Preoperative C-Reactive Protein/Albumin Ratio Predicts Prognosis of Patients after Curative Resection for Gastric Cancer.
Preoperative C-Reactive Protein/Albumin Ratio Predicts Prognosis of Patients after Curative Resection for Gastric Cancer.
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DOI：
10.1016/j.tranon.2015.06.006
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发表时间：
2015-08
影响因子：
5
通讯作者：
Xu D
中科院分区：
文献类型：
--
作者：
Liu X;Sun X;Liu J;Kong P;Chen S;Zhan Y;Xu D
背景：据报道，术前 C 反应蛋白/白蛋白 (CRP/Alb) 比率升高与肝细胞癌的不良预后相关。本研究的目的是探讨胃癌（GC）患者术前CRP/Alb比值的预后价值，并将其与其他全身炎症反应标志物进行比较。方法：对 455 例接受根治性切除的 GC 患者进行回顾性研究。我们研究了术前 CRP/Alb 比值与总生存期 (OS) 之间的相关性。 Kaplan-Meier 和 Cox 回归模型用于评估独立预后因素。曲线下面积用于比较不同标志物的预后价值。结果：在多变量分析中，CRP/Alb 比值与 GC 患者的 OS 独立相关（风险比：1.626；95% 置信区间：1.191-2.219；P = .002），以及年龄 (P = .003)、术前体重减轻 (P = .001)、肿瘤位置 (P = .008)、转移淋巴结比率 (P < .001）和第七肿瘤淋巴结转移阶段（美国癌症联合委员会）（P = .007）。然而，其他几种基于全身炎症的预后评分（中性粒细胞淋巴细胞比率、血小板淋巴细胞比率和全身免疫炎症指数、格拉斯哥预后评分、改良格拉斯哥预后评分和高灵敏度改良格拉斯哥预后评分）则不然。此外，与其他几个基于全身炎症的预后评分相比，CRP/Alb 比值具有更高的曲线下面积 (0.625) (P < .001)。结论：术前 CRP/Alb 比值（一种基于炎症的系统预后评分）是接受 GC 根治性切除的患者 OS 的优良预测因子，可能有助于识别高风险患者以做出治疗决策。
BACKGROUND: An elevated preoperative C-reactive protein/albumin (CRP/Alb) ratio has been reported to be associated with a poor prognosis for hepatocellular carcinoma. The aim of the present study was to investigate the prognostic value of the preoperative CRP/Alb ratio and compare it with other systemic inflammatory response markers in patients with gastric cancer (GC). METHODS: A retrospective study was performed in 455 patients with GC undergoing curative resection. We investigated the correlations between the preoperative CRP/Alb ratio and overall survival (OS). Kaplan-Meier and Cox regression models were used to assess independent prognostic factors. The area under the curve was used to compare the prognostic value of different markers. RESULTS: On multivariate analysis, the CRP/Alb ratio were independently associated with OS in patients with GC (hazard ratio: 1.626; 95% confidence interval: 1.191-2.219; P = .002), along with age (P = .003), preoperative body weight loss (P = .001), tumor location (P = .008), metastatic lymph node ratio (P < .001), and seventh tumor-nodes-metastasis stage (American Joint Committee on Cancer) (P = .007). However, several other systemic inflammation–based prognostic scores (neutrophil lymphocyte ratio, platelet lymphocyte ratio and systemic immune-inflammation index, Glasgow Prognostic Score, modified Glasgow prognostic score, and high-sensitivity modified Glasgow prognostic score) were not. In addition, the CRP/Alb ratio had a higher area under the curve value (0.625) compared with several other systemic inflammation–based prognostic scores (P < .001). CONCLUSION: The preoperative CRP/Alb ratio, a system inflammation-based prognostic score, is a superior predictor of OS in patients undergoing curative resection for GC and may help to identify the high-risk patients for treatment decisions.