Zuqiang Liu1, Kaizhou Jin1,2, Meng Guo3, Jiang Long1,2,3, Liang Liu1,2,3, Chen Liu1,2,3, Jin Xu1,2,3, Quanxing Ni1,2,3, Guopei Luo4,5,6, Xianjun Yu7,8,9. 1. Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. 2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China. 3. Pancreatic Cancer Institute, Fudan University, Shanghai, People's Republic of China. 4. Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. luoguopei@hotmail.com. 5. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China. luoguopei@hotmail.com. 6. Pancreatic Cancer Institute, Fudan University, Shanghai, People's Republic of China. luoguopei@hotmail.com. 7. Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. yuxianjun@fudanpci.org. 8. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China. yuxianjun@fudanpci.org. 9. Pancreatic Cancer Institute, Fudan University, Shanghai, People's Republic of China. yuxianjun@fudanpci.org.
Abstract
BACKGROUND: The C-reactive protein/albumin (CRP/Alb) ratio is associated with outcome in septic patients. However, as an inflammation-based score, its prognostic value for cancer has scarcely been investigated. METHODS: Between February 2010 and January 2015, we enrolled 386 patients with pancreatic ductal adenocarcinoma. Univariate and multivariate survival analysis between the groups were evaluated. Receiver operating characteristics curves were generated and areas under the curve (AUC) were compared to evaluate the discriminatory ability of the inflammation-based prognostic scoring systems, including CRP/Alb ratio, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and modified Glasgow prognostic score (mGPS). RESULTS: The optimal cutoff level of the CRP/Alb ratio was defined as 0.180. The prognosis of patients with CRP/Alb ratio ≥0.180 was significantly worse than CRP/Alb ratio <0.180 in univariate analysis (p < 0.001). In multivariate analysis, the CRP/Alb ratio was still associated with overall survival (p < 0.001). In addition, the CRP/Alb ratio had significantly higher AUC values compared with PLR (6, 12, and 24 months: p < 0.001, 0.017, 0.012) and mGPS (6, 12, and 24 months: p = 0.002, 0.020, 0.046) and had similar AUC values to NLR (6, 12, and 24 months: p = 0.052, 0.139, 0.041). CONCLUSIONS: The current study demonstrated the CRP/Alb ratio may serve as a significant and promising inflammatory prognostic score in pancreatic cancer. An elevated CRP/Alb ratio is an independent factor for poor prognosis with the cutoff value of 0.180.
BACKGROUND: The C-reactive protein/albumin (CRP/Alb) ratio is associated with outcome in septicpatients. However, as an inflammation-based score, its prognostic value for cancer has scarcely been investigated. METHODS: Between February 2010 and January 2015, we enrolled 386 patients with pancreatic ductal adenocarcinoma. Univariate and multivariate survival analysis between the groups were evaluated. Receiver operating characteristics curves were generated and areas under the curve (AUC) were compared to evaluate the discriminatory ability of the inflammation-based prognostic scoring systems, including CRP/Alb ratio, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and modified Glasgow prognostic score (mGPS). RESULTS: The optimal cutoff level of the CRP/Alb ratio was defined as 0.180. The prognosis of patients with CRP/Alb ratio ≥0.180 was significantly worse than CRP/Alb ratio <0.180 in univariate analysis (p < 0.001). In multivariate analysis, the CRP/Alb ratio was still associated with overall survival (p < 0.001). In addition, the CRP/Alb ratio had significantly higher AUC values compared with PLR (6, 12, and 24 months: p < 0.001, 0.017, 0.012) and mGPS (6, 12, and 24 months: p = 0.002, 0.020, 0.046) and had similar AUC values to NLR (6, 12, and 24 months: p = 0.052, 0.139, 0.041). CONCLUSIONS: The current study demonstrated the CRP/Alb ratio may serve as a significant and promising inflammatory prognostic score in pancreatic cancer. An elevated CRP/Alb ratio is an independent factor for poor prognosis with the cutoff value of 0.180.
Authors: Eileen N Phan; Steven W Thorpe; Felix S Wong; Augustine M Saiz; Sandra L Taylor; Robert J Canter; Leon Lenchik; R Lor Randall; Robert D Boutin Journal: J Surg Oncol Date: 2020-07-01 Impact factor: 3.454
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