Pretreatment C-reactive protein to albumin ratio for predicting overall survival in advanced pancreatic cancer patients

Abstract

Although previous studies demonstrated that elevated C-reactive protein to albumin ratio (CAR) predicted poor prognosis in various solid tumors, little was known about the prognostic value of CAR in patients with advanced pancreatic cancer (APC). The aim of the present study was to assess CAR as one independent prognostic factor in predicting overall survival (OS) in APC patients who had received palliative chemotherapy. Data of 142 APC patients who received palliative chemotherapy between 2009 and 2014 were retrospectively documented. We classified the patients into two groups based on the optimal cutoff value of CAR identified by generating receiver operating characteristics (ROC) curve. The clinicopathological parameters were compared between two CAR groups. Pearson correlation test showed that the level of C-reactive protein (CRP) was inversely correlated with albumin (r = −0.387; P < 0.001). Kaplan-Meier analysis demonstrated overall survival (OS) was significantly longer in CAR < 0.156 group than CAR ≥ 0.156 group (11.2 vs 5.9 months, P < 0.001). CAR was an independent prognostic factor for OS in the Cox regression model (HR, 1.623; 95% CI, 1.093–2.410; P = 0.016). Furthermore, the discrimination ability of CAR (AUC = 0.648, P = 0.025) was slightly higher than that of other inflammation-based factors. Therefore, pretreatment CAR could be an independent prognostic biomarker for APC patients.

C reactive protein impairs adaptive immunity in immune cells of patients with melanoma

“…Recent data suggest that chronic inflammation and high CRP levels are associated with poor survival in renal cell, lung, pancreatic and breast cancer, in patients with head and neck cancer treated with radiotherapy and that CRP is associated with bone destruction in multiple myeloma. [3][4][5][6][7][8][9] CRP has been shown to supress T cell function in autoimmunity in mouse models and to suppress dendritic cell function in normals. 10 11 High CRP levels have been shown in small studies to be associated with a poor outcome with the use of the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) blocking antibody tremelimumab.…”

Clinicopathologic characteristics, laboratory parameters, treatment protocols, and outcomes of pancreatic cancer: a retrospective cohort study of 1433 patients in China

“…In a retrospective study in China which included 96 patients with pancreatic cancer ( Lin et al, 2017 ), HR of pancreatic cancer mortality associated with elevated CEA reached 2.59 (95% CI [1.17–5.70]). However, several other studies found no association between CEA level and pancreatic cancer mortality ( Hang et al, 2017 ; Tas et al, 2013 ), casting doubt on the prognostic value of CEA. In the present study, univariate analysis findings revealed a positive association between elevated CEA and pancreatic cancer mortality.…”

<p>Prognostic Value of the Combination of CEA and Fibrinogen/Albumin Ratio in Resectable Gastric Cancer</p>

“…Malnutrition can lead to the decline of immune function in cancer patients, thus increasing the risk of postoperative complications and tumor progression. 21 Previous studies have reported that hypoalbuminemia is associated with disease progression and poor prognosis in patients with colon cancer, 22 pancreatic cancer, 23 non-small cell lung cancer, 24 ovarian cancer, 25 and GC. 26 Furthermore, this study shows that preoperative CEA is an independent prognostic factor of survival, consistent with previous studies.…”