Measuring C reactive protein concentrations may be more useful

EDITOR—Nielsen et al reported an association between circulating concentrations of plasminogen activator inhibitor-1 and survival in patients with colorectal cancer.1 They suggest that this reflects the specific role of plasminogen activator inhibitor-1 in tumour progression.

It has been known for some time that disease progression in colorectal cancer is associated with an increase in the acute phase response as evidenced by the prototypical acute phase protein (C reactive protein).2 We have reported that an increase in circulating C reactive protein concentrations is associated with increased recurrence of tumour in patients who have undergone curative surgery for colorectal cancer.3 There is also evidence that an increased C reactive protein concentration is an independent predictive factor of survival in patients with gastrointestinal cancer.4 Therefore the association between increased plasminogen …