Tamai Koki, Hirose Hajime, Okamura Shu, Akazawa Yo, Koh Masahiro, Hayashi Koji, Katsura Yoshiteru, Tanaka Natsumi, Ebisui Chikara, Yano Masahiko
Department of Surgery, Suita Municipal Hospital, Suita, Japan.
J Anus Rectum Colon. 2023 Oct 25;7(4):273-283. doi: 10.23922/jarc.2023-016. eCollection 2023.
The current retrospective study aimed to evaluate the association between combined preoperative and postoperative C-reactive protein-to-albumin ratio, which is correlated with prognosis in different types of malignancies, and prognosis after curative resection in patients with colorectal cancer.
This study enrolled 263 patients who underwent curative resection for stage II/III colorectal cancer. C-reactive protein-to-albumin ratio was calculated within 30 days before and 7 days after surgery. Receiver operating characteristic curve analyses were performed to determine the optimal cutoff values of preoperative and postoperative C-reactive protein-to-albumin ratio. The correlations between combined preoperative and postoperative C-reactive protein-to-albumin ratio and prognosis were analyzed.
The cutoff values of preoperative and postoperative C-reactive protein-to-albumin ratio were 0.223 and 0.813, respectively; higher ratios were significantly associated with poor overall survival, based on the Kaplan-Meier curves (p < 0.001, p = 0.003, respectively). Further, preoperative and postoperative C-reactive protein-to-albumin ratios were correlated with poor progression-free survival (p < 0.001, p = 0.064, respectively). In the multivariate analysis, combined preoperative and postoperative C-reactive protein-to-albumin ratio was an independent predictor of overall survival and progression-free survival (p = 0.012, p = 0.044, respectively). Compared with low preoperative and postoperative C-reactive protein-to-albumin ratio, high ratios of that were significantly associated with poor overall survival (hazard ratio = 3.897, p = 0.006) and progression-free survival (hazard ratio = 2.130, p = 0.029).
Combined preoperative and postoperative C-reactive protein-to-albumin ratio, useful for prognostic prediction, can be a promising prognostic marker after curative resection in patients with colorectal cancer.
本项回顾性研究旨在评估术前及术后C反应蛋白与白蛋白比值（该比值与不同类型恶性肿瘤的预后相关）与结直肠癌患者根治性切除术后预后之间的关联。
本研究纳入了263例行II/III期结直肠癌根治性切除术的患者。在手术前30天内及手术后7天内计算C反应蛋白与白蛋白比值。进行受试者操作特征曲线分析以确定术前及术后C反应蛋白与白蛋白比值的最佳临界值。分析术前及术后C反应蛋白与白蛋白比值之和与预后之间的相关性。
术前及术后C反应蛋白与白蛋白比值的临界值分别为0.223和0.813；根据Kaplan-Meier曲线，较高的比值与较差的总生存期显著相关（分别为p<0.001，p = 0.003）。此外，术前及术后C反应蛋白与白蛋白比值与较差的无进展生存期相关（分别为p<0.001，p = 0.064）。在多变量分析中，术前及术后C反应蛋白与白蛋白比值之和是总生存期和无进展生存期的独立预测因素（分别为p = 0.012，p = 0.044）。与术前及术后C反应蛋白与白蛋白比值低的患者相比，比值高的患者总生存期（风险比=3.897，p = 0.006）和无进展生存期（风险比=2.130，p = 0.029）显著较差。
术前及术后C反应蛋白与白蛋白比值之和可用于预后预测，可能是结直肠癌患者根治性切除术后有前景的预后标志物。
