Xu Hong-Jun, Ma Yan, Deng Fang, Ju Wen-Bo, Sun Xin-Yi, Wang Hua
Department of Gastroenterology, Affiliated Hospital of Beihua University, Jilin, Jilin province, China.
Onco Targets Ther. 2017 Jun 19;10:3059-3070. doi: 10.2147/OTT.S137002. eCollection 2017.
This study aims to investigate the prognostic value of pretreatment C-reactive protein/albumin ratio (CAR) in human malignancies by an updated meta-analysis.
PubMed, Web of Science, Cochrane Library and Wanfang databases were searched. Pooled hazard ratios (HRs) and odds ratios (ORs) with their corresponding 95% confidence intervals (CIs) were used as effective values.
A total of 25 studies with 12,097 patients were included in this meta-analysis. Pooled results showed that high pretreatment CAR was associated with poor overall survival (OS) (HR =1.99, 95% CI: 1.65-2.40, =0.000) and poor disease-free survival (HR =1.55, 95% CI: 1.34-1.79, =0.000). In addition, high pretreatment CAR was associated with increased 5-year mortality (OR =2.74, 95% CI: 2.11-3.55, =0.000). Moreover, subgroup analysis demonstrated that high CAR was associated with poor OS despite variations in publication year, country, sample size, CAR cut-off value and treatment. However, high CAR was associated with poor OS in human malignancies except colorectal cancer (HR =1.64, 95% CI: 0.96-2.80, =0.069).
High pretreatment CAR indicates poor prognosis in human malignancies except colorectal cancer. Thus, pretreatment CAR serves as a prognostic marker in human malignancies and could be used in the evaluation of prognosis in clinical work.
本研究旨在通过一项更新的荟萃分析探讨治疗前C反应蛋白/白蛋白比值（CAR）在人类恶性肿瘤中的预后价值。
检索了PubMed、Web of Science、Cochrane图书馆和万方数据库。汇总的风险比（HRs）和比值比（ORs）及其相应的95%置信区间（CIs）用作有效数值。
本荟萃分析共纳入25项研究，涉及12097例患者。汇总结果显示，治疗前高CAR与总生存期（OS）较差（HR =1.99，95%CI：1.65 - 2.40，P =0.000）和无病生存期较差（HR =1.55，95%CI：1.34 - 1.79，P =0.000）相关。此外，治疗前高CAR与5年死亡率增加相关（OR =2.74，95%CI：2.11 - 3.55，P =0.000）。而且，亚组分析表明，尽管在发表年份、国家、样本量、CAR临界值和治疗方法存在差异，但高CAR与较差的OS相关。然而，除结直肠癌外，高CAR与人类恶性肿瘤的较差OS相关（HR =1.64，95%CI：0.96 - 2.80，P =0.069）。
除结直肠癌外，治疗前高CAR提示人类恶性肿瘤预后不良。因此，治疗前CAR可作为人类恶性肿瘤的预后标志物，并可用于临床工作中的预后评估。
