Ann Surg Treat Res.  2021 Jun;100(6):338-346. 10.4174/astr.2021.100.6.338.

Clinical significance and prognostic value of C-reactive protein/albumin ratio in gastric cancer

• Yu Q
• Li Kz
• Fu Yj
• Tang Y
• Liang Xq
• Liang Zq
• Bai Jh

• KMID: 2516227
• DOI: http://doi.org/10.4174/astr.2021.100.6.338

Abstract

Purpose
This study was aimed to evaluate the clinical significance and prognostic value of CRP/albumin ratio (CAR) in patients with gastric cancer.
Methods
The data of 205 gastric cancer patients who underwent surgery was analyzed retrospectively. The association of CAR with the clinical features and prognostic value in gastric cancer was analyzed. The data of this study was combined with previous studies to further determine the prognostic value of CAR in patients with gastric cancer using a metaanalysis method.
Results
Cox analysis revealed that preoperative CAR was an independent prognosis indicator in patients with gastric cancer. High expression of CAR indicated a shorter survival time than in those with lower expression. CAR has a higher prognostic value in the 1-, 3-, and 5-year overall survival in patients with gastric cancer. CAR showed significant difference regarding the gastric cancer patients’ age, M stage, and clinical stage. The discriminate value of CAR in M stage of gastric cancer was high (area under the curve, 0.809). A meta-analysis combining previous data and our data showed that preoperative CAR demonstrated a significant association with the overall survival of patients with gastric cancer.
Conclusion
This study demonstrated that preoperative CAR could serve as an important prognostic indicator in patients with gastric cancer.

Keyword

C-reactive protein/albumin ratio; Preoperative; Prognosis; Stomach neoplasms

Figure

• 

  Fig. 1 The patient selection flowchart of the present study. CAR, CRP/albumin ratio.

• 

  Fig. 2 (A) Kaplan-Meier curve for the CRP/albumin ratio (CAR) in patients with gastric cancer using median value as a cutoff. (B) The prognostic value of CAR in predicting the 1-, 3-, and 5-year survival in patients with gastric cancer. ROC, receiver operating characteristic; AUC, area under the curve.

• 

  Fig. 3 Discriminated value of C-reactive protein/albumin ratio (CAR) in different TNM stage of gastric cancer. (A) M stage (M0 vs. M1; cutoff: 0.357). (B) Clinical stage (I vs. II + III + IV; cutoff: 0.048). ROC, receiver operating characteristic; FPR, false positive rate; TPR, true positive rate; AUC, area under the curve.

• 

  Fig. 4 Forest plot of the Meta analysis. (A) Forest plot of hazard ratio (HR) for the association of CRP/albumin ratio (CAR) with overall survival (OS) in patients with gastric cancers. (B) Forest plot of HR for the association of CAR with OS in gastric cancers with different cutoff values. TE, treatment estimate; seTE, standard error of TE; CI, confidence interval.

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