C-reactive protein may be a prognostic factor for the whole gastroenteropancreatic neuroendocrine tumor group

Table 1 Relationship between demographic data and numeric independent variables on 5-year survival

	Patient group, n = 93	5-yr survival		P value
		Yes (alive), n = 57	No (dead), n = 36
Age (yr)	Mean: 53.45	Mean: 50.9	Mean: 57.4	0.02
	SD: 13.46	SD: 12.2	SD: 13.6
Gender (F/M)	F 54.8%	F 64.9%	F 38.9%	0.01
	M 45.2%	M 35.1%	M 61.1%
Tumor diameter (cm)	Mean: 3.1	Mean: 2.39	Mean: 4.20	0.01
	SD: 3.45	SD: 3.56	SD: 3.03
Hgb level (g/dL), n = 89	Mean: 12.21	Mean: 12.31	Mean: 12.05	0.54
	SD: 1.99	SD: 1.86	SD: 2.22
Albumin level (g/dL), n = 87	Mean: 4.08	Mean: 4.16	Mean: 3.94	0.07
	SD: 0.53	SD: 0.56	SD: 0.44
LDH level (U/L), n = 83	Mean: 291.1	Mean: 255.6	Mean: 347.5	0.11
	SD: 213.1	SD: 95.11	SD: 316.5
CRP level (mg/L), n = 72	Mean: 22.5	Mean: 14.63	Mean: 37.31	0.02
	SD: 33.8	SD: 25.48	SD: 42.25
ESR (mm/h), n = 63	Mean: 37.7	Mean: 33.905	Mean: 45.429	0.09
	SD: 25.9	SD: 24.3329	SD: 27.8039

F: Female; M: Male; Hgb: Hemoglobin; LDH: Lactate dehydrogenase; CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate; SD: Standard deviation.

Table 2 Relationship between categorical independent variables and survival

		Mean survival (mo)	Standard deviation (± mo)	1-yr survival (%)	3-yr survival (%)	5-yr survival (%)	P value
All patients	n = 93	102.5	6.3	90	72	61
Non-surgical (non-invasive) group	Yes (n = 56)	101.9	7.3	91	75	66	0.25
	No (n = 37)	93.2	10.3	89	67	54
Surgical resection	Yes (n = 54)	99.6	8.4	89	70	59	0.62
	No (n = 39)	97	8.5	92	74	64
Liver metastasis	Present (n = 38)	61.3	9.5	81	47	29	< 0.001
	Absent (n = 55)	122.6	5.5	96	89	83
Extrahepatic metastasis	Present (n = 23)	32	5.8	78	30	08	< 0.001
	Absent (n = 70)	124	6	94	85	78
Stage	1 (n = 35)	132.8	4.3	100	94	91	< 0.001
	2 (n = 7)			100	100	100
	3 (n = 13)	69.7	8.5	84	70	54
	4 (n = 38)			81	47	29
Grade mitotic count	1 (n = 62)	111	6.2	97	84	72	< 0.001
	2 (n = 21)	87.1	14.4	81	57	52
	3 (n = 10)	35.1	11.3	70	30	10
Grade Ki-67 level	1 (n = 43)	124.6	6.1	97	90	86	< 0.001
	2 (n = 30)	83.9	9.9	90	66	50
	3 (n = 20)	54.4	12.7	75	40	25
Anemia	Present (n = 42)	92.9	8.7	90	71	57	0.34
	Absent (n = 47)	110	8.6	90	76	68
Hypoalbuminemia	Present (n = 10)	91	15.7	100	70	60	0.60
	Absent (n = 77)	105.4	6.8	89	75	63
ESR elevation	Present (n = 30)	93.5	9.5	93	76	60	0.28
	Absent (n = 33)	117.7	9.2	93	81	72
CRP elevation (mg/L)	< 5 (n = 28)	118.1	8.2	100	85	78	0.009
	5-20 (n = 20)	118.6	12.2	90	80	75
	> 20 (n = 24)	72.3	10.5	83	66	41

CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate.

Table 3 Correlation analysis of tumor properties and C-reactive protein level

Correlation coefficients (r)	Tumor diameter (cm)	Tumor stage	Tumor grade (mitotic index)	Tumor grade (Ki-67 level)	Tumor grade (determined)	CRP (mg/L)
Tumor diameter (cm)	-
Tumor stage	0.76b	-
Tumor grade (mitotic count)	0.37b	0.39b	-
Tumor grade (Ki-67 level)	0.59b	0.55b	0.75b	-
Tumor grade (determined)	0.57b	0.53b	0.78b	0.99b	-
CRP (mg/L)	0.25a	0.26a	0.22	0.17	0.17	-

^aP < 0.05.

^bP < 0.001.

CRP: C-reactive protein.

Table 4 Five-year survival according to primary tumor location

Tumor location, n = 93	N	%	Survivors at the end of 5 yr (%)
Appendix	3	3.2	100
Duodenum	2	2.2	100
Ileum	7	7.5	43
Liver	2	2.2	50
Colon	13	14	54
Stomach	29	31.2	79
Esophagus	1	1.1	0
Pancreas	25	26.9	48
Periampullary	7	7.5	43
Rectum	4	4.3	75

Table 5 Survival difference between pancreatic and stomach neuroendocrine tumors

	Tumor location, n = 54	5-yr survival		P value
		Yes, n = 35	No, n = 19
Stomach	53.7%	65.7%	31.5%	0.016
Pancreas	46.3%	34.3%	68.5%

Table 6 Relative increase in risk of death in unit changes of determined variables

	Significance level (P)	Relative increase in risk of death according to unit change (fold)	95%CI
			Lower limit	Upper limit
Age (yr)	0.041	1.04	1.007	1.066
Gender (M/F)	0.015	2.0	1.028	3.976
Tumor diameter (cm)	0.02	1.09	1.014	1.169
Tumor grade (Ki-67) (3/1-2)	< 0.001	3.6	1.873	7.206
Tumor grade (mitosis) (3/1-2)	0.006	3.0	2.823	13.362
Determined tumor grade (3/1-2)	< 0.001	3.6	1.873	7.206
Tumor stage (3-4/1-2)	< 0.001	12.7	3.869	41.708
CRP level (mg/L )	0.005	1.01	1.022	1.253
Liver metastasis (P/A)	< 0.001	6.1	2.823	13.362

F: Female; M: Male; CRP: C-reactive protein; ESR: Erythrocyte sedimentation rate; P: Present; A: Absent.