Interest of C-reactive protein assay in small cell lung cancer. A pros
pective analysis of serum levels of C-reactive protein (CRP) has been
conducted on a series of 39 small cell lung cancer (SCLC) patients dur
ing the first course of chemotherapy in order to evaluate the predicti
ve value of this marker on tumoral extension at diagnosis and response
to therapy. Serum levels of CRP were measured before chemotherapy (da
y 0) and during the first two days of treatment (day 1, day 2). Twenty
-three of 32 evaluable patients (71%) had extensive disease. The mean
pre-treatment CRP level was significantly higher in this group than in
the group of patients with limited disease (52.3 mg/l vs 15.8 mg/l, P
= 0.02). Twenty-three patients responded to treatment and nine did no
t. The evolution of serum CRP levels in both groups was compared betwe
en day 0 and day 2. A more than two-fold increase of initial CRP level
s showed a 100% predictive value for response. On the other hand, a de
crease by more than 50% of initial serum levels was associated with a
negative predictive value of 75% for response. We conclude that the fo
llow-up of CRP levels during initial chemotherapy of SCLC might, be us
eful in the initial evaluation of tumoral extension and in the early p
rediction of response to therapy.