Haruki Koichiro, Shiba Hiroaki, Shirai Yoshihiro, Horiuchi Takashi, Iwase Ryota, Fujiwara Yuki, Furukawa Kenei, Misawa Takeyuki, Yanaga Katsuhiko
Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
World J Surg. 2016 Sep;40(9):2254-60. doi: 10.1007/s00268-016-3491-4.
The C-reactive protein to albumin (CRP/Alb) ratio, a novel inflammation-based prognostic score, is associated with outcomes in septic patients. The prognostic value of CRP/Alb ratio has not been established in cancer patients. The aim of this study is to evaluate the significance of CRP/Alb ratio in therapeutic outcome after pancreatic resection for pancreatic cancer.
The study comprised 113 patients who had undergone pancreatic resection for pancreatic cancer between April 2001 and December 2011. We retrospectively investigated the relation between CRP/Alb ratio and disease-free as well as overall survival.
The optimal cut-off level of the CRP/Alb ratio was 0.03. For disease-free survival, preoperative biliary drainage (p = 0.011), advanced tumor-node-metastasis (TNM) classification (p = 0.002), and higher CRP/Alb ratio (p = 0.049) by univariate analysis, and advanced TNM classification (p = 0.003) by multivariate analysis, were independent and significant predictors of cancer recurrence. For overall survival, preoperative biliary drainage (p = 0.012), advanced TNM classification (p = 0.001), and higher CRP/Alb ratio (p = 0.023) by univariate analysis, and advanced TNM classification (p = 0.003) and higher CRP/Alb ratio (p = 0.035) by multivariate analysis, were independent and significant predictors of poor patient outcome.
The CRP/Alb ratio may be an independent and significant indicator of poor long-term outcomes in patients with pancreatic cancer after pancreatic resection.
C反应蛋白与白蛋白比值（CRP/Alb）是一种基于炎症的新型预后评分，与脓毒症患者的预后相关。CRP/Alb比值在癌症患者中的预后价值尚未确立。本研究旨在评估CRP/Alb比值在胰腺癌胰切除术后治疗结局中的意义。
本研究纳入了2001年4月至2011年12月期间接受胰腺癌胰切除术的113例患者。我们回顾性研究了CRP/Alb比值与无病生存期及总生存期之间的关系。
CRP/Alb比值的最佳临界值为0.03。单因素分析显示，对于无病生存期，术前胆道引流（p = 0.011）、晚期肿瘤-淋巴结-转移（TNM）分期（p = 0.002）以及较高的CRP/Alb比值（p = 0.049），多因素分析显示晚期TNM分期（p = 0.003）是癌症复发的独立且显著的预测因素。对于总生存期，单因素分析显示术前胆道引流（p = 0.012）、晚期TNM分期（p = 0.001）以及较高的CRP/Alb比值（p = 0.023），多因素分析显示晚期TNM分期（p = 0.003）和较高的CRP/Alb比值（p = 0.035）是患者预后不良的独立且显著的预测因素。
CRP/Alb比值可能是胰腺癌患者胰切除术后长期预后不良的独立且显著的指标。
