Matsumoto T, Itoh S, Yoshizumi T, Kurihara T, Yoshiya S, Mano Y, Takeishi K, Harada N, Ikegami T, Soejima Y, Baba H, Mori M
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
BJS Open. 2020 Sep 21;4(6):1146-52. doi: 10.1002/bjs5.50348.
The C-reactive protein : albumin ratio (CAR) has been reported as a novel prognostic marker in several cancers. The aim of this study was to investigate the prognostic value of CAR in patients with intrahepatic cholangiocarcinoma (ICC).
This was a single-centre retrospective study of patients who underwent surgery for ICC in a university hospital in Japan between 1998 and 2018. CAR, Glasgow Prognostic Score (GPS) and modified GPS (mGPS) were calculated. Their correlation with recurrence-free survival (RFS) and overall survival (OS) was analysed with Cox proportional hazards models.
Seventy-two patients were included in the study. Patients were divided into two groups according to the optimal CAR cut-off value of 0·02. CAR above 0·02 was associated with higher carbohydrate antigen 19-9 levels (20·5 versus 66·1 units/ml for CAR of 0·02 or less; P = 0·002), larger tumour size (3·2 versus 4·4 cm respectively; P = 0·031) and a higher rate of microvascular invasion (9 of 28 versus 25 of 44; P = 0·041). RFS and OS were shorter in patients with CAR above 0·02: hazard ratio (HR) 4·31 (95 per cent c.i. 2·02 to 10·63) and HR 4·80 (1·85 to 16·40) respectively. In multivariable analysis CAR above 0·02 was an independent prognostic factor of RFS (HR 3·29 (1·33 to 8·12); P < 0·001), but not OS.
CAR was associated with prognosis in patients who had hepatic resection for ICC.
C反应蛋白与白蛋白比值（CAR）已被报道为多种癌症的新型预后标志物。本研究旨在探讨CAR在肝内胆管癌（ICC）患者中的预后价值。
这是一项对1998年至2018年期间在日本一家大学医院接受ICC手术的患者进行的单中心回顾性研究。计算了CAR、格拉斯哥预后评分（GPS）和改良GPS（mGPS）。使用Cox比例风险模型分析它们与无复发生存期（RFS）和总生存期（OS）的相关性。
72例患者纳入研究。根据最佳CAR临界值0·02将患者分为两组。CAR高于0·02与较高的糖类抗原19-9水平相关（CAR为0·02或更低时为20·5对66·1单位/毫升；P = 0·002）、更大的肿瘤大小（分别为3·2对4·4厘米；P = 0·031）和更高的微血管侵犯率（28例中的9例对44例中的25例；P = 0·041）。CAR高于0·02的患者RFS和OS较短：风险比（HR）分别为4·31（95%置信区间2·02至10·63）和HR 4·80（1·85至16·40）。在多变量分析中，CAR高于0·02是RFS的独立预后因素（HR 3·29（1·33至8·12）；P < 0·001），但不是OS的独立预后因素。
CAR与接受肝切除术的ICC患者的预后相关。
