Prognostic value of the C-reactive protein to albumin ratio in colorectal cancer: an updated systematic review and meta-analysis

Liao, Chun-Kai; Yu, Yen-Lin; Lin, Yueh‐Chen; Hsu, Yu-Jen; Chern, Yih-Jong; Chiang, Jy-Ming; You, Jeng-Fu

doi:10.1186/s12957-021-02253-y

Cited by 75 publications

(50 citation statements)

References 37 publications

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“…15,[35][36][37][38] Two studies reported that a higher CAR was associated with poor overall survival rates in lung cancer and colorectal cancer adult patients. 39,40 In addition, it could also be a reliable proinflammation marker for increased coronary thrombus burden, 35 acute kidney injury development, 41 coronary artery lesions formation and intravenous immunoglobulin resistance in adults. 42 In the case of sepsis, Kim et al 43 reported that the CAR was an independent predictor of mortality in adult patients with severe sepsis or septic shock.…”

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confidence: 99%

Predictive Value of C-Reactive Protein-to-Albumin Ratio for Neonatal Sepsis

Li¹,

Li²,

Wei³

et al. 2021

JIR

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Previous studies have reported that C-reactive protein-to-albumin ratio (CAR) was a risk factor for sepsis in adults. However, little is known regarding the role of CAR in neonates with sepsis. The aim of this study was to explore the relationship between CAR and neonatal sepsis. Patients and Methods: In this research, from January 2016 to February 2020, a total of 1076 neonates were enrolled at Henan Children's Hospital in China. Complete clinical and laboratory data were collected. To identify the potential independent risk factor for neonatal sepsis, multivariate logistic regression analysis was performed. Receiver operating characteristic (ROC) curve analysis was used to evaluate the prediction accuracy of CAR in identifying neonatal sepsis. Results: CAR levels were higher in neonates with sepsis and showed a gradual increase among the control group, mild sepsis group and severe sepsis group. The prevalence of neonates with overall sepsis, mild sepsis and severe sepsis increased significantly from CAR tertile 1 to tertile 3. Multiple logistic regression analysis showed that CAR was an independent risk factor for the presence of sepsis (OR = 10.144, 95% CI 4.151-24.790, P < 0.001) and severe sepsis (OR = 1.876, 95% CI 1.562-2.253, P < 0.001). ROC curve analysis showed that CAR had a well discriminatory power in predicting sepsis (area under curve (AUC) = 0.74, 95% CI, 0.71-0.77, P < 0.001) and severe sepsis (AUC = 0.70, 95% CI, 0.67-0.74, P < 0.001). Conclusion: CAR was an independent predictor for the presence and severity of neonatal sepsis.

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confidence: 99%

Predictive Value of C-Reactive Protein-to-Albumin Ratio for Neonatal Sepsis

Li¹,

Li²,

Wei³

et al. 2021

JIR

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“…Tumor growth, invasion, necrosis, and hypoxia initiate immune responses in the tumor microenvironment, which consequently triggers the production of a variety of inflammatory cytokines (28). CRP is an acute-phase protein that is mediated by several proinflammatory cytokines, including interleukin-1 (IL-1), IL-6, and tumor necrosis factor-a (29). IL-6 can lead to inflammation and angiogenesis, which contribute to tumor progression (30).…”

Section: Discussionmentioning

confidence: 99%

“…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%

“…A high CRP/Alb ratio was shown to be associated with clinicopathological features that reflect tumor progression in patients with gastric cancer (26). A meta-analysis of 15 studies that included 6,329 patients reported that a high CRP/Alb ratio was associated with various survival outcomes in patients with CRC (29). Another recent meta-analysis suggested that an elevated pretreatment CRP/Alb ratio could independently predict poor OS in patients with pancreatic cancer (33).…”

Section: Discussionmentioning

confidence: 99%

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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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“…Dysregulated inflammatory response has been shown to have an essential impact on the activation and progression of tumors [ 23 ]. Inflammatory factors promote the proliferation, neovascularization, metastasis, invasion, and therapeutic resistance of tumor cells through various molecular mechanisms [ 24 – 26 ]. Peripheral inflammatory factors are of excellent research value due to their convenience, non-invasive features.…”

Section: Discussionmentioning

confidence: 99%

The decreased platelet-to-lymphocyte ratio could predict a good prognosis in patients with oligometastatic colorectal cancer: a single-center cohort retrospective study

Huang

Cui

et al. 2021

World J Surg Onc

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Background Inflammation markers have an important effect on tumor proliferation, invasion, and metastasis. Oligometastatic disease (OMD) is an intermediate state between widespread metastases and locally confined disease, where curative strategies may be effective for some patients. We aimed to explore the predictive value of inflammatory markers in patients with oligometastatic colorectal cancer (OMCC) and build a nomogram to predict the prognosis of these patients. Methods Two hundred nine patients with OMCC were retrospectively collected in this study. The Kaplan-Meier survival curves and Cox regression analysis were used to estimate overall survival (OS) and progression-free survival (PFS). A multivariate Cox analysis model was utilized to establish the nomogram. The concordance index (C-index), calibration curve, and receiver operating characteristics (ROC) were established to verify the validity and accuracy of the prediction model. Results According to the multivariate analysis, decreased platelet-to-lymphocyte ratio (PLR) might independently improve OS in patients with OMCC (HR = 2.396, 95% CI 1.391–4.126, P = 0.002). Metastases of extra-regional lymph nodes indicated poor OS (HR = 2.472, 95% CI 1.247–4.903, P = 0.010). While the patients with early N stage had better OS (HR = 4.602, 95% CI 2.055–10.305, P = 0.001) and PFS (HR = 2.100, 95% CI 1.364–3.231, P = 0.007). Primary tumor resection (HR = 0.367, 95% CI 0.148–0.908, P = 0.030) and lower fibrinogen (HR = 2.254, 95% CI 1.246–4.078, P = 0.007) could significantly prolong the OS in patients with OMCC. PLR, metastases of extra-regional lymph nodes, N stage, primary tumor resection, and fibrinogen were used to make up the nomogram. The C-index and area under the curve (AUC) of the ROC in nomogram were 0.721 and 0.772 respectively for OS, showed good consistency between predictive probability of OS and actual survival. Conclusions Decreased PLR could predict a good prognosis in patients with OMCC. The nomogram including inflammatory factors and clinicopathological markers was credible and accurate to predict survivals in patients with OMCC.

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Prognostic value of the C-reactive protein to albumin ratio in colorectal cancer: an updated systematic review and meta-analysis

Cited by 75 publications

References 37 publications

Predictive Value of C-Reactive Protein-to-Albumin Ratio for Neonatal Sepsis

Predictive Value of C-Reactive Protein-to-Albumin Ratio for Neonatal Sepsis

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

The decreased platelet-to-lymphocyte ratio could predict a good prognosis in patients with oligometastatic colorectal cancer: a single-center cohort retrospective study

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