Preoperative C-Reactive Protein/Albumin Ratio Predicts Prognosis of Patients after Curative Resection for Gastric Cancer

Liu, Xuechao; Sun, Xiaowei; Li, Jianjun; Kong, Pengfei; Chen, Shangxiang; Zhan, Youqing; Xu, Dazhi

doi:10.1016/j.tranon.2015.06.006

Cited by 179 publications

(187 citation statements)

References 39 publications

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“…The CRP/Alb ratio is a useful prognostic indicator that was initially used to identify patients with serious conditions on an acute medical ward by Fairclough et al (41). Subsequently, multiple studies have demonstrated that the CRP/Alb ratio exhibited prognostic value in numerous types of cancer (15)(16)(17)(18)42). The present study revealed that a high CRP/Alb ratio indicated increased tumor invasion and metastasis and poorer prognosis compared with a low CRP/Alb ratio.…”

Section: Discussionmentioning

confidence: 52%

“…Although the prognostic value of the CRP/Alb ratio and NLR in GC has been reported previously (42,50), to the best of our knowledge, the present study is the first to report that the that the combination of the CRP/Alb ratio and NLR is associated with significant prognostic value and may further stratify prognosis compared with using single indicators.…”

Section: Discussionmentioning

confidence: 54%

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C‑reactive protein/albumin and neutrophil/lymphocyte ratios and their combination predict overall survival in patients with gastric cancer

et al. 2017

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Abstract. Multiple studies have reported the prognostic association of certain inflammatory factors with various types of cancer. The present study assessed the prognostic value of the C-reactive protein (CRP)/albumin (Alb) ratio and the neutrophil/lymphocyte ratio (NLR), separately and in combination, in gastric cancer (GC). A total of 337 cases pathologically diagnosed with gastric adenocarcinoma were retrospectively evaluated. The clinicopathological and prognostic relevance of the CRP/Alb ratio and NLR and their combination were analyzed. The optimal cut-off values of the CRP/Alb ratio and NLR were 0.38 and 3.14, respectively. High CRP/Alb ratio (≥0.38) and NLR (≥3.14) values were associated with increased tumor invasion, more distant metastasis and a more advanced tumor-node-metastasis stage (all P<0.05). In addition, a high NLR value was also associated with increased tumor size (P= 0.02). The CRP/Alb ratio (≥0.38/<0.38) and NLR (≥3.14/<3.14) were independent prognostic factors for overall survival time (OS) in GC by multivariate analysis (P= 0.005 and P= 0.001). Using the CRP/Alb ratio and NLR classification, patients were stratified into three subgroups with different OS time (P<0.001), which were identified as independent prognostic variables in multivariate analysis (P<0.001). The present study demonstrated that the CRP/Alb ratio and NLR were independent prognostic factors for OS in patients with GC. The combination of these indexes was associated with significant prognostic value and may further stratify prognosis. IntroductionGastric cancer (GC) is one of the most common types of tumor globally. In 2015, GC had the second highest incidence and rate of mortality among cancer patients in China (1). Due to the rapid progression of GC and the absence of early specific symptoms and signs, the majority of patients are diagnosed at the late stage of gastric carcinoma (2-5). At present, surgery is the preferred treatment for patients without distant metastasis, and postoperative metastasis and recurrence are the predominant causes of mortality (3,5). Although disease-free and overall survival (OS) may be improved by postoperative chemotherapy and radiotherapy, the prognosis of GC remains poor (3,6). Identifying simple but effective prognostic markers for GC remains an important aim for researchers.Inflammation occurs in various types of tumor, and serves a crucial function in tumor development and distant metastasis (7-10). Previous studies have indicated that inflammation is associated with the formation of the tumor microenvironment by inflammatory mediators, including vasoactive amines and cytokines (11-13). The C-reactive protein (CRP)/albumin (Alb) ratio is used as a novel inflammation-based prognostic indicator in multiple types of tumor. Previous studies have demonstrated the prognostic value of CRP/Alb ratio in colorectal (14) and esophageal cancer (15), hepatocellular carcinoma (16), and renal (17) and pancreatic cancer (18). Another important inflammatory marker is the neutrophil/lymphocyte ratio (...

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 54%

C‑reactive protein/albumin and neutrophil/lymphocyte ratios and their combination predict overall survival in patients with gastric cancer

et al. 2017

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“…On the other hand, another inflammation-related biomarker, the blood C-reactive protein (CRP)-to-albumin ratio (CAR), has also been reported to be a good prognostic factor in various cancer types (9)(10)(11)(12)(13)(14)(15). In some of these studies, CAR and NLR were assessed simultaneously, and both of them were reported to be prognostic factors for OS in patients with operable non-small cell lung cancer and those with unresectable metastatic colorectal cancer (9,11).…”

Section: The Prognostic Utility Of the Pretreatment Blood Neutrophiltmentioning

confidence: 99%

Prognostic Impact of Inflammation-related Biomarkers on Overall Survival of Patients with Inoperable Malignant Pleural Mesothelioma

Otoshi

Kataoka

Kaku

et al. 2018

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“…5 Liu et al, reported a significant correlation of decreased albumin and increased CRP levels with shorter survival, and CRP/albumin ratio as an independent prognostic marker, particularly in cases with Stage I and Stage III disease. 7 The authors proved that this ratio might be related to the nutritional status; but they could not demonstrate its correlation with weight loss and body mass index. Administration of anti-inflammatory therapy and nutritional support was also recommended for cases with increased CRP/albumin ratio.…”

Section: Discussionmentioning

confidence: 92%

“…7 There are studies which show correlation between proliferative activity and systemic inflammatory response associated with the tumor. 8 Hypoalbuminemia is a typical index of malnutrition and has been associated with poor prognosis in patients with advanced cancers.…”

Section: Discussionmentioning

confidence: 99%

Albumin, prealbumin and CRP levels can be used to predict prognosis in gastric cancer

Rao¹,

Phanikumar²,

Kumar³

2017

Int Surg J

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Background: malnutrition and systemic inflammatory response in cancers result in a shorter survival rate, reduced treatment response and a higher rate of complications associated with therapy. Prealbumin, albumin and CRP Levels has utility as a prognostic indicator of cancer survival in cancer. The objective of this study was to albumin, pre-albumin and CRP levels of the patients who underwent surgery for gastric cancer were prospectively recorded and retrospectively evaluated.Methods: Study was done for period of 1 year in patients underwent surgery for gastric cancer. Details noted from records are as age, gender, duration of hospital stay, TNM stage, and preoperative albumin, pre-albumin and CRP levels.Results: A total number of 44 patients, 32 (72.7%) men and 12 (27.7%) women, were included in the study. The mean age was 64.1 (43-89) years. The mean duration of hospital stay was 12.8 (4-46) days. Preoperative albumin levels were below the expected range in 16 (41%) of 44 patients. Mean age of the patients with normal and decreased albumin levels was 62.7±12.8 and 65.3±12.3 years, respectively; albumin levels were insignificantly associated with the age (p = 0.54). When these 16 cases were evaluated in terms of disease stage-3 had 11(68.7%). Preoperative pre-albumin levels were decreased in 23 (53%) of 44 cases. Among the cases with decreased pre-albumin levels, stage 1 and 3 had 5 (21.7%) cases. There was a significant correlation between the TNM stage and pre-albumin levels (P = 0.014). CRP levels were elevated in 19 (43.2%) of 44 cases with CRP. Among these Stage-3 had 8 cases, 4 (42.1%). There was no significant correlation between disease stage, presence of metastatic lymph nodes and albumin levels (p>0.05).Conclusions: Preoperative albumin, pre-albumin and CRP levels can be useful to predict prognosis of patients with gastric cancer.

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Preoperative C-Reactive Protein/Albumin Ratio Predicts Prognosis of Patients after Curative Resection for Gastric Cancer

Cited by 179 publications

References 39 publications

C‑reactive protein/albumin and neutrophil/lymphocyte ratios and their combination predict overall survival in patients with gastric cancer

C‑reactive protein/albumin and neutrophil/lymphocyte ratios and their combination predict overall survival in patients with gastric cancer

Prognostic Impact of Inflammation-related Biomarkers on Overall Survival of Patients with Inoperable Malignant Pleural Mesothelioma

Albumin, prealbumin and CRP levels can be used to predict prognosis in gastric cancer

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