Liu Xuechao, Sun Xiaowei, Liu Jianjun, Kong Pengfei, Chen Shangxiang, Zhan Youqing, Xu Dazhi
Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China; Department of Gastric and Pancreatic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
Transl Oncol. 2015 Aug;8(4):339-45. doi: 10.1016/j.tranon.2015.06.006.
An elevated preoperative C-reactive protein/albumin (CRP/Alb) ratio has been reported to be associated with a poor prognosis for hepatocellular carcinoma. The aim of the present study was to investigate the prognostic value of the preoperative CRP/Alb ratio and compare it with other systemic inflammatory response markers in patients with gastric cancer (GC).
A retrospective study was performed in 455 patients with GC undergoing curative resection. We investigated the correlations between the preoperative CRP/Alb ratio and overall survival (OS). Kaplan-Meier and Cox regression models were used to assess independent prognostic factors. The area under the curve was used to compare the prognostic value of different markers.
On multivariate analysis, the CRP/Alb ratio were independently associated with OS in patients with GC (hazard ratio: 1.626; 95% confidence interval: 1.191-2.219; P = .002), along with age (P = .003), preoperative body weight loss (P = .001), tumor location (P = .008), metastatic lymph node ratio (P < .001), and seventh tumor-nodes-metastasis stage (American Joint Committee on Cancer) (P = .007). However, several other systemic inflammation-based prognostic scores (neutrophil lymphocyte ratio, platelet lymphocyte ratio and systemic immune-inflammation index, Glasgow Prognostic Score, modified Glasgow prognostic score, and high-sensitivity modified Glasgow prognostic score) were not. In addition, the CRP/Alb ratio had a higher area under the curve value (0.625) compared with several other systemic inflammation-based prognostic scores (P < .001).
The preoperative CRP/Alb ratio, a system inflammation-based prognostic score, is a superior predictor of OS in patients undergoing curative resection for GC and may help to identify the high-risk patients for treatment decisions.
据报道，术前C反应蛋白/白蛋白（CRP/Alb）比值升高与肝细胞癌预后不良相关。本研究旨在探讨术前CRP/Alb比值在胃癌（GC）患者中的预后价值，并将其与其他全身炎症反应标志物进行比较。
对455例行根治性切除的GC患者进行回顾性研究。我们调查了术前CRP/Alb比值与总生存期（OS）之间的相关性。采用Kaplan-Meier法和Cox回归模型评估独立预后因素。采用曲线下面积比较不同标志物的预后价值。
多因素分析显示，GC患者的CRP/Alb比值与OS独立相关（风险比：1.626；95%置信区间：1.191-2.219；P = 0.002），同时还与年龄（P = 0.003）、术前体重减轻（P = 0.001）、肿瘤位置（P = 0.008）、转移淋巴结比例（P < 0.001）和第七版肿瘤-淋巴结-转移分期（美国癌症联合委员会）（P = 0.007）相关。然而，其他几种基于全身炎症的预后评分（中性粒细胞淋巴细胞比值、血小板淋巴细胞比值和全身免疫炎症指数、格拉斯哥预后评分、改良格拉斯哥预后评分和高敏改良格拉斯哥预后评分）则不然。此外，与其他几种基于全身炎症的预后评分相比，CRP/Alb比值的曲线下面积值更高（0.625）（P < 0.001）。
术前CRP/Alb比值作为一种基于系统炎症的预后评分，是行GC根治性切除患者OS的更佳预测指标，可能有助于识别高危患者以制定治疗决策。
