Stellenwert des Serum-CRP-Wertes zur Einschätzung von Prognose und therapeutischem Ansprechen urologischer Malignome

Zusammenfassung

Das C-reaktive Protein (CRP) ist ein unspezifischer Parameter der systemischen Entzündungsreaktion, der auch im Rahmen von Autoimmunerkrankungen, Traumata oder bei malignen Erkrankungen vermehrt exprimiert wird. Unter urologischen Karzinomerkrankungen zeigt sich für das Nierenzell- und Harnblasenkarzinom ein mehrfach belegter Zusammenhang zwischen der Höhe des CRP und dem Krankheitsverlauf bzw. der Prognose. Beim bereits metastasierten sowie kastrationsresistenten Prostatakarzinom kann das CRP zur Abschätzung des Krankheitsausmaßes und der Mortalität herangezogen werden. Der CRP-Wert scheint neben dem PSA einen weiteren unabhängigen prognostischen Marker für das tumorspezifische Überleben darzustellen, auch wenn er weder organ- noch tumorspezifisch ist. Die Bestimmung der CRP Konzentration im Serum ist als weltweit standardisierter laborchemischer Parameter routinemäßig durchführbar. Bevor allerdings das CRP im klinischen Alltag auch als etablierter Prognoseparameter angesehen werden kann, ist eine Validierung seines prognostischen und prädiktiven Wertes mittels großer, multizentrischer und vorzugsweise prospektiver Studien nötig.

Abstract

C-reactive protein (CRP) is an unspecific marker of systemic inflammation. It is known to be elevated in autoimmune disease, traumata and malignancies. Increased CRP levels have specifically been shown to be associated with disease progression and prognosis in various studies on renal cell carcinoma and transitional cell carcinoma. Although CRP, unlike PSA, is neither organ-specific nor tumour-specific, studies were able to show that increased CRP values are an independent prognostic marker for tumour-specific survival of patients with prostate cancer. In metastatic and castration-resistant prostate cancer elevated CRP levels have been approved as a useful marker to estimate the extent of disease and mortality. CRP measurements in serum are standardised worldwide and widely used in daily clinical routine. However, until CRP can be firmly established as a prognostic marker in daily routine, we need validation of its prognostic and predictive value with large and preferably prospective multicentre studies.

Schlüsselwörter

C-Reaktives Protein - Prognoseparameter - urologische Tumore - Prostatakarzinom - Nierenkrebs - Blasenkrebs

Key words

c-reactive protein - prognostic marker - urological cancer - prostate cancer kidney cancer - bladder cancer

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