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Plasma tumor necrosis factor-α and C-reactive protein as biomarker for survival in head and neck squamous cell carcinoma

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Tumor TNM staging is the main basis for prognosis and treatment decision for head and neck squamous cell carcinoma (HNSCC) despite significant heterogeneity in terms of outcome among patients with the same clinical stage. In this study, a possible role of plasma interleukin-2 (IL-2), interleukin-6 (IL-6), granulocyte–macrophage colony-stimulating factor (GM-CSF), tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) as biomarkers for survival of HNSCC patients was investigated.


In this prospective study, plasma levels of IL-2, IL-6, GM-CSF, TNF-α and CRP in patients (n = 100) and controls (n = 48) were analyzed.


Significantly elevated levels of CRP and TNF-α (p < 0.001) were found in the patients. Combination of upregulated CRP and TNF-α in the patient plasma was significantly related to shorter patient survival, independent of clinical stage.


Our findings indicate that CRP and TNF-α might be suitable as biomarkers in combination with tumor TNM staging for predicting survival and individualized treatment of HNSCC patients. Plasma CRP and TNF-α analysis are simple, rapid, cost effective and suitable for clinical practice.

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Grants were received from Futurum-Academy of HealthCare at Jönköping County Council (No. 307251, 144631, 151361) and Foundation of Clinical Cancer Research, Jönköping, Sweden (No. 110426-1). We would like to thank the patients and healthy controls for blood samples, Annette Nilsson Bowers, Egon Karlsson and David Lewin for practical help.

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No potential conflict of interest was disclosed.

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Correspondence to Bengt-Åke Andersson.

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Andersson, B., Lewin, F., Lundgren, J. et al. Plasma tumor necrosis factor-α and C-reactive protein as biomarker for survival in head and neck squamous cell carcinoma. J Cancer Res Clin Oncol 140, 515–519 (2014).

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  • Head and neck squamous cell carcinoma
  • Biomarkers
  • Survival
  • CRP
  • TNF-α