Prognostic and Clinicopathological Significance of C-Reactive Protein to Albumin Ratio in Patients With Pancreatic Cancer: A Meta-Analysis

Xie, Qinfen; Wang, Lidong; Zheng, Shusen

doi:10.1177/1559325820931290

Cited by 13 publications

(9 citation statements)

References 44 publications

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“…Furthermore, the prognostic value of elevated CRP/Albumin ratio (CAR), reflecting increased CRP values and decreased albumin concentration as indicator of poor nutritional and activated acute phase response, has been widely explored. Elevated CAR has been shown to predict poor outcome in acute diseases including sepsis [178,179] as well as in various malignant diseases [96,99,[180][181][182][183]. Takamori et al investigated CAR for MPM patients and found a high CAR to be independently prognostic [184].…”

Section: Albumin-a Negative Acute Phase Proteinmentioning

confidence: 99%

Biomarkers for Malignant Pleural Mesothelioma—A Novel View on Inflammation

Vogl

Rosenmayr

Bohanes

et al. 2021

Cancers

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Malignant pleural mesothelioma (MPM) is an aggressive disease with limited treatment response and devastating prognosis. Exposure to asbestos and chronic inflammation are acknowledged as main risk factors. Since immune therapy evolved as a promising novel treatment modality, we want to reevaluate and summarize the role of the inflammatory system in MPM. This review focuses on local tumor associated inflammation on the one hand and systemic inflammatory markers, and their impact on MPM outcome, on the other hand. Identification of new biomarkers helps to select optimal patient tailored therapy, avoid ineffective treatment with its related side effects and consequently improves patient’s outcome in this rare disease. Additionally, a better understanding of the tumor promoting and tumor suppressing inflammatory processes, influencing MPM pathogenesis and progression, might also reveal possible new targets for MPM treatment. After reviewing the currently available literature and according to our own research, it is concluded that the suppression of the specific immune system and the activation of its innate counterpart are crucial drivers of MPM aggressiveness translating to poor patient outcome.

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Section: Albumin-a Negative Acute Phase Proteinmentioning

confidence: 99%

Biomarkers for Malignant Pleural Mesothelioma—A Novel View on Inflammation

Vogl

Rosenmayr

Bohanes

et al. 2021

Cancers

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“…In Kaplan-Meier survival curve analysis, OS and PFS were significantly better in the low-CAR group than in the high-CAR group, which also indicated that CAR could predict patient prognosis. Previous studies have shown that CAR can be used as a prognostic factor to predict the prognosis of patients with pancreatic cancer, gallbladder cancer, non-small cell lung cancer, neck squamous cell carcinoma, and cholangiocarcinoma[ 41 - 43 ]. At present, the mechanism of the effect of CAR on the prognosis of HCC patients is not completely clear, but there are some possible explanations.…”

Section: Discussionmentioning

confidence: 99%

C-reactive protein to albumin ratio predict responses to programmed cell death-1 inhibitors in hepatocellular carcinoma patients

Li,

Chen,

et al. 2024

World J Gastrointest Oncol

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BACKGROUND Over the years, programmed cell death-1 (PD-1) inhibitors have been routinely used for hepatocellular carcinoma (HCC) treatment and yielded improved survival outcomes. Nonetheless, significant heterogeneity surrounds the outcomes of most studies. Therefore, it is critical to search for biomarkers that predict the efficacy of PD-1 inhibitors in patients with HCC. AIM To investigate the role of the C-reactive protein to albumin ratio (CAR) in evaluating the efficacy of PD-1 inhibitors for HCC. METHODS The clinical data of 160 patients with HCC treated with PD-1 inhibitors from January 2018 to November 2022 at the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed. RESULTS The optimal cut-off value for CAR based on progression-free survival (PFS) was determined to be 1.20 using x-tile software. Cox proportional risk model was used to determine the factors affecting prognosis. Eastern Cooperative Oncology Group performance status [hazard ratio (HR) = 1.754, 95% confidence interval (95%CI) = 1.045-2.944, P = 0.033], CAR (HR = 2.118, 95%CI = 1.057-4.243, P = 0.034) and tumor number (HR = 2.932, 95%CI = 1.246-6.897, P = 0.014) were independent prognostic factors for overall survival. CAR (HR = 2.730, 95%CI = 1.502-4.961, P = 0.001), tumor number (HR = 1.584, 95%CI = 1.003-2.500, P = 0.048) and neutrophil to lymphocyte ratio (HR = 1.120, 95%CI = 1.022-1.228, P = 0.015) were independent prognostic factors for PFS. Two nomograms were constructed based on independent prognostic factors. The C-index index and calibration plots confirmed that the nomogram is a reliable risk prediction tool. The ROC curve and decision curve analysis confirmed that the nomogram has a good predictive effect as well as a net clinical benefit. CONCLUSION Overall, we reveal that the CAR is a potential predictor of short- and long-term prognosis in patients with HCC treated with PD-1 inhibitors. If further verified, CAR-based nomogram may increase the number of markers that predict individualized prognosis.

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“…Many studies have investigated the prognostic value of the CRP/Alb ratio in a variety of cancer types (26,29,(32)(33)(34)(35). Yu et al showed that an elevated pretreatment CRP/Alb ratio was a prognostic marker of poor OS and CSS in patients with gastric cancer (26).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Role of the C-Reactive Protein/Albumin Ratio in Patients With Gynecological Cancers: A Meta-Analysis

2021

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BackgroundMany studies have investigated the prognostic role of the C-reactive protein/albumin ratio (CRP/Alb ratio) in patients with gynecological cancers; however, there is lack of consensus owing to conflicting results across studies. We performed a meta-analysis to determine the prognostic role of the CRP/Alb ratio in gynecological cancers.MethodsWe searched the PubMed, Embase, the Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang electronic databases since inception to April 2021. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) were used to estimate the prognostic effect of the CRP/Alb ratio in gynecological cancers. Pooled odds ratios (ORs) and 95% CIs were used to investigate the association between the CRP/Alb ratio and clinicopathological features.ResultsThe meta-analysis included seven studies with 1,847 patients. The pooled results showed that a high pretreatment CRP/Alb ratio was associated with poor overall survival (HR, 1.84; 95% CI, 1.41–2.40; p < 0.001) and progression-/disease-free survival (HR, 2.58; 95% CI, 1.42–4.68; p = 0.002). Additionally, a high CRP/Alb ratio was significantly associated with stages III–IV disease (the International Federation of Gynecology and Obstetrics classification) (OR, 2.98; 95% CI, 1.45–6.14; p = 0.003). However, we observed a non-significant correlation between the CRP/Alb ratio and lymph node metastasis, tumor size, and histopathological grade.ConclusionsThe CRP/Alb ratio is a convenient and accurate predictor of survival outcomes in gynecological cancers. A high CRP/Alb ratio also predicts tumor progression.

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Prognostic and Clinicopathological Significance of C-Reactive Protein to Albumin Ratio in Patients With Pancreatic Cancer: A Meta-Analysis

Cited by 13 publications

References 44 publications

Biomarkers for Malignant Pleural Mesothelioma—A Novel View on Inflammation

Biomarkers for Malignant Pleural Mesothelioma—A Novel View on Inflammation

C-reactive protein to albumin ratio predict responses to programmed cell death-1 inhibitors in hepatocellular carcinoma patients

Prognostic Role of the C-Reactive Protein/Albumin Ratio in Patients With Gynecological Cancers: A Meta-Analysis

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