Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka, 545-8585, Japan.
Asian Pac J Cancer Prev. 2020 Aug 1;21(8):2373-2379. doi: 10.31557/APJCP.2020.21.8.2373.
The present study aimed to investigate the impact of preoperative C-reactive protein to albumin (CRP/Alb) ratio on the long-term outcomes of patients with intrahepatic cholangiocarcinoma (ICC).
82 patients who underwent hepatic resection for mass-forming type of ICC were evaluated. The relationship between preoperative CRP/Alb ratio and survival outcomes was investigated.
The optimal cutoff value of CRP/Alb ratio for assessing overall survival (OS) was determined as 0.089. Univariate analysis for recurrence-free survival (RFS) showed that CRP/Alb ratio >0.089, carbohydrate antigen 19-9 (CA 19-9) >37 U/mL, lymph node metastasis, vascular invasion, and multiple tumors were significantly associated with postoperative recurrence. On multivariate analysis, the independent prognostic factors identified were CRP/Alb ratio >0.089 (p < 0.001), lymph node metastasis (p = 0.006), and multiple tumors (p < 0.001). Univariate analysis for OS showed that CRP/Alb ratio >0.089, CA 19-9 >37 U/mL, lymph node metastasis, vascular invasion, multiple tumors, and positive surgical margin were significantly associated with overall death. On multivariate analysis, the independent prognostic factors identified were CRP/Alb ratio >0.089 (p < 0.001), lymph node metastasis (p = 0.01), and multiple tumors (p = 0.005).
Preoperative CRP/Alb ratio may predict poor long-term outcomes after hepatic resection in patients with ICC.
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本研究旨在探讨术前 C 反应蛋白与白蛋白（CRP/Alb）比值对肝内胆管细胞癌（ICC）患者长期预后的影响。
方法：评估了 82 例行肝切除术的肿块型 ICC 患者。研究了术前 CRP/Alb 比值与生存结局之间的关系。
结果：确定 CRP/Alb 比值评估总生存期（OS）的最佳截断值为 0.089。单因素分析显示，对于无复发生存期（RFS），CRP/Alb 比值>0.089、碳水化合物抗原 19-9（CA 19-9）>37 U/mL、淋巴结转移、血管侵犯和多发病灶与术后复发显著相关。多因素分析确定的独立预后因素包括 CRP/Alb 比值>0.089（p<0.001）、淋巴结转移（p=0.006）和多发病灶（p<0.001）。单因素分析显示，对于 OS，CRP/Alb 比值>0.089、CA 19-9>37 U/mL、淋巴结转移、血管侵犯、多发病灶和阳性手术切缘与总死亡显著相关。多因素分析确定的独立预后因素包括 CRP/Alb 比值>0.089（p<0.001）、淋巴结转移（p=0.01）和多发病灶（p=0.005）。
结论：术前 CRP/Alb 比值可能预测 ICC 患者肝切除术后的长期不良预后。
