Chen Zhen, Shao Yingjie, Fan Min, Zhuang Qianfeng, Wang Kun, Cao Wei, Xu Xianlin, He Xiaozhou
Department of Urology, The Third Affiliated Hospital of Soochow University Changzhou 213003, P. R. China.
Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University Changzhou 213003, P. R. China.
Int J Clin Exp Pathol. 2015 Nov 1;8(11):14893-900. eCollection 2015.
We undertook a retrospective analysis to evaluate the C-reactive protein/albumin (CRP/Alb) ratio for its prognostic value in patients with clear cell renal cell carcinoma (CCRCC). The study comprised 406 CCRCC patients undergoing nephrectomy between 2003 and 2012 in our hospital. The correlations among the pretreatment CRP/Alb ratio, clinicopathological parameters, and overall survival (OS) were evaluated. An elevated CRP/Alb ratio was associated with older age at surgery (P=0.007), more advanced TNM stage (P<0.001), more presence of tumor necrosis (P<0.001) and lymphovascular invasion (P<0.001), lower concentration of hemoglobin (P<0.001) and calcium (P=0.005), and shorter OS (P<0.001). The multivariate analysis confirmed that the CRP/Alb ratio independently predicted the OS of patients with CCRCC (P<0.001), the Glasgow Prognostic Score (GPS) (P=0.001) and modified GPS (mGPS) (P=0.019) were independent prognostic factors also. At last, we evaluated the prognostic value of the CRP/Alb ratio compared with the similar inflammation-based prognostic scores GPS and mGPS using the area under the curve (AUC). Although the differences were not statistically significant, the AUC value of the CRP/Alb ratio (continuous, categorical) was higher compared with the GPS and mGPS, except that the AUC value for the CRP/Alb ratio (categorical) at 3 years was lower than that for the GPS. The CRP/Alb ratio could take the place of the GPS and mGPS in terms of predicting prognosis in CCRCC.
我们进行了一项回顾性分析，以评估C反应蛋白/白蛋白（CRP/Alb）比值在透明细胞肾细胞癌（CCRCC）患者中的预后价值。该研究纳入了2003年至2012年期间在我院接受肾切除术的406例CCRCC患者。评估了术前CRP/Alb比值、临床病理参数与总生存期（OS）之间的相关性。CRP/Alb比值升高与手术时年龄较大（P=0.007）、TNM分期更晚（P<0.001）、肿瘤坏死（P<0.001）和淋巴管侵犯（P<0.001）更常见、血红蛋白浓度（P<0.001）和钙浓度（P=0.005）较低以及OS较短（P<0.001）相关。多因素分析证实，CRP/Alb比值可独立预测CCRCC患者的OS（P<0.001），格拉斯哥预后评分（GPS）（P=0.001）和改良GPS（mGPS）（P=0.019）也是独立的预后因素。最后，我们使用曲线下面积（AUC）评估了CRP/Alb比值与基于炎症的类似预后评分GPS和mGPS相比的预后价值。尽管差异无统计学意义，但CRP/Alb比值（连续型、分类型）的AUC值高于GPS和mGPS，除了3年时CRP/Alb比值（分类型）的AUC值低于GPS。在预测CCRCC的预后方面，CRP/Alb比值可替代GPS和mGPS。
