High CRP: a marker for depression in metastatic lung cancer


Takeaway

  • C-reactive protein (CRP), a measure of inflammation, is a strong predictor of clinically significant depression in patients with lung cancer.
  • Patients with moderate or high inflammation are more likely to have depression.

Why this matters

  • Lung cancer has 1 of the highest rates of comorbid depression among all types of cancer, ranging from 16% to 29%.
  • Inflammation is elevated in both lung cancer and depression.

Study design

  • 109 patients undergoing treatment for stage IV lung cancer.
  • Funding: National Cancer Institute.

Key results

  • 71.8% had NSCLC adenocarcinoma, 6.4% squamous cell carcinoma NSCLC, and 16.5% SCLC; the remaining were unspecified.
  • 23.9% overall had clinically significant depression symptoms.
  • After multiregression analysis, only CRP (log-transformed) was significantly associated with depression (aR2, 0.23; P=.001).
  • After linear regression, CRP was a predictor for approximately 20% of depression variability (aR2, 0.2; P=.001), and patients with clinically significant depression scores had higher median CRP levels (3.4 vs 1.3 mg/mL; P=.003) and were more likely to be receiving advanced lines of treatment (P=.24).
  • Among those with depression, 76.9% had a CRP level ≥1 mg/mL, and 50% had a CRP level ≥3 mg/mL.
  • Only 7 of the patients with clinically significant depression were receiving antidepressants.

Limitations

  • Retrospective study.

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