Kunizaki Masaki, Tominaga Tetsuro, Wakata Kouki, Miyazaki Takuro, Matsumoto Keitaro, Sumida Yorihisa, Hidaka Shigekazu, Yamasaki Takuya, Yasutake Toru, Sawai Terumitu, Hamamoto Ryuji, Nanashima Atsushi, Nagayasu Takeshi
Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Hospital, Nagasaki, Nagasaki 852-8501, Japan.
Division of Radiology, Nagasaki University Hospital, Nagasaki, Nagasaki 852-8501, Japan.
Mol Clin Oncol. 2018 Feb;8(2):370-374. doi: 10.3892/mco.2017.1527. Epub 2017 Dec 8.
The aim of the present study was to investigate the prognostic value of the C-reactive protein-to-albumin ratio (CAR) and compare it with other inflammation-based prognostic scores (Glasgow prognostic score, modified Glasgow prognostic score, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, prognostic nutritional index and prognostic index) in patients with esophageal squamous cell cancer (ESCC). A database of 116 patients with primary ESCC who underwent treatment at the Division of Surgical Oncology at Nagasaki University Hospital between January 2007 and August 2014 was retrospectively reviewed and the correlations between CAR and overall survival (OS) were investigated. Kaplan-Meier and Cox regression analyses were used to assess independent prognostic factors. The area under the curve (AUC) was used to compare the prognostic value of different scores. According to the receiver operator characteristics analysis, the recommended cut-off value for CAR was 0.042, with an AUC of 0.678 (sensitivity 31.1%, specificity 66.7%). Thus, patients were dichotomized into low (<0.042) and high (≥0.042) CAR groups. On multivariate analysis, CAR was found to be significantly associated with OS in patients with ESCC [hazard ratio (HR)=2.350; 95% confidence interval (CI): 1.189-4.650; P=0.014], as was tumor-node-metastasis stage (HR=3.059; 95% CI: 1.422-6.582; P=0.004). In addition, CAR had a higher AUC value (0.678) compared with several other systemic inflammation-based prognostic scores (P<0.001). This study suggested that CAR is a novel and promising inflammation-based prognostic score in patients with ESCC. Due to its simplicity, affordability and availability, CAR may be important for improving clinical decision-making and may contribute to more rational study design and analyses.
本研究旨在探讨C反应蛋白与白蛋白比值（CAR）的预后价值，并将其与其他基于炎症的预后评分（格拉斯哥预后评分、改良格拉斯哥预后评分、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值、预后营养指数和预后指数）在食管鳞状细胞癌（ESCC）患者中的情况进行比较。回顾性分析了2007年1月至2014年8月期间在长崎大学医院外科肿瘤学部接受治疗的116例原发性ESCC患者的数据库，并研究了CAR与总生存期（OS）之间的相关性。采用Kaplan-Meier法和Cox回归分析评估独立预后因素。用曲线下面积（AUC）比较不同评分的预后价值。根据受试者工作特征分析，CAR的推荐临界值为0.042，AUC为0.678（敏感性31.1%，特异性66.7%）。因此，将患者分为CAR低（<0.042）和高（≥0.042）两组。多因素分析发现，CAR与ESCC患者的OS显著相关[风险比（HR）=2.350；95%置信区间（CI）：1.189 - 4.650；P = 0.014]，肿瘤-淋巴结-转移分期也是如此（HR = 3.059；95% CI：1.422 - 6.582；P = 0.004）。此外，与其他几个基于全身炎症的预后评分相比，CAR具有更高的AUC值（0.678）（P < 0.001）。本研究表明，CAR是ESCC患者中一种新型且有前景 的基于炎症的预后评分。由于其简单、经济且易于获得，CAR可能对改善临床决策很重要，并可能有助于更合理的研究设计和分析。
