Predictive values of acute phase reactants, basic fetoprotein, and immunosuppressive acidic protein for staging and survival in renal cell carcinoma

Objectives. To determine the clinical significance and predictive value of three acute phase reactants (erythrocyte sedimentation rate, C-reactive pro tein, and ferritin), as well as basic fetoprotein (BFP) and immunosuppressi ve acidic protein, in patients with renal cell carcinoma. Methods. Erythrocyte sedimentation rate, C-reactive protein, ferritin, BFP, and immunosuppressive acidic protein levels were measured in 92 patients w ith renal cell carcinoma diagnosed in 1989 to 1999. The levels were compare d with the clinical stage and nuclear grade, and their predictive values of survival were evaluated statistically. Results. All markers, with the exception of BFP, correlated with each other and with the clinical stage and nuclear grade. BFP did not correlate with the acute phase reactants. The log-rank test revealed that the levels of C- reactive protein, immunosuppressive acidic protein, and ferritin significan tly influenced survival. Multivariate stepwise analysis identified ferritin as the only independent and significant prognostic marker (hazard ratio = 5.624, P = 0.001). However, when age, sex, clinical stage, and nuclear grad e were entered into the same analysis, only clinical stage was an independe nt marker of prognosis. Conclusions. The results of our study demonstrated that serum ferritin is t he most useful marker among five tested factors for staging and predicting survival, although the clinical stage is the best parameter that predicts t he prognosis of patients with renal cell carcinoma accurately. UROLOGY 58: 161-164, 2001. (C) 2001, Elsevier Science Inc.