Prognostic role of C-reactive protein to albumin ratio in cancer patients treated with immune checkpoint inhibitors: a meta-analysis

Dai, Menglu; Wu, Wei

doi:10.3389/fonc.2023.1148786

Cited by 4 publications

(2 citation statements)

References 46 publications

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“…In addition, CAR was introduced as a prognostic indicator of survival in patients with non-small cell lung cancer [54]. Interestingly, a meta-analysis suggested that CAR was useful in predicting outcome after treatment in patients with various types of cancer [55]. Infectious diseases are also characterized with high CAR levels.…”

Section: Discussionmentioning

confidence: 99%

Serum C-Reactive Protein to Albumin Ratio as a Reliable Marker of Diabetic Neuropathy in Type 2 Diabetes Mellitus

Aktas¹

2023

Preprint

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Type 2 diabetes mellitus may be complicated with chronic complications including diabetic neuropathy (DN). Timely diagnosis is crucial in treatment and maybe reversal of this complication. C reactive protein to albumin ratio (CAR) is considered as a marker of inflammation in various diseases that characterized with acute or chronic inflammation. Since diabetic neuropathy and type 2 diabetes mellitus are also associated with chronic, low grade inflammation, we aimed to study CAR levels of type 2 diabetic subjects with diabetic neuropathy and to compare to those in patients without diabetic neuropathy. Type 2 diabetic patients presented to our institutional outpatient clinics were divided into two according to the presence of DN. Subjects with DN were listed as DN group and others were as non-DN group. Characteristics and laboratory data, including CAR, in DN and non-DN groups were compared. Median CAR of the DN and non-DN groups were 2,19 (0,2-49)% and 0,56 (0,02-5,8)%, respectively (p&lt;0.001). CAR was significantly and positively correlated with age (r=0.15, p&lt;0.001), weight (r=0.19, p=0.01), BMI (r=0.11, p=0.03), waist circumference (r=0.10, p=0.046), fasting plasma glucose (r=0.14, p=0.004), serum creatinine (r=0.25, p&lt;0.001), triglyceride (r=0.17, p&lt;0.001), and LDL-cholesterol (r=0.13, p=0.001) levels. Moreover, CAR was inversely correlated with eGFR levels (r=-0.16, p&lt;0.001). The sensitivity and specificity of CAR (when higher than 1,02%) in predicting diabetic neuropathy were 78% and 73%, respectively (AUC: 0.84, p&lt;0.001, 95% CI: 0,82-0,87). Moreover, high CAR level was an independent risk factor of diabetic neuropathy (p&lt;0.001, OR: 1.34, 95% CI: 0.48-1.62). In conclusion, elevated CAR levels could be considered as a marker of diabetic neuropathy.

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Section: Discussionmentioning

confidence: 99%

Serum C-Reactive Protein to Albumin Ratio as a Reliable Marker of Diabetic Neuropathy in Type 2 Diabetes Mellitus

Aktas¹

2023

Preprint

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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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Combining dynamics of serum inflammatory and nutritional indicators as novel biomarkers in immune checkpoint inhibitor treatment of non-small-cell lung cancer with bone metastases

Asano,

Hayashi,

Takeuchi

et al. 2024

International Immunopharmacology

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Prognostic role of C-reactive protein to albumin ratio in cancer patients treated with immune checkpoint inhibitors: a meta-analysis

Cited by 4 publications

References 46 publications

Serum C-Reactive Protein to Albumin Ratio as a Reliable Marker of Diabetic Neuropathy in Type 2 Diabetes Mellitus

Serum C-Reactive Protein to Albumin Ratio as a Reliable Marker of Diabetic Neuropathy in Type 2 Diabetes Mellitus

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

Combining dynamics of serum inflammatory and nutritional indicators as novel biomarkers in immune checkpoint inhibitor treatment of non-small-cell lung cancer with bone metastases

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