145-c1

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