Association of C-reactive protein with grade of soft tissue sarcoma: a single centre study

Background: Soft tissue sarcomas (STS) are a rare and heterogeneous group of malignant tumors originating from mesenchymal tissues. Tumor grade is a critical prognostic factor in STS, influencing treatment decisions and patient outcomes. Systemic inflammation, reflected by elevated levels of C-reactive protein (CRP), has been associated with tumor aggressiveness and poor prognosis in various cancers. However, the relationship between CRP levels and tumor grade in STS remains underexplored. To evaluate the association between pre-treatment serum CRP levels and histological tumor grade in patients diagnosed with soft tissue sarcoma. Method: This cross-sectional study was conducted at Bangladesh Medical University (BMU) from December 2023 to December 2024. A total of 71 adult patients with histologically confirmed STS were included. Tumor grade was determined using the FNCLCC grading system, and serum CRP levels were measured prior to treatment. Statistical analyses were performed using SPSS version 27. A p value less than 0.05 was considered statistically significant. Results: The mean age of participants was 43.65±14.84 years, with a male predominance (59.2%). High-grade STS cases showed significantly elevated CRP levels (mean: 84.14 mg/l) compared to low-grade tumors (mean: 10 mg/l). The association between CRP level and tumor grade was statistically significant (p<0.001). ROC analysis revealed excellent discriminative ability of CRP for high-grade STS (AUC=0.944), with an optimal cut-off at 10 mg/l (81% sensitivity, 77% specificity). Conclusion: Elevated CRP levels are significantly associated with high-grade soft tissue sarcoma, suggesting CRP may serve as a useful, low-cost prognostic biomarker to aid in tumor grading and risk stratification.