CRP/prealbumin, a novel inflammatory index for predicting recurrence after radical resection in gastric cancer patients: post hoc analysis of a randomized phase III trial

Lü, Jun; Xu, Binbin; Zheng, Zhifang; Xie, Jian‐Wei; Wang, Jia-Bin; Ji, Lin; Chen, Qi‐Yue; Cao, Long‐Long; Ma, Lin; Tu, Ru‐Hong; Huang, Ze-Ning; Zheng, Chao‐Hui; Huang, Chang‐Ming; Li, Ping

doi:10.1007/s10120-018-0892-0

Cited by 78 publications

(81 citation statements)

References 48 publications

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“…The preoperative measurements of the complete blood counts (CBC), C-reactive protein (CRP) and albumin (ALB) were derived within the 7 days prior to surgery as stated previously [19]. All blood tests were performed using the same sample.…”

Section: Definitionsmentioning

confidence: 99%

The predictive value of the preoperative C-reactive protein–albumin ratio for early recurrence and chemotherapy benefit in patients with gastric cancer after radical gastrectomy: using randomized phase III trial data

Lü

Zheng

et al. 2019

Gastric Cancer

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Background The definition and predictors of early recurrence (ER) for gastric cancer (GC) patients after radical gastrectomy are unclear. Methods A minimum-p value approach was used to evaluate the optimal cutoff value of recurrence-free survival to determine ER and late recurrence (LR). Receiver operating characteristic curves were generated for inflammatory indices. Potential risk factors for ER were assessed with a Cox regression model. A decision curve analysis was performed to evaluate the clinical utility. Results A total of 401 patients recruited in a clinical trial (NCT02327481) from January 2015 to April 2016 were included in this study. The optimal length of recurrence-free survival to distinguish between ER (n = 44) and LR (n = 52) was 12 months. Factors associated with ER included a preoperative C-reactive protein-albumin ratio (CAR) ≥ 0.131, stage III and postoperative adjuvant chemotherapy (PAC) > 3 cycles. The risk model consisting of both the CAR and TNM stage had a higher predictive ability and better clinical utility than TNM stage alone. Further stratification analysis of the stage III patients found that for the patients with a CAR < 0.131, both PAC with 1-3 cycles (p = 0.029) and > 3 cycles (p < 0.001) could reduce the risk of ER. However, for patients with a CAR ≥ 0.131, a benefit was observed only if they received PAC > 3 cycles (54.2% vs 16.0%, p = 0.004), rather than 1-3 cycles (58.3% vs 54.2%, p = 0.824). Conclusions A recurrence-free interval of 12 months was found to be the optimal threshold for differentiating between ER and LR. Preoperative CAR was a promising predictor of ER and PAC response. PAC with 1-3 cycles may not exert a protective effect against ER for stage III GC patients with CAR ≥ 0.131.

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Section: Definitionsmentioning

confidence: 99%

The predictive value of the preoperative C-reactive protein–albumin ratio for early recurrence and chemotherapy benefit in patients with gastric cancer after radical gastrectomy: using randomized phase III trial data

Lü

Zheng

et al. 2019

Gastric Cancer

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“…6 To achieve precise individualized therapy in patients with HCC, the discovery of appropriate markers for proper prognostic evaluation is urgently needed. 11,12 Nevertheless, whether the CAR is linked to the prognosis in patients with HCC following TACE and RFA is unknown. 7 Recently, accumulating evidence has indicated that the systemic inflammatory response (SIR) is pivotal in tumor development.…”

Section: Introductionmentioning

confidence: 99%

“…An increased CAR is related to an unfavorable prognosis of various cancers, for example, cervical cancer and esophageal cancer. 11,12 Nevertheless, whether the CAR is linked to the prognosis in patients with HCC following TACE and RFA is unknown. Therefore, our study examined the prognostic importance of combining the CAR and the NLR in patients with HCC following TACE and RFA.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of the CRP/Alb and neutrophil to lymphocyte ratios in hepatocellular carcinoma patients undergoing TACE and RFA

Shen

Wang

et al. 2019

Clinical Laboratory Analysis

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Background The C‐reactive protein (CRP)/albumin (Alb) ratio (CAR) is a basic inflammatory factor that has been related to poor survival of patients with various tumors. Our research retrospectively examined the relationship between the CAR and the prognosis of hepatocellular carcinoma (HCC). Methods This study included 172 patients with HCC who were treated with transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA). Results The CAR was weakly related to the neutrophil/lymphocyte ratio (NLR, r = .159, P = .037) and the lymphocyte/monocyte ratio (LMR, r = −.263, P = .001). The Glasgow Prognostic Score (GPS) (0/1‐2) was related to liver cirrhosis (P = .003), tumor number (P = .02), Child‐Pugh grade (P = .001), the platelet/lymphocyte ratio (PLR, P = .006), and the LMR (P = .021). Correlation analysis demonstrated that an elevated CAR was markedly correlated with the tumor size (P = .019), alpha‐fetoprotein (AFP) level (P = .033), thrombosis of the portal vein (P = .004), the NLR (P = .036), and the LMR (P = .001). Multivariate analysis indicated that the prognosis of the CAR‐High and NLR‐High cohort (mOS = 7 months) was significantly worse than those of the CAR‐High or NLR‐High cohort (mOS = 15 months) and the CAR‐Low and NLR‐Low cohort (mOS = 26.5 months). Conclusions Combination of the NLR and the CAR represents a convenient, quick, and noninvasive biological marker that could improve prognostic prediction in patients with HCC.

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“…CRP is not only a marker of inflammation, but also a significant predictor of many chronic diseases, such as cardiovascular disease and inflammatory related chronic diseases as well as cancer incidence and cancer survival, as shown in cohort studies . Elevated triglycerides and reduced high‐density lipoprotein (HDL) cholesterol are associated with metabolic syndrome and cardiovascular disease .…”

Section: Introductionmentioning

confidence: 99%

“…CRP is not only a marker of inflammation, but also a significant predictor of many chronic diseases, such as cardiovascular disease and inflammatory related chronic diseases [27][28][29][30][31] as well as cancer incidence 32 and cancer survival, as shown in cohort studies. 31,[33][34][35][36] Elevated triglycerides and reduced high-density lipoprotein (HDL) cholesterol are associated with metabolic syndrome and cardiovascular disease. 37,38 Therefore, it is important to investigate the associations between unprocessed red meat and CRP and lipid biomarkers in populations with different smoking status.…”

Section: Introductionmentioning

confidence: 99%

Unprocessed red meat intakes are associated with increased inflammation, triglycerides and HDL cholesterol in past smokers

Sonoda

Liu

2019

Nutrition & Dietetics

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Aim To determine the associations of unprocessed red meat with serum C‐reactive protein and traditional lipid biomarkers among adults with different smoking status. Methods Using a cross‐sectional design, we analysed data collected from 5011 adults (men and women) who had provided information on dietary intakes and the proposed biomarkers for the 2005–2006 National Health and Nutrition Examination Survey (NHANES). Results We found positive associations between unprocessed red meat and serum C‐reactive protein and triglycerides and an inverse association between unprocessed red meat and high‐density lipoprotein (HDL) cholesterol in past smokers, but no associations in never smokers and current smokers. Among past smokers, the percent difference of biomarkers between participants with the highest and the lowest quintiles for the intakes of unprocessed red meat was 42% (P = 0.03) for CRP, 32% for triglycerides and −11% (P = 0.02) for HDL cholesterol. No association was found between unprocessed red meat and other lipid biomarkers. Conclusions Providing individualised nutritional guidelines according to smoking status is important. Our study provided evidence for developing specific guidelines on red meat for past smokers.

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CRP/prealbumin, a novel inflammatory index for predicting recurrence after radical resection in gastric cancer patients: post hoc analysis of a randomized phase III trial

Cited by 78 publications

References 48 publications

The predictive value of the preoperative C-reactive protein–albumin ratio for early recurrence and chemotherapy benefit in patients with gastric cancer after radical gastrectomy: using randomized phase III trial data

The predictive value of the preoperative C-reactive protein–albumin ratio for early recurrence and chemotherapy benefit in patients with gastric cancer after radical gastrectomy: using randomized phase III trial data

Prognostic significance of the CRP/Alb and neutrophil to lymphocyte ratios in hepatocellular carcinoma patients undergoing TACE and RFA

Unprocessed red meat intakes are associated with increased inflammation, triglycerides and HDL cholesterol in past smokers

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