Elevated C-reactive Protein Levels and Malignant Transformation Risk in Patients With Oral Mucosal Diseases

Area of Science:

• Oncology
• Inflammation Research
• Oral Pathology

Background:

• Chronic inflammation is a known hallmark of various cancers.
• Systemic inflammation, indicated by elevated C-reactive protein (CRP), may influence cancer development.
• Oral inflammatory conditions and lesions with malignant potential require further investigation regarding cancer transformation risks.

Purpose of the Study:

• To investigate the association between elevated serum C-reactive protein (CRP) levels and the risk of malignant transformation in oral inflammatory diseases and lesions.
• To determine if CRP levels can predict the risk of developing oral squamous cell carcinoma (OSCC).

Main Methods:

• A multicentre, retrospective, observational cohort study utilizing the Observational Medical Outcomes Partnership Common Data Model.
• Analysis of serum CRP levels within 30 days of oral disease diagnosis, with a threshold of 0.269 mg/dL identified for malignancy prediction.
• Cox proportional hazard models, propensity score matching (1:1 and 1:2), and pooled meta-analyses were employed to assess OSCC risk.

Main Results:

• 10,029 individuals were included, with 4,142 in the elevated CRP group (≥ 0.269 mg/dL) and 5,887 in the control group (< 0.269 mg/dL).
• A total of 204 individuals (2.03%) progressed to OSCC, with a higher incidence in the elevated CRP group (2.32%) versus controls (1.83%).
• Elevated CRP was significantly associated with an increased risk of OSCC (HR = 1.79 [95% CI 1.08-2.95] for 1:1 matching; HR = 1.55 [95% CI 1.01-2.38] for 1:2 matching).

Conclusions:

• Elevated serum CRP levels, a marker of systemic inflammation, are significantly linked to an increased risk of malignant progression in patients with inflammatory oral conditions.
• These findings highlight the potential role of inflammation in assessing OSCC risk and developing preventive strategies.
• Understanding the inflammatory processes involved in oral lesions may improve early detection and management of oral cancer.