Prognostic and clinicopathological significance of C-reactive protein/albumin ratio (CAR) in patients with gastric cancer: A meta-analysis

Abstract

Background In recent years, many studies have explored the potential prognostic utility of C-reactive protein/albumin ratio (CAR) in patients with gastric cancer (GC), however, the results remain conflicting. We thus performed a meta-analysis to determine the association of CAR and prognosis of GC. Methods This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. PubMed, Web of science, Embase, and Cochrane Library were searched. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) and cancer-specific survival (CSS) of included studies were pooled to estimate the prognostic value of CAR. Results Eight studies with a total of 3,216 patients were included in this meta-analysis. High CAR was significantly associated with poor OS (HR = 1.59, 95%CI = 1.36–1.85, p<0.001) and worse CSS (HR = 1.65, 95%CI = 1.21–2.25, p = 0.002). In addition, high CAR was significantly associated with male sex (OR = 1.80, 95%CI = 1.31–2.47, p<0.001), advanced tumor stage (OR = 2.14, 95%CI = 1.48–3.09, p<0.001), and tumor size ≥3cm (OR = 2.69, 95%CI = 1.84–3.93, p<0.001). Conclusion Elevated pretreatment CAR is a prognostic marker of poor OS and CSS in patients with GC. Furthermore, high CAR levels are associated with clinicopathological features reflecting tumor progression.

Prognostic Role of the C-Reactive Protein/Albumin Ratio in Patients With Gynecological Cancers: A Meta-Analysis

“…Many studies have investigated the prognostic value of the CRP/Alb ratio in a variety of cancer types (26,29,(32)(33)(34)(35). Yu et al showed that an elevated pretreatment CRP/Alb ratio was a prognostic marker of poor OS and CSS in patients with gastric cancer (26).…”

“…Many studies have investigated the prognostic value of the CRP/Alb ratio in a variety of cancer types (26,29,(32)(33)(34)(35). Yu et al showed that an elevated pretreatment CRP/Alb ratio was a prognostic marker of poor OS and CSS in patients with gastric cancer (26). A high CRP/Alb ratio was shown to be associated with clinicopathological features that reflect tumor progression in patients with gastric cancer (26).…”

“…Yu et al showed that an elevated pretreatment CRP/Alb ratio was a prognostic marker of poor OS and CSS in patients with gastric cancer (26). A high CRP/Alb ratio was shown to be associated with clinicopathological features that reflect tumor progression in patients with gastric cancer (26). A meta-analysis of 15 studies that included 6,329 patients reported that a high CRP/Alb ratio was associated with various survival outcomes in patients with CRC (29).…”

“…We performed a comprehensive search of the PubMed, Embase, the Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang electronic databases from inception to April 2021. Based on relevant studies (25,26), we used the following search terms: gynecological cancer OR gynecological carcinoma OR gynecological neoplasm OR endometrial neoplasm OR endometrial carcinoma OR endometrial cancer OR endometrium cancer OR endometrium carcinoma OR cervical cancer OR cervical carcinoma OR ovarian carcinoma OR ovarian cancer OR uterine neoplasm and C-reactive protein OR albumin OT CAR OR CRP/ Alb OR C-reactive protein to albumin ratio, C-reactive protein/ albumin ratio and prognosis OR prognostic OR survival OR outcome OR mortality. Both free text and medical subject heading terms were used for the literature search.…”

Effects of probiotics on gastric cancer‐related inflammation: A systematic review and meta‐analysis

“…C‐reactive protein (CRP), high sensitivity C‐reactive protein (hs‐CRP), tumor necrosis factor‐α (TNF‐α), soluble intercellular adhesion molecule (sICAM), and interleukin‐6 (IL‐6) are important inflammatory biomarkers in clinical trials (Farsi et al., 2019; Morvaridzadeh et al., 2020). The levels of TNF‐α (Htet et al., 2021), IL‐6 (Santos et al., 2021), and CRP (Yu et al., 2021) are closely related to the occurrence of gastric cancer. CRP is a classic acute phase protein and often elevated in serum during acute inflammation, gastric cancer, and other diseases (Hunter et al., 2021; Matsui et al., 2021).…”