The Ratio of C-Reactive Protein to Albumin Is an Independent Predictor of Malignant Intraductal Papillary Mucinous Neoplasms of the Pancreas

Serafini, Simone; Friziero, Alberto; Sperti, Cosimo; Vallese, Lorenzo; Grego, Andrea; Piangerelli, Alfredo; Belluzzi, Amanda; Moletta, Lucia

doi:10.3390/jcm10102058

Cited by 8 publications

(12 citation statements)

References 39 publications

(45 reference statements)

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“…The role of the ratio between the CAR has been less investigated. Very recently, Serafini et al conducted a retrospective analysis on 83 patients who underwent pancreatic resection for IPMNs [ 50 ]. Their results suggest that CAR > 0.083 was a statistically significant predictor of invasive carcinoma or high-grade dysplasia in IPMNs with a sensitivity of 52% and a specificity of 93%.…”

Section: Circulating Humoral Predictors Of Malignancymentioning

confidence: 99%

Humoral Predictors of Malignancy in IPMN: A Review of the Literature

Nista

Schepis

Candelli

et al. 2021

IJMS

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Pancreatic cystic lesions are increasingly detected in cross-sectional imaging. Intraductal papillary mucinous neoplasm (IPMN) is a mucin-producing subtype of the pancreatic cyst lesions arising from the pancreatic duct system. IPMN is a potential precursor of pancreatic cancer. The transformation of IPMN in pancreatic cancer is progressive and requires the occurrence of low-grade dysplasia, high-grade dysplasia, and ultimately invasive cancer. Jaundice, enhancing mural nodule >5 mm, main pancreatic duct diameter >10 mm, and positive cytology for high-grade dysplasia are considered high-risk stigmata of malignancy. While increased levels of carbohydrate antigen 19-9 (CA 19-9) (>37 U/mL), main pancreatic duct diameter 5–9.9 mm, cyst diameter >40 mm, enhancing mural nodules <5 mm, IPMN-induced acute pancreatitis, new onset of diabetes, cyst grow-rate >5 mm/year are considered worrisome features of malignancy. However, cross-sectional imaging is often inadequate in the prediction of high-grade dysplasia and invasive cancer. Several studies evaluated the role of humoral and intra-cystic biomarkers in the prediction of malignancy in IPMN. Carcinoembryonic antigen (CEA), CA 19-9, intra-cystic CEA, intra-cystic glucose, and cystic fluid cytology are widely used in clinical practice to distinguish between mucinous and non-mucinous cysts and to predict the presence of invasive cancer. Other biomarkers such as cystic fluid DNA sequencing, microRNA (mi-RNA), circulating microvesicles, and liquid biopsy are the new options for the mini-invasive diagnosis of degenerated IPMN. The aim of this study is to review the literature to assess the role of humoral and intracystic biomarkers in the prediction of advanced IPMN with high-grade dysplasia or invasive carcinoma.

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Section: Circulating Humoral Predictors Of Malignancymentioning

confidence: 99%

Humoral Predictors of Malignancy in IPMN: A Review of the Literature

Nista

Schepis

Candelli

et al. 2021

IJMS

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“…Recently, the C-reactive protein-to-albumin ratio (CAR) was identified as a non-specific marker of systemic inflammation (14)(15)(16). CAR has been shown to have some clinical impact on both the short-and long-term oncological outcomes of patients with gastrointestinal cancer, including hepatocellular, esophageal, colorectal, and pancreatic, and some studies have shown similar tendencies for gastric cancer.…”

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confidence: 99%

The Clinical Influence of the C-Reactive Protein-to-Albumin Ratio in Patients Who Received Curative Treatment for Gastric Cancer

Aoyama

Nakazono

Segami

et al. 2021

In Vivo

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Background: We investigated the impact of the pre-surgical C-reactive protein-to-albumin ratio (CAR) on survival and recurrence after curative treatment for gastric cancer. Patients and Methods: This study included 481 patients who underwent curative treatment for gastric cancer between 2013 and 2017. The risk factors for overall (OS) and recurrence-free (RFS) survival were identified. Results: A CAR of 0.05 was regarded as the optimal critical point of classification considering the 3-and 5-year survival rates and patients were divided according to their CAR. The OS rates at 3 and 5 years after surgery were significantly higher at 92.5% and 87.9%, respectively, in the low-CAR group compared with 84.9% and 71.9%, respectively, in the high-CAR group. The corresponding RFS rates were 89.1% and 85.5%, and 81.0% and 72.2%, respectively, also a significant difference. A multivariate analysis demonstrated that the CAR was a significant independent risk factor for the OS and marginally significant independent risk factor for the RFS. In addition, the incidences of pancreatic fistula and abdominal abscess were significantly higher and the rate of introduction of adjuvant chemotherapy significantly lower in the high-CAR group. Conclusion: The CAR was a risk factor influencing survival in patients who underwent curative treatment for gastric cancer. An effective perioperative care plan and surgical strategy need to be developed according to the CAR.

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“…This Special Issue of the Journal of Clinical Medicine , entitled “Recent Advances in Pancreatic Neoplasms”, focuses on new possible strategies to treat pancreatic neoplasms, especially pancreatic adenocarcinoma (PDCA). This Special Issue contains 13 articles, 11 studies and 2 review articles, focusing on the pancreatic ductal adenocarcinoma ( n = 10), intraductal papillary mucinous neoplasm (IPMN) ( n = 1), neuroendocrine tumors ( n = 1) and secondary tumor to the pancreas ( n = 1) [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. Seven papers [ 4 , 5 , 6 , 9 , 10 , 11 , 14 ] explored new prognostic factors potentially able to stratify patients with pancreatic cancer and different survival rates in order to select the adequate treatment.…”

mentioning

confidence: 99%

“…This Special Issue contains 13 articles, 11 studies and 2 review articles, focusing on the pancreatic ductal adenocarcinoma ( n = 10), intraductal papillary mucinous neoplasm (IPMN) ( n = 1), neuroendocrine tumors ( n = 1) and secondary tumor to the pancreas ( n = 1) [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ]. Seven papers [ 4 , 5 , 6 , 9 , 10 , 11 , 14 ] explored new prognostic factors potentially able to stratify patients with pancreatic cancer and different survival rates in order to select the adequate treatment. Allen et al [ 6 ] examined the relationship between the daily rate of change in CA 19-9 over the first 90 days of chemotherapy for unresectable and metastatic pancreatic cancer and the pretreatment levels of neutrophils, lymphocytes and platelets with an overall progression-free survival.…”

mentioning

confidence: 99%

“…However, there is still a lack of accuracy in detecting the early invasive carcinoma in IPMNs. Serafini et al [ 4 ] from the University of Padua (Italy) investigated the role of some systemic, inflammatory biomarkers in the diagnosis and prognosis of malignant, intraductal, papillary, mucinous neoplasms (IPMNs) of the pancreas. In 83 patients with histologically proven IPMN, the ratio of the C-reactive protein to the albumin ratio (CAR) was an independent predictor of high- grade dysplasia or invasive carcinoma in a multivariate analysis, and therefore, it could be useful to stratify the patients’ prognosis.…”

mentioning

confidence: 99%

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