Prognostic significance of C-reactive protein to albumin ratio in colorectal cancer patients: a meta-analysis

Fan, Yu; Xiang, Shouyan; Dai, Zhe; Zou, Chen; Wang, Xiaoyan; Gao, Zhihua

doi:10.1007/s00384-019-03299-x

Cited by 15 publications

(13 citation statements)

References 22 publications

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“…However, both previous studies [29,30] and ours [31] documented that the predictive values of serum CRP and ALB as a single marker for initial IVIG resistance were not ideal. Notably, CAR as a ratio of CRP to ALB initially proposed by Fairclough [48], has been widely demonstrated to be more valuable and accurate than either CRP or ALB alone, providing a variable capable of merging information in the prediction of the systemic inflammatory state and prognosis in adverse cardiovascular events, cancers, inflammatory bowel disease, arteritis and critically ill septic patients [32][33][34][35][36][37][38][39][40][48][49][50][51]. In almost previous studies, CAR performed better predictive ability than either CRP or ALB alone, nonetheless, Cagdas et al found that CAR had better predictive accuracy than CRP but was not superior to ALB [52].…”

Section: Discussionmentioning

confidence: 99%

“…However, both previous studies [29,30] and ours [31] have documented that the predictive values of serum CRP and ALB as a single marker for IVIG resistance were not ideal. Notably, a newly introduced and novel parameter defined as the ratio of CRP to ALB (CAR), has been proposed as more valuable and accurate than either CRP or ALB alone in predicting inflammatory status and prognosis in various clinical settings, including the stable angina pectoris [32,33], colorectal cancer [34,35], coronary artery ectasia [36], inflammatory bowel disease [37], Takayasu arteritis [38], rheumatoid arthritis [39] and sepsis [40]. As a novel parameter, CAR might provide a variable capable of merging both information of CRP and ALB in patients with KD, nonetheless, the relationship of CAR and IVIG resistance in KD has never been evaluated.…”

Section: Introductionmentioning

confidence: 99%

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Predictive value of C-reactive protein to albumin ratio as a biomarker for initial and repeated intravenous immunoglobulin resistance in a large cohort of Kawasaki disease patients: a prospective cohort study

et al. 2021

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Background Intravenous immunoglobulin (IVIG) resistance prediction is one pivotal topic of interests in Kawasaki disease (KD). This study aimed to prospectively investigated the value of C-reactive protein-to-albumin (CAR) in predicting both initial and repeated IVIG resistance in patients with KD, and to test the hypothesis that CAR was more valuable or accurate than either C-reactive protein (CRP) or albumin (ALB) alone in IVIG resistance prediction. Method A prospective cohort study involving 550 patients with KD was conducted. The clinical and laboratory data were compared between IVIG-response group and IVIG-resistance group. Multivariate logistic regression analysis was performed to identify the independent risk factors of initial/repeated IVIG resistance. Receiver operating characteristic (ROC) curves analysis was applied to assess the validity of CAR, CRP and ALB in predicting both initial and repeated IVIG resistance. Results CAR was significantly higher in IVIG non-responders and was identified as independent risk factor for both initial and repeated IVIG resistance in KD. The best cut-off value of CAR for initial and repeated IVIG resistance prediction was 2.07 and 3.34, with a corresponding sensitivity of 0.610 and 0.548, a specificity of 0.552 and 0.813, respectively. The value of CAR was not better than either CRP or ALB alone for both initial and repeated IVIG resistance prediction. Conclusion A higher CAR was an independent risk factor for both initial and repeated IVIG resistance. However, similar with that of CRP or ALB, the predictive value of CAR was not good enough for both initial and repeated IVIG resistance prediction in KD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictive value of C-reactive protein to albumin ratio as a biomarker for initial and repeated intravenous immunoglobulin resistance in a large cohort of Kawasaki disease patients: a prospective cohort study

et al. 2021

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“…CAR, as a star prognostic biomarker for cancer [ 24 , 25 ], two of whose elements, CRP and ALB, are derived from blood. Recently, CAR has been confirmed by several meta-analysis in colorectal cancer [ 12 ], esophageal cancer [ 11 ], and nasopharyngeal cancer [ 10 ], except hepatocellular carcinoma. In this meta-analysis, we found that high CAR was associated with poor prognosis for all patients with HCC.…”

Section: Discussionmentioning

confidence: 99%

“…C-reactive protein to albumin ratio (CAR) has been reported as a powerful prognostic indicator for solid tumors [ 7 – 9 ], and it has been confirmed in colorectal cancer, esophageal cancer, and nasopharyngeal cancer by several newly published meta-analysis [ 10 – 12 ]. Reasons might be as follows: (1) many of the solid tumors are highly associated with inflammation, and C-reactive protein (CRP) is one of the most common kinds of systematic inflammatory index; (2) nutritional status is one of the crucial factors for the long-term prognosis of patients with cancers, which is attracting more and more attentions, and albumin (ALB) level is the simplest marker to evaluate the status of nutrition.…”

Section: Introductionmentioning

confidence: 99%

Clinical Significance of C-Reactive Protein to Albumin Ratio in Patients with Hepatocellular Carcinoma: A Meta-Analysis

Lin

et al. 2020

Disease Markers

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Aim. To evaluate the prognostic significance of C-reactive protein to albumin ratio (CAR) for clinical outcomes in hepatocellular carcinoma (HCC) patients. Material and Methods. Eligible studies were searched by PubMed, MedLine, the Cochrane Library, from January 1, 2000, to June 30, 2019, investigating the prognostic value of CAR in patients with HCC. Primary endpoint was OS. Hazard ratio (HR) with 95% confidence interval (CI) was used to determine the effect size. Results. 7 records including 2208 patients published since 2014 were enrolled into our meta-analysis. Clinicopathological characteristics were also correlated with the level of CAR. The pooled HR for the OS rate between low and high CAR groups was 2.13 (95% CI 1.70~2.68, P<0.00001) using a random model, but sensitivity analysis showed that the pooled HR for the OS rates did not change substantially after removal of any included study. As for patients receiving surgery, the pooled HR for the OS rate between low and high CAR groups was 2.04 (95% CI 1.59~2.61, P<0.00001). Subgroup analysis showed that CAR could be a prognostic biomarker for HCC patients regardless of regions (China, HR=1.75, 95% CI 1.51~2.02; Japan, HR=3.36, 95% CI 2.07~5.45; Korea, HR=2.26, 95% CI 1.47~4.47; respectively), the cut-off value (<0.1, HR=2.84, 95% CI 1.90~4.24; >0.1, HR=1.99, 95% CI 1.52~2.61; respectively), and sample size (<200, HR=2.85, 95% CI 2.01~4.03; >200, HR=1.75, 95% CI 1.52~2.02; respectively). Conclusion. With the current data, we clearly concluded that CAR was closely correlated with prognosis of patients with HCC. Multicenter, prospective randomized trials are warranted to confirm the conclusion.

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“…Compared with CRP or albumin alone, CAR is a preferable indicator of immune response and nutritional status [35]. And CAR has been used as a prognostic factor in variety of solid cancers including esophageal cancer, lung cancer, gastric cancer, colorectal cancer and so on [36][37][38][39]. Recent reports by Yu et al have found preoperative CAR was an independent risk factor for AL in elderly colorectal cancer patients with a cut-off value of 2.44 [40].…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Postoperative C-reactive Protein-to-Albumin Ratio in Anastomotic Leakage after Esophagectomy

Zhang

et al. 2021

Preprint

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Introduction: Among the many possible postoperative complications, anastomotic leakage (AL) is the most common and serious. Therefore, the purpose of this study was to explore the ability of various inflammatory and nutritional markers to predict postoperative AL in patients after esophagectomy. Methods: A total of 273 patients were retrospectively evaluated and enrolled into this study. Perioperative, surgery-related, tumor-related and laboratory tests data were extracted and analyzed. The discriminatory ability and optimal cut-off value was evaluated according to the receiver operating characteristic (ROC) curve analysis. Univariate and multivariate analyses were performed to access the potential risk factors for AL. Results: The overall incidence of AL was 12.5% (34/273). C-reactive protein-to-albumin ratio (CAR) [AUC 0.943 (95% confidence interval (CI) = 0.911–0.976, p < 0.001)] and operation time [AUC 0.747 (95% CI = 0.679–0.815, p < 0.001)] had the greatest discrimination on AL prediction. Multivariate analysis demonstrated that CAR and operation time were two independent risk factors for AL, and CAR (OR = 87.150, p < 0.001) had an advantage over operation time (OR = 11.178, p = 0.011). Conclusion: Operation time and postoperative CAR were two independent predictive indexes for AL. Postoperative CAR greater than 3.00 indicated a high risk of AL. For patients with abnormal postoperative CAR, early non-operative treatment or surgical intervention are needed to reduce the serious sequelae of AL.

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Prognostic significance of C-reactive protein to albumin ratio in colorectal cancer patients: a meta-analysis

Cited by 15 publications

References 22 publications

Predictive value of C-reactive protein to albumin ratio as a biomarker for initial and repeated intravenous immunoglobulin resistance in a large cohort of Kawasaki disease patients: a prospective cohort study

Predictive value of C-reactive protein to albumin ratio as a biomarker for initial and repeated intravenous immunoglobulin resistance in a large cohort of Kawasaki disease patients: a prospective cohort study

Clinical Significance of C-Reactive Protein to Albumin Ratio in Patients with Hepatocellular Carcinoma: A Meta-Analysis

Predictive Value of Postoperative C-reactive Protein-to-Albumin Ratio in Anastomotic Leakage after Esophagectomy

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