Impact of serum C-reactive protein level as a biomarker of cancer dissemination in canine lymphoid neoplasia

Abstract

Background and Aim: C-reactive protein (CRP) is a highly sensitive but non-specific acute phase protein that has been widely used to predict the biological behavior of patients with cancer. This study aimed to examine the significance of the serum CRP biomarker in predicting the prognosis of dogs with lymphoma. Materials and Methods: Blood samples (5 mL) were collected from 34 lymphoma dogs and control healthy dogs. Canine lymphoma clinical staging was classified using the World Health Organization (WHO) criteria. All lymphoma dogs were reclassified into two groups based on the disease stage. Stages IV and V were designated as advanced stages, and Stages I–III were designated as other stages. The serum CRP level was then determined using a commercial canine CRP fluorescent immunoassay kit and routine hematological and biochemical analyses. C-reactive protein levels, circulating inflammatory parameters, such as neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, and platelet-to-lymphocyte ratio, and albumin levels were compared between advanced stages (IV and V) and Stages I to III using Mann–Whitney U tests. Receiver operating characteristic (ROC) curves were also generated to determine the cutoff value, diagnostic sensitivity, and specificity of the CRP level. Results: A prospective study identified 34 dogs recently diagnosed with canine lymphoma. C-reactive protein levels were significantly higher in lymphoma dogs in advanced stages (IV and V) than in lymphoma dogs in Stages I–III. According to the ROC curve analysis, a CRP cutoff level of 54.1 mg/L indicates advanced-stage canine lymphoma, which can be used as a biomarker to predict cancer dissemination. Conclusion: Serum CRP concentrations can assist clinical decision-making on the WHO stage in lymphoma dogs in clinical applications. The limitations of this study include a small number of lymphomas and no survival analysis.