Prognostic role of serum C-reactive protein in esophageal cancer: a systematic review and meta-analysis

Figures & data

Figure 1 Flow chart of the meta-analysis.

Abbreviation: CRP, C-reactive protein.

Table 1 Characteristics of included studies

Author	Year	Country	Sample (M/F)	Treatment	Survival analysis	Pathological type	HR (95% CI)	Cut-off level (mg/L)	TNM stage I–II/III–IV
Nozoe et al^Citation26	2001	Japan	262 (227/35)	C/R + S	OS	SCC + AC	3.300 (2.174–5.000)	5	157/105
Ikeda et al^Citation27	2003	Japan	356 (327/29)	C/R + S + C/R	OS	SCC + AC + OT	1.52 (1.05–2.21)	5	186/170
Shimada et al^Citation28	2003	Japan	150 (128/22)	S	OS	SCC	1.42 (0.83–2.41)	10	67/83
Gockel et al^Citation29	2006	Germany	291 (NA)	S	OS	SCC + AC + OT	1.182 (1.030–1.356)	5	NA
Wang et al^Citation30	2009	Taiwan	123 (120/3)	R	OS	SCC + AC	12.116 (3.449–42.567)	5	22/101
Zingg et al^Citation31	2010	Australia	90 (74/16)	C/R + S	OS	SCC + AC	1.42 (0.71–2.85)	10	75/15
Feng et al^Citation32	2013	People’s Republic of China	43 (30/13)	S + C/R	OS	SCCE	2.756 (1.115–6.813)	10	NA
Song et al^Citation33	2013	People’s Republic of China	156 (134/22)	S + C/R	OS	SCC	2.131 (1.213–4.451)	5	NA

Abbreviations: M/F, male/female; S, surgery; C/R, chemotherapy/radiotherapy; R, radiotherapy; OS, overall survival; SCC, squamous cell carcinoma; AC, adenocarcinoma; OT, others; SCCE, small cell carcinoma of the esophagus; NA, not available; HR, hazard ratio; CI, confidence interval; TNM, tumor-node-metastasis.

Figure 2 Forest plot of the association between serum CRP and OS in EC.

Abbreviations: CRP, C-reactive protein; OS, overall survival; EC, esophageal cancer; HR, hazard ratio; CI, confidence interval.

Figure 3 Forest plot of the association between serum CRP and OS in EC by subgroup analyses.

Notes: Subgroup analysis according to treatment (A) surgery only; (B) surgery combined with chemotherapy/radiotherapy, pathological type; (C) squamous cell carcinoma; (D) squamous cell carcinoma, adenocarcinoma and others and cut-off level (E) cut-off =10 mg/L; (F) cut-off =5 mg/L.
Abbreviations: CRP, C-reactive protein; OS, overall survival; EC, esophageal cancer; HR, hazard ratio; CI, confidence interval.

Table 2 Subgroup analyses of pooled HRs for increased serum CRP and OS in EC

Subgroup	Number of cohorts	Number of patients	References	HR (95% CI)	Heterogeneity
					I^2 (%)	P-value
Treatment
S	2	441	^Citation28, ^Citation29	1.20 (1.05–1.37)	0.0	0.514
S + AT	5	907	^Citation26, ^Citation27, ^Citation31, ^Citation32, ^Citation33	2.08 (1.65–2.62)	55.5	0.061
Pathological type
SCC	2	306	^Citation28, ^Citation33	1.67 (1.11–2.52)	0.0	0.344
SCC + AC/OT	5	1,122	^Citation26, ^Citation27, ^Citation29, ^Citation30, ^Citation31	1.36 (1.20–1.53)	88.0	<0.0001
Cut-off level
5 mg/L	5	1,188	^Citation19, ^Citation20, ^Citation23, ^Citation24, ^Citation27	1.38 (1.22–1.56)	88.6	<0.0001
10 mg/L	3	283	^Citation22, ^Citation25, ^Citation26	1.60 (1.09–2.35)	0.0	0.429

Abbreviations: S, surgery; AT, adjuvant therapy; SCC, squamous cell carcinoma; AC, adenocarcinoma; OT, others; HR, hazard ratio; CI, confidence interval; CRP, C-reactive protein; OS, overall survival; EC, esophageal cancer.

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