C-reactive protein and its association with depression in patients receiving treatment for metastatic lung cancer Journal Article


Authors: McFarland, D. C.; Shaffer, K.; Breitbart, W.; Rosenfeld, B.; Miller, A. H.
Article Title: C-reactive protein and its association with depression in patients receiving treatment for metastatic lung cancer
Abstract: Background: Depression is highly prevalent in lung cancer. Although there is a known association between inflammation and depression, this relationship has not been examined in patients with lung cancer who undergo treatment with immune and other targeted drug therapies. Peripheral blood C-reactive protein (CRP), a marker of systemic inflammation, may help identify metastatic lung cancer patients with inflammation-associated depression. Method: Patients with metastatic lung cancer undergoing treatment were evaluated for depression using the Hospital Anxiety and Depression Scale (HADS). Inflammation (CRP and CRP cutoffs ≥1 and ≥3 mg/mL) and demographic and treatment variables were analyzed for association with depression. Results: One hundred nine consecutive participants exhibited an average plasma CRP concentration of 1.79 mg/mL (median, 0.75 mg/mL [standard deviation, 2.5 mg/mL), and 20.7% had a CRP concentration of ≥3.0 mg/mL; 23.9% met depression screening criteria (HADS ≥8). A log transformation of CRP was significantly correlated with depression severity (r = 0.47, P <.001). CRP was the only covariate to predict depression severity (P =.008) in a multivariate model including lung cancer disease subtype and type of systemic treatment. Receiver operating characteristic analysis indicated that CRP had moderate predictive accuracy in identifying elevated depression (area under the curve = 0.74). A cutoff of CRP ≥3.0 generated high specificity (88%) but identified only 50% of those with elevated depression. Conclusion: Elevated CRP is associated with depression in patients with metastatic lung cancer. Thus, CRP may identify a subset of lung cancer patients with inflammation-induced depression and may be useful in predicting response to treatments that target inflammation or its downstream mediators on the brain. © 2018 American Cancer Society
Keywords: inflammation; lung cancer; c-reactive protein; depression; hospital anxiety and depression scale; acute phase reactant
Journal Title: Cancer
Volume: 125
Issue: 5
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2019-03-01
Start Page: 779
End Page: 787
Language: English
DOI: 10.1002/cncr.31859
PROVIDER: scopus
PMCID: PMC6378137
PUBMED: 30521079
DOI/URL:
Notes: Source: Scopus
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MSK Authors
  1. William S Breitbart
    344 Breitbart
  2. Kelly M Shaffer
    18 Shaffer