Prognostic value of serum C-reactive protein in idiopathic multicentric Castleman disease and construction of a prognostic model for patients

BackgroundIdiopathic Multicentric Castleman disease (iMCD) is a type of the rare lymphoproliferative diseases. C-reactive protein (CRP) is a well-recognized biomarker of inflammation, frequently exhibits elevated levels in individuals diagnosed with iMCD. However, its prognostic value of this factor...

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Main Authors: Zhixiang Lei, Ya Wang, Tiantian Yu, Yiting Zhang, Wenting Cui, Cancan Luo, Qingqing Luo, Lili Zhou, Yuchen Gao, Li Yu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1544250/full
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author Zhixiang Lei
Ya Wang
Tiantian Yu
Yiting Zhang
Wenting Cui
Wenting Cui
Cancan Luo
Qingqing Luo
Lili Zhou
Yuchen Gao
Li Yu
author_facet Zhixiang Lei
Ya Wang
Tiantian Yu
Yiting Zhang
Wenting Cui
Wenting Cui
Cancan Luo
Qingqing Luo
Lili Zhou
Yuchen Gao
Li Yu
author_sort Zhixiang Lei
collection DOAJ
description BackgroundIdiopathic Multicentric Castleman disease (iMCD) is a type of the rare lymphoproliferative diseases. C-reactive protein (CRP) is a well-recognized biomarker of inflammation, frequently exhibits elevated levels in individuals diagnosed with iMCD. However, its prognostic value of this factor in iMCD remains uncertain.MethodsThe clinical manifestations, biochemical information, treatment plan and overall survival time (OS) of 68 iMCD patients with basic information such as age, sex, time of first diagnosis, blood routine and serum CRP level data from 6 medical institutionsin China and abroad were retrospectively analyzed. The median follow-up time of the study was 44.47 months. The serum CRP level was divided into two groups according to the prognostic relationship by X-tile software, and then it was included in the risk model CRP-A for predicting death, together with the age of first visit > 60 years old, Hemoglobin (HGB) ≤ 80g/L, hepatomegaly and/or splenomegaly and plasma cell (PC) type. The predictive ability of the clinical model was evaluated by drawing calibration curve and ROC curve. The factors affecting the level of serum CRP were analyzed.ResultsUsing the Kaplan-Meier method, our analysis suggested that a higher serum CRP level (>26.8 mg/L) was associated with worse overall survival in patients (p = 0.004). We developed a multivariable prognostic model based on serum CRP levels to assess survival outcomes in iMCD. The discriminative performance of the model for mortality events was validated through calibration plots and receiver operating characteristic (ROC) curves highlighting CRP as a key biomarker associated with disease prognosis. Additionally, analyzing by chi-square test and Fisher’s exact test showed that age, B-symptoms, hypoalbuminemia, ECOG and plasma cell type were significantly associated with high serum CRP level in patients with iMCD, and that fibrinogen levels was positively correlated with CRP level.ConclusionHigh serum CRP levels are associated with a variety of clinical manifestations and laboratory abnormalities.
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spelling doaj-art-532215ffdc3b45f89ccf4e92cef886062025-08-20T02:26:25ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-04-011210.3389/fmed.2025.15442501544250Prognostic value of serum C-reactive protein in idiopathic multicentric Castleman disease and construction of a prognostic model for patientsZhixiang Lei0Ya Wang1Tiantian Yu2Yiting Zhang3Wenting Cui4Wenting Cui5Cancan Luo6Qingqing Luo7Lili Zhou8Yuchen Gao9Li Yu10The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, ChinaThe Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, ChinaThe Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, ChinaJiangxi Provincial Children's Hospital, Nanchang, ChinaThe Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, ChinaThe First People’s Hospital of Jiujiang, Jiujiang, ChinaThe Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, ChinaThe Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, ChinaThe Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, ChinaThe Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, ChinaThe Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, ChinaBackgroundIdiopathic Multicentric Castleman disease (iMCD) is a type of the rare lymphoproliferative diseases. C-reactive protein (CRP) is a well-recognized biomarker of inflammation, frequently exhibits elevated levels in individuals diagnosed with iMCD. However, its prognostic value of this factor in iMCD remains uncertain.MethodsThe clinical manifestations, biochemical information, treatment plan and overall survival time (OS) of 68 iMCD patients with basic information such as age, sex, time of first diagnosis, blood routine and serum CRP level data from 6 medical institutionsin China and abroad were retrospectively analyzed. The median follow-up time of the study was 44.47 months. The serum CRP level was divided into two groups according to the prognostic relationship by X-tile software, and then it was included in the risk model CRP-A for predicting death, together with the age of first visit > 60 years old, Hemoglobin (HGB) ≤ 80g/L, hepatomegaly and/or splenomegaly and plasma cell (PC) type. The predictive ability of the clinical model was evaluated by drawing calibration curve and ROC curve. The factors affecting the level of serum CRP were analyzed.ResultsUsing the Kaplan-Meier method, our analysis suggested that a higher serum CRP level (>26.8 mg/L) was associated with worse overall survival in patients (p = 0.004). We developed a multivariable prognostic model based on serum CRP levels to assess survival outcomes in iMCD. The discriminative performance of the model for mortality events was validated through calibration plots and receiver operating characteristic (ROC) curves highlighting CRP as a key biomarker associated with disease prognosis. Additionally, analyzing by chi-square test and Fisher’s exact test showed that age, B-symptoms, hypoalbuminemia, ECOG and plasma cell type were significantly associated with high serum CRP level in patients with iMCD, and that fibrinogen levels was positively correlated with CRP level.ConclusionHigh serum CRP levels are associated with a variety of clinical manifestations and laboratory abnormalities.https://www.frontiersin.org/articles/10.3389/fmed.2025.1544250/fulliMCDrisk factorsCRPnomogramprognostic assessment
spellingShingle Zhixiang Lei
Ya Wang
Tiantian Yu
Yiting Zhang
Wenting Cui
Wenting Cui
Cancan Luo
Qingqing Luo
Lili Zhou
Yuchen Gao
Li Yu
Prognostic value of serum C-reactive protein in idiopathic multicentric Castleman disease and construction of a prognostic model for patients
Frontiers in Medicine
iMCD
risk factors
CRP
nomogram
prognostic assessment
title Prognostic value of serum C-reactive protein in idiopathic multicentric Castleman disease and construction of a prognostic model for patients
title_full Prognostic value of serum C-reactive protein in idiopathic multicentric Castleman disease and construction of a prognostic model for patients
title_fullStr Prognostic value of serum C-reactive protein in idiopathic multicentric Castleman disease and construction of a prognostic model for patients
title_full_unstemmed Prognostic value of serum C-reactive protein in idiopathic multicentric Castleman disease and construction of a prognostic model for patients
title_short Prognostic value of serum C-reactive protein in idiopathic multicentric Castleman disease and construction of a prognostic model for patients
title_sort prognostic value of serum c reactive protein in idiopathic multicentric castleman disease and construction of a prognostic model for patients
topic iMCD
risk factors
CRP
nomogram
prognostic assessment
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1544250/full
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