Hemoglobin, C-reactive protein and ferritin in patients with oral carcinoma and their clinical significance – A prospective clinical study. Issue 2 (February 2018) - Blatt, Sebastian
Abstract: Aim: For oral squamous cell carcinoma (OSCC), biomarkers are much in need to predict prognosis and to overcome possible resistance mechanisms to adjuvant therapies. The aim of this study was to evaluate serum level of hemoglobin, C-reactive protein (CRP) and ferritin as possible liquid biopsy to predict survival, metastasis and tumor relapse of OSCC. Material and methods: A prospective clinical study was conducted. Overall, serum levels of hemoglobin, CRP and ferritin in 82 OSCC patients and 63 controls were preoperatively investigated. Results: Patients with an anemia showed a significant lower survival than patients with no anemia preoperative. Patients with T3/T4 cancer had significant lower hemoglobin values (p = 0.002). CRP and ferritin were statistically overexpressed in late tumor stages T3/T4 (ferritin: p = 0.045, CRP: p < 0.05) compared to control. Log Rank testing indicated a statistical correlation of up regulated ferritin levels with local tumor recurrence (p = 0.012) and local lymph node metastasis (p = 0.008). Conclusion: Presented biomarker CRP, ferritin and hemoglobin may serve as a liquid biopsy for prediction of OSCC especially for larger tumor sizes, overall survival and tumor relapse and demand a more radical therapy approach. Highlights: For oral squamous cell carcinoma (OSCC), biomarkers are much needed to predict prognosis and to overcome possible resistance mechanisms to adjuvant therapies. C-reactive protein (CRP), ferritin and hemoglobin are noninvasive, relatively cheap and routinely available. High preoperative level of the serum marker CRP and ferritin demand a more radical therapy approach. Patients with preoperative anemia showed significant lower survival than patients with no anemia. CRP, ferritin and hemoglobin may serve as a liquid biopsy for prediction of OSCC especially for larger tumor sizes, overall survival and tumor relapse.