NARCA: A novel prognostic scoring system using neutrophil‐albumin ratio and Ca19‐9 to predict overall survival in palliative pancreatic cancer

Tingle, Samuel J; Severs, George R.; Goodfellow, Michael; Moir, John; White, Steven A.

doi:10.1002/jso.25209

Cited by 66 publications

(55 citation statements)

References 25 publications

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“…Serum albumin protects the kidneys from toxic substances and maintains optimal colloid pressure to ensure renal perfusion [30]. Tawfik et al [12] and Tingle et al [13] suggested that NAR is an independent prognostic marker for survival in patients with solid tumors. e findings of the present study suggested that NPAR was an independent predictor of all-cause mortality in critically ill patients with AKI and was a better predictor than neutrophil percentage or albumin alone.…”

Section: Discussionmentioning

confidence: 99%

“…erefore, we hypothesize that neutrophil percentage-to-albumin (NPAR) could serve as an inflammation-based prognostic score. Neutrophil-to-albumin ratio (NAR) has been identified as a biomarker predicting prognosis in patients with rectal cancer and end-stage pancreatic cancer [12,13]. Based on these findings, we have reason to speculate that NPAR may affect the prognosis of AKI in critical illness.…”

Section: Introductionmentioning

confidence: 99%

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The Neutrophil Percentage‐to‐Albumin Ratio Is Associated with All‐Cause Mortality in Critically Ill Patients with Acute Kidney Injury

Wang

Cheng

et al. 2020

BioMed Research International

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Background. There is no evidence to suggest the predictive power of neutrophil percentage-to-albumin ratio (NPAR) in patients with acute kidney injury (AKI). We hypothesized that NPAR would correlate with all-cause mortality in critically ill patients with AKI. Methods. From the MIMIC-III V1.4 database, we extracted demographics, vital signs, comorbidities, laboratory tests, and other clinical data. The clinical endpoints were 30-, 90- and 365-day all-cause mortality in critically ill patients with AKI. Cox proportional hazards models were used to evaluate the prognostic values of NPAR, and subgroup analyses were performed to measure mortality across various subgroups. Results. A total of 7,481 eligible subjects were enrolled. In multivariate analysis, after adjustments for age, ethnicity, gender, and other confounding factors, higher NPARs were associated with an increased risk of 30-, 90- and 365-day all-cause mortality in critically ill patients with AKI (tertile 3 versus tertile 1: adjusted HR, 95% CI: 1.48, 1.30–1.69; 1.47, 1.31–1.66; 1.46, 1.32–1.62, respectively; P trend <0.01). A similar trend was observed in the NPAR group division by quintiles. Subgroup analysis revealed no significant interactions in most strata. Conclusions. Increased NPAR correlates with increased risk of all-cause mortality in critically ill patients with AKI.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Neutrophil Percentage‐to‐Albumin Ratio Is Associated with All‐Cause Mortality in Critically Ill Patients with Acute Kidney Injury

Wang

Cheng

et al. 2020

BioMed Research International

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“…24 In this study, alongside CAR and CBC-derived biomarkers of inflammation, we also focused on the neutrophil/albumin ratio (NAR), which has recently only been studied in patients with cancer, because higher NAR indicates an enhanced inflammatory status that worsens cancer prognosis and treatment response. 25 Likewise CAR, NAR has not been examined in psychiatric disorders to date. In this study, our aims were as follows: 1) to examine CAR and NAR as novel peripheral inflammatory markers in patients with both acutely exacerbated and remitted schizophrenia, and to compare them between patient and control groups; 2) to reveal whether peripheral inflammatory markers discriminated patients and controls and whether these markers varied between patients with acute exacerbation and remission; and 3) to determine optimum cutoff levels of CAR and NAR for the diagnosis of schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

C-Reactive Protein/Albumin and Neutrophil/Albumin Ratios as Novel Inflammatory Markers in Patients with Schizophrenia

Balcıoğlu

Kırlıoğlu

2020

Psychiatry Investig

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Objective Peripheral biomarker studies in schizophrenia are insufficient to correspond to whether inflammatory markers are trait- or state-related. The main objective of this study was to compare novel biomarkers C-reactive protein/albumin ratio (CAR), neutrophil/albumin ratio (NAR), and complete blood count-derived inflammatory markers; neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), red-cell distribution width (RDW), and mean platelet volume (MPV) between patients with acutely exacerbated and remitted schizophrenia and healthy controls.Methods Anonymous data of a total of 618 patients with schizophrenia (179 in remission, 439 with acute exacerbation) and 445 psychiatrically and medically healthy subjects admitted to outpatient units were included. One-way ANOVA with Tukey’s HSD post-hoc test, Pearson’s correlation test, receiver operating characteristic analysis, and binomial logistic regression analysis were performed.Results CAR, NAR, NLR, PLR, MLR, RDW, MPV values were found higher in patients with schizophrenia than in healthy subjects. Except for NAR (p=0.007), none of the markers differed between acute exacerbation and remission. As a cut-off value of CAR, 0.388 differentiated patients with schizophrenia from controls (sensitivity 81%, specificity 81%). CAR, NAR, and MPV significantly predicted the diagnosis of schizophrenia.Conclusion CAR and NAR are reliable biomarkers of inflammation and a combination of inflammatory markers including CAR and NAR could be used to reflect the increased inflammatory status in schizophrenia, regardless of relapse or remission.

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“…A total of 113 studies was identified and screened for eligibility ( Figure S3 ). Eighteen studies, including ours, reported on the prognostic value determined at diagnosis of either CEA, CA19-9 serum levels or both on survival in PDAC patients ( Table S3 ) [ 7 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. Several cut-off values were used varying from 5–4000 kU/L for CA19-9 and 3–20 µg/L for CEA.…”

Section: Resultsmentioning

confidence: 99%

Stage-Specific Value of Carbohydrate Antigen 19-9 and Carcinoembryonic Antigen Serum Levels on Survival and Recurrence in Pancreatic Cancer: A Single Center Study and Meta-Analysis

Manen

Groen

Putter

et al. 2020

Cancers

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This study aimed to determine the stage-specific prognostic value of carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) serum levels at diagnosis on overall survival (OS) and time to local recurrence or distant metastases in patients with pancreatic ductal adenocarcinoma (PDAC). Consecutive PDAC patients, discussed at multidisciplinary team meetings from 2013 through 2017, were reviewed. Prognostic factors were stage-specific (resection vs. advanced PDAC) evaluated in Cox proportional hazard models. Additionally, a systematic literature search and meta-analysis was performed, as current literature is lacking a complete overview of used cut-off values and the added value of CEA as prognostic marker. In the retrospective cohort, elevated CA19-9 (>305 kU/L) level was independently associated with poor OS (Hazard ratio (HR): 1.72(1.31–2.26)) and early recurrence (HR: 1.74(1.06–2.86)), whereas CEA was not significantly associated. The meta-analysis showed that both elevated CA19-9 and CEA serum levels were predictors for poor OS (pooled HR: 1.29(1.17–1.42) and HR: 1.51(1.33–1.73), respectively). In the resected cohort, elevated CA19-9 level was significantly associated with early recurrence (pooled HR: 2.41(1.77–3.29)), whereas CEA was not. Elevated CA19-9 serum level appear to be an independent prognostic factor for poor OS and early recurrence in PDAC patients, whereas the prognostic value of CEA is disputable.

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NARCA: A novel prognostic scoring system using neutrophil‐albumin ratio and Ca19‐9 to predict overall survival in palliative pancreatic cancer

Abstract: Combining NAR and Ca19-9 into a prognostic score allows stratification of unresectable PDAC patients into groups with significantly different overall survival.

Cited by 66 publications

References 25 publications

The Neutrophil Percentage‐to‐Albumin Ratio Is Associated with All‐Cause Mortality in Critically Ill Patients with Acute Kidney Injury

The Neutrophil Percentage‐to‐Albumin Ratio Is Associated with All‐Cause Mortality in Critically Ill Patients with Acute Kidney Injury

C-Reactive Protein/Albumin and Neutrophil/Albumin Ratios as Novel Inflammatory Markers in Patients with Schizophrenia

Stage-Specific Value of Carbohydrate Antigen 19-9 and Carcinoembryonic Antigen Serum Levels on Survival and Recurrence in Pancreatic Cancer: A Single Center Study and Meta-Analysis

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