Luo B Y, Yang Y, Duan Y F, Cai H H, An Y, Sun D L
Department of Hepatobiliary and Pancreatic Surgery, the third Affiliated Hospital of Soochow University, Changzhou 213003, Jiangsu Province, China.
Zhonghua Wai Ke Za Zhi. 2018 Sep 1;56(9):712-717. doi: 10.3760/cma.j.issn.0529-5815.2018.09.013.
To evaluate the clinical significance of C-reactive protein/albumin ratio in predicting the postoperative prognosis of pancreatic cancer patients. The clinical date of 97 patients with resectable pancreatic cancers who treated at Department of Hepatobiliary and Pancreatic Surgery, the third Affiliated Hospital of Soochow University from January 2005 to December 2015 were analyzed retrospectively. The cut-off value of CRP/Alb ratio was determined by the receiver operating characteristic(ROC) curve. According to the CRP/Alb ratio, patients were respectively divided into two groups: the high group(CRP/Alb ratio≥0.109) and the low group(CRP/Alb<0.109). The relationships between CRP/Alb ratio and clinical characteristics were analyzed by χ(2) test. Median survival and 1-year overall survival rate(OS) was calculated by Kaplan-Meier method.The risk factors of patients with poor prognosis were analyzed by univariate and multivariate Cox regression analysis model. Tumor TNM stage(χ(2)=4.280, =0.039) and differentiation(χ(2)=6.635, =0.010) had significant relationship with CRP/Alb ratio. The median survival of higher CRP/Alb ratio group and lower CRP/Alb ratio group was 15 months and 23 months respectively. Compared with lower CRP/Alb ratio group, the 1-year OS of higher CRP/Alb ratio group decreased remarkablely, and the difference was statistically(χ(2)=10.207, =0.001). Moreover, median survival and OS were decreased in patients with advanced age(≥65 years old: χ(2) =5.338, =0.021), high TNM stage(ⅡB-Ⅲ: χ(2) =10.529, =0.001), poor tumor differentiation(χ(2)=5.380, =0.020), vascular invasion(χ(2) =7.856, =0.005) and positive surgical margin(χ(2)=9.059, =0.003). A high CRP/Alb ratio was identified as an independent risk factor of poor prognosis for patients with pancreatic cancer(=1.832, 95% : 1.067-3.144, =0.028). Besides, old age(=1.684, =0.014), high TNM stage(=1.666, =0.031), vascular invasion(=1.834, =0.024) and positive surgical margin(=2.205, =0.023) were also included. Preoperative CRP/Alb ratio can be an important clinical factor for assessing the prognosis of patients with resectable pancreatic cancers, and high CRP/Alb ratio suggests poor prognosis.
评估C反应蛋白/白蛋白比值在预测胰腺癌患者术后预后中的临床意义。回顾性分析2005年1月至2015年12月在苏州大学附属第三医院肝胆胰外科接受治疗的97例可切除胰腺癌患者的临床资料。通过受试者工作特征(ROC)曲线确定CRP/Alb比值的截断值。根据CRP/Alb比值,将患者分为两组:高比值组(CRP/Alb比值≥0.109)和低比值组(CRP/Alb<0.109)。采用χ²检验分析CRP/Alb比值与临床特征之间的关系。采用Kaplan-Meier法计算中位生存期和1年总生存率(OS)。通过单因素和多因素Cox回归分析模型分析预后不良患者的危险因素。肿瘤TNM分期(χ² = 4.280,P = 0.039)和分化程度(χ² = 6.635,P = 0.010)与CRP/Alb比值有显著关系。CRP/Alb比值较高组和较低组的中位生存期分别为15个月和23个月。与CRP/Alb比值较低组相比,CRP/Alb比值较高组的1年OS显著降低,差异有统计学意义(χ² = 10.207,P = 0.001)。此外,高龄(≥65岁:χ² = 5.338,P = 0.021)、高TNM分期(ⅡB-Ⅲ期:χ² = 10.529,P = 0.001)、肿瘤分化差(χ² = 5.380,P = 0.020)、血管侵犯(χ² = 7.856,P = 0.005)和手术切缘阳性(χ² = 9.059,P = 0.003)患者的中位生存期和OS均降低。高CRP/Alb比值被确定为胰腺癌患者预后不良的独立危险因素(HR = 1.832,95%CI:1.067 - 3.144,P = 0.028)。此外,高龄(HR = 1.684,P = 0.014)、高TNM分期(HR = 1.666,P = 0.031)、血管侵犯(HR = 1.834,P = 0.024)和手术切缘阳性(HR = 2.205,P = 0.023)也包括在内。术前CRP/Alb比值可作为评估可切除胰腺癌患者预后的重要临床因素,高CRP/Alb比值提示预后不良。