Does Moh's surgery on a facial squamous cell carcinoma elevate C
Reactive Protein and/or other lab ( blood ) biochem test results such
as creatinnine, ast,alt,et.

Hello -

Quick disclaimer - while I am an MD, proper interpretation of any lab
results should be performed by the physician treating you.

C-reactive protein is one of the markers of inflammation that is
commonly measured.  As surgery produces an injury to the body, the
body's inflammatory responses are acivated.  As Kevinmd points out,
other markers which might be expected to transiently rise with surgery
would be the ESR, ferritin levels, and the WBC count.

Creatinine is produced in the body in rough proportion to energy
utilization and as such can be a marker of nutritional status.  It is
also removed from the body via the kidneys, so an elevation in
creatinine suggests kidney disfunction.

AST and ALT are enzymes produced in the liver (predominately) and the
serum levels are elevated with liver damage (hepatitis, drugs,
alcohol, metastatic disease).

Surgery can elevate inflammatory responses, and levels of c-reactive
protein as a result.  Abdominal surgery is known to do this, with a
peak at 48 hours:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12499737&dopt=Abstract

One good review of the literature, however, suggests little predictive
value to elevations in inflammatory markers due to elevations in these
markers by many of the underlying diseases for which the surgery was
performed.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12499737&dopt=Abstract

Altered levels of the substances mentioned have been noted in
association with head and neck squamous cell carcinomas, however.

Elevated inflammatory mediators (like c-reactive protein) and
cytokines have been noted in association with head and neck squamous
cell carcinomas:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10389921&dopt=Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7544987&dopt=Abstract

An association has been suggested between elevated C-reactive protein
and poor prognosis in esophageal squamous cell carcinomas (abstracts
only, full-text not available without fee):
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12637157&dopt=Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12563234&dopt=Abstract
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11574097&dopt=Abstract

Poor nutritional status in patients with head and neck squamous cell
carcinomas has been shown to be associated with decreased creatinine:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7544987&dopt=Abstract

AST and ALT levels may be elevated with metastatic disease to the
liver; in one study elevated levels were not found to correlate well
enough with metastatic disease to necessitate a work-up without other
indications (there are other reasons, mainly alcohol related that they
found elevations in the levels of ast and alt in patients with head
and neck squamous cell carcinoma)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8847212&dopt=Abstract

UpToDate, a commonly used medical reference database, also concurs
that "Screening with chest x-ray, serum alkaline phosphatase, and
liver function tests (ie AST, ALT - comment mine) is insufficient to
demonstrate metastatic disease" and "The lack of predictive value of
liver function tests was further demonstrated in a study of 140
patients with HNC. Approximately one-half had abnormal liver function
tests; none of these patients had liver metastases and all of the
abnormalities were attributed to alcohol abuse (a major risk factor
for HNC). Three patients who subsequently developed liver metastases
had normal liver function tests. Liver spleen scans are non-specific
."  - UpToDate version 11.1 topic "Diagnosis and staging of head and
neck cancer"

Additionally, creatinine (often due to kidney damage from cisplatin or
other drugs), ast and alt levels (due to liver damage from various
chemotherapeutics) have been found to be altered in response to
chemotherapy for head and neck squamous cell carcinomas; but I don't
know if this is applicable as you did not mention any chemotherapy.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8687091&dopt=Abstract


Please let me know if you need any further explanations.

synarchy

search strategy:
PubMed - "squamous cell carcinoma c-reactive protein", "squamous cell
carcinoma liver function", "squamous cell carcinoma creatinine"
UpToDate - "squamous cell carcinoma head neck"
Google searches: no relevant results found

Hello,
I do not know offhand if Moh's surgery will raise levels of specific
tests.  It would not be surprising if some of the markers of
inflammation would increase due to the surgery.  Any surgery would
result in inflammation during the healing process and thus may
increase some of the markers of inflammation.

These would include the following:
CRP (C-reactive protein)
ESR (erythrocyte sedimentation rate)
ferritin
WBC (white blood count)

Thanks,
Kevin, M.D.