Mao Minjie, Wei Xiaoli, Sheng Hui, Chi Peidong, Liu Yijun, Huang Xiaoyan, Xiang Yifan, Zhu Qianying, Xing Shan, Liu Wanli
Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China.
Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China.
Oncol Lett. 2017 Dec;14(6):7417-7424. doi: 10.3892/ol.2017.7179. Epub 2017 Oct 13.
Multiple studies have reported the prognostic association of certain inflammatory factors with various types of cancer. The present study assessed the prognostic value of the C-reactive protein (CRP)/albumin (Alb) ratio and the neutrophil/lymphocyte ratio (NLR), separately and in combination, in gastric cancer (GC). A total of 337 cases pathologically diagnosed with gastric adenocarcinoma were retrospectively evaluated. The clinicopathological and prognostic relevance of the CRP/Alb ratio and NLR and their combination were analyzed. The optimal cut-off values of the CRP/Alb ratio and NLR were 0.38 and 3.14, respectively. High CRP/Alb ratio (≥0.38) and NLR (≥3.14) values were associated with increased tumor invasion, more distant metastasis and a more advanced tumor-node-metastasis stage (all P<0.05). In addition, a high NLR value was also associated with increased tumor size (P=0.02). The CRP/Alb ratio (≥0.38/<0.38) and NLR (≥3.14/<3.14) were independent prognostic factors for overall survival time (OS) in GC by multivariate analysis (P=0.005 and P=0.001). Using the CRP/Alb ratio and NLR classification, patients were stratified into three subgroups with different OS time (P<0.001), which were identified as independent prognostic variables in multivariate analysis (P<0.001). The present study demonstrated that the CRP/Alb ratio and NLR were independent prognostic factors for OS in patients with GC. The combination of these indexes was associated with significant prognostic value and may further stratify prognosis.
多项研究报告了某些炎症因子与各种类型癌症的预后关联。本研究评估了C反应蛋白（CRP）/白蛋白（Alb）比值和中性粒细胞/淋巴细胞比值（NLR）分别及联合应用对胃癌（GC）的预后价值。对337例经病理诊断为胃腺癌的病例进行了回顾性评估。分析了CRP/Alb比值和NLR及其联合应用与临床病理和预后的相关性。CRP/Alb比值和NLR的最佳截断值分别为0.38和3.14。高CRP/Alb比值（≥0.38）和NLR（≥3.14）与肿瘤侵袭增加、远处转移更多及肿瘤-淋巴结-转移分期更晚相关（均P<0.05）。此外，高NLR值还与肿瘤大小增加相关（P=0.02）。多因素分析显示，CRP/Alb比值（≥0.38/<0.38）和NLR（≥3.14/<3.14）是GC患者总生存时间（OS）的独立预后因素（P=0.005和P=0.001）。根据CRP/Alb比值和NLR分类，患者被分为三个总生存时间不同的亚组（P<0.001），在多因素分析中被确定为独立预后变量（P<0.001）。本研究表明，CRP/Alb比值和NLR是GC患者OS的独立预后因素。这些指标的联合应用具有显著的预后价值，可能进一步对预后进行分层。
