Guangxi Clinical Research Center for Colorectal Cancer, Nanning, Guangxi Zhuang Autonomous Region 530021, China.
Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region 530021, China.
Biomed Res Int. 2020 Nov 22;2020:8812974. doi: 10.1155/2020/8812974. eCollection 2020.
Different opinions exist on the relationship between the C-reactive protein-to-albumin ratio (CAR) and the prognosis of colon cancer. This study is aimed at evaluating the relationship between CAR and prognosis of stage II-III colon cancer and establishing a clinical prognosis model. Patients were randomised to a training set (566 cases) and validation set (110 cases). The relationship between CAR and clinicopathological variables was calculated, and the Kaplan-Meier method was used to analyse the overall survival (OS) rate of colon cancer. In the training set, colon cancer independent risk factors were included in the prognosis model and then tested in the validation set. The accuracy and discrimination of the model were assessed using the C-index and calibration curves. Compared with patients with low CAR, patients with high CAR showed significantly poorer survival ( = 0.020). In the multivariate analysis, CAR, carcinoembryonic antigen (CEA), lymph node metastasis, operation mode, and perineural invasion were identified as independent prognostic indicators and adopted to establish the prediction model. The C-index of the nomogram for predicting OS reached 0.751 in the training set and 0.719 in the validation set. The calibration curve exhibited good consistency. In the present study, the CAR may be an independent prognostic factor for stage II-III colon cancer, and the nomogram has a certain predictive value. However, further prospective large-sample research needs to be conducted to validate our findings.
关于 C 反应蛋白与白蛋白比值 (CAR) 与结肠癌预后的关系,存在不同意见。本研究旨在评估 CAR 与 II-III 期结肠癌预后的关系,并建立临床预后模型。患者被随机分配到训练集(566 例)和验证集(110 例)。计算 CAR 与临床病理变量之间的关系,并采用 Kaplan-Meier 法分析结肠癌的总生存率(OS)。在训练集中,将结肠癌独立危险因素纳入预后模型,并在验证集中进行测试。采用 C 指数和校准曲线评估模型的准确性和判别能力。与 CAR 低的患者相比,CAR 高的患者的生存情况明显较差(=0.020)。在多因素分析中,CAR、癌胚抗原(CEA)、淋巴结转移、手术方式和神经周围侵犯被确定为独立的预后指标,并用于建立预测模型。预测 OS 的列线图在训练集中的 C 指数为 0.751,在验证集中为 0.719。校准曲线显示出良好的一致性。在本研究中,CAR 可能是 II-III 期结肠癌的独立预后因素,列线图具有一定的预测价值。然而,需要进一步进行前瞻性大样本研究来验证我们的研究结果。