The prognostic value of C-reactive protein/albumin ratio in human malignancies: an updated meta-analysis

Xu, Hongjun; Ma, Yan; Deng, Fang; Ju, Wenbo; Sun, Xiance; Wang, Hua

doi:10.2147/ott.s137002

Cited by 72 publications

(69 citation statements)

References 56 publications

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“…The CAR has the most satisfying prognostic predicting value among systems based on systemic inflammation. Initially, the prognosis value of CAR was found in the outcome of acute exacerbations of chronic disease by Fairclough et al And the correlation between CAR and tumor was subsequently evaluated in various studies . Kinoshita and his colleagues suggested that CAR may be an independent prognostic marker in patients with HCC, and may have comparable prognostic value with other established inflammation‐based prognostic scores (GPS, mGPS, and NLR) .…”

Section: Discussionsupporting

confidence: 72%

“…Initially, the prognosis value of CAR was found in 20 And the correlation between CAR and tumor was subsequently evaluated in various studies. 9,21,22 Kinoshita and his colleagues suggested that CAR may be an independent prognostic marker in patients with HCC, and may have comparable prognostic value with other established inflammation-based prognostic scores (GPS, mGPS, and NLR). 9 With a similar result in Kinoshita's study, we proved that the prognostic capacity of CAR was superior to the other inflammation-based prognostic scores.…”

Section: T a B L E 3 Univariate And Multivariatementioning

confidence: 99%

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A novel inflammation‐based nomogram system to predict survival of patients with hepatocellular carcinoma

et al. 2018

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Background and AimThe existed staging systems were limited in the accuracy of prediction for overall survival (OS) of hepatocellular carcinoma (HCC) patients. The aim of this study is to establish a novel inflammation‐based prognostic system with nomogram for HCC patients.MethodsA prospective cohort of patients was recruited and assigned to the training cohort (n = 659) and validation cohort (n = 320) randomly. Different inflammation‐based score systems were evaluated to select the best one predicting overall survival (OS). The inflammation‐based score system with the highest predicting value and the parameters best reflecting tumor burden identified by multivariate analysis were selected to construct a novel predicting nomogram system. The predictive accuracy and discriminative ability of the nomogram were evaluated by concordance index (C‐index) and calibration curve and compared with conventional staging systems.ResultsWith a highest C‐index and areas under the receiver operating characteristic curve (AUC), C‐reactive protein/albumin ratio (CAR) was selected to construct the novel system, along with tumor number, tumor size, macrovascular invasion and extra‐hepatic metastases. The C‐index of the nomogram was 0.813 (95% CI, 0.789‐0.837) in the training cohort and 0.794 (95% CI, 0.756‐0.832) in the validation cohort. The calibration curve for predicting probability of survival showed that the nomogram had a high consistency with follow‐up data. The C‐index of the novel system was higher than other conventional staging systems (P < 0.001).ConclusionsThe novel inflammation‐based nomogram, developed from prospectively collected data in the present study, predicted the OS of HCC patients.

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Section: Discussionsupporting

confidence: 72%

Section: T a B L E 3 Univariate And Multivariatementioning

confidence: 99%

A novel inflammation‐based nomogram system to predict survival of patients with hepatocellular carcinoma

et al. 2018

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“…These findings further indicated that a positive relationship exists between the CAR and NLR with respect to predicting the prognosis. Furthermore, the CAR has a much stronger prognostic ability than the GPS in pancreatic cancer 26,29 and patients with HCC. 12,26 In addition, this conclusion demonstrated that There were several limitations of our study.…”

Section: Discussionmentioning

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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“…Commonly measured laboratory blood values, not necessarily aging biomarkers, also might be interesting for this purpose. [14][15][16] The objective of the current study was to compare the added prognostic value of the aforementioned laboratory parameters (Hb, albumin, and CRP) and the composite scores (GPS, mGPS, and the CRP/ albumin ratio) with the added prognostic value of GA and to evaluate their combined prognostic value for OS in addition to clinical information in patients with cancer. 7 For patients with cancer, various studies have identified several blood values routinely measured at the time of diagnosis as prognostic factors for OS.…”

Section: Introductionmentioning

confidence: 99%

“…Their prognostic value for mortality has been shown in multiple studies with various types of cancer in different settings. [14][15][16] The objective of the current study was to compare the added prognostic value of the aforementioned laboratory parameters (Hb, albumin, and CRP) and the composite scores (GPS, mGPS, and the CRP/ albumin ratio) with the added prognostic value of GA and to evaluate their combined prognostic value for OS in addition to clinical information in patients with cancer.…”

Section: Introductionmentioning

confidence: 99%

The prognostic value of 3 commonly measured blood parameters and geriatric assessment to predict overall survival in addition to clinical information in older patients with cancer

Baitar

Kenis

Decoster

et al. 2018

Cancer

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BACKGROUND:The current study was performed to evaluate the prognostic value of laboratory parameters and geriatric assessment (GA) in addition to a baseline model with clinical information regarding overall survival (OS) in patients with cancer. METHODS: GA was systematically performed in patients aged ≥70 years. The baseline model consisted of age, tumor type, and stage of disease. The incremental prognostic values of the GA as a whole (10-item GA) and laboratory parameters were assessed separately and combined. The parameters included hemoglobin (Hb), albumin, C-reactive protein (CRP), and the Glasgow Prognostic Score (GPS). Analyses were conducted with continuous and dichotomized variables. Cox models were compared based on Akaike information criterion (ΔAIC) and their discriminatory ability was assessed using the concordance probability estimate (CPE). RESULTS: A total of 328 patients were considered for this analysis. The baseline model had a CPE of 0.725. The addition of CRP, albumin, and Hb combined resulted in the best performing model (ΔAIC: 40.12 and CPE: 0.757) among the laboratory parameters. However, the 10-item GA improved the baseline model even more (ΔAIC: 46.03 and CPE: 0.769). Similar results were observed in the analysis with dichotomous variables. The addition of the 3 laboratory parameters (CRP, albumin, and Hb) improved the CPE by 1.4% compared with the baseline model already extended with the 10-item GA. The CPE increase (1.7%) was the highest with the GPS in the analysis with dichotomous variables. CONCLUSIONS: GA appears to add slightly more prognostic information than laboratory parameters in addition to clinical information. The laboratory parameters have an additional prognostic value beyond clinical and geriatric information. Cancer 2018;124:3764-3775.

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The prognostic value of C-reactive protein/albumin ratio in human malignancies: an updated meta-analysis

Cited by 72 publications

References 56 publications

A novel inflammation‐based nomogram system to predict survival of patients with hepatocellular carcinoma

A novel inflammation‐based nomogram system to predict survival of patients with hepatocellular carcinoma

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

The prognostic value of 3 commonly measured blood parameters and geriatric assessment to predict overall survival in addition to clinical information in older patients with cancer

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