TY - JOUR
T1 - Prognostic Significance of the Preoperative Ratio of C-Reactive Protein to Albumin and Neutrophil–Lymphocyte Ratio in Gastric Cancer Patients
AU - Saito, Hiroaki
AU - Kono, Yusuke
AU - Murakami, Yuki
AU - Shishido, Yuji
AU - Kuroda, Hirohiko
AU - Matsunaga, Tomoyuki
AU - Fukumoto, Yoji
AU - Osaki, Tomohiro
AU - Ashida, Keigo
AU - Fujiwara, Yoshiyuki
N1 - Publisher Copyright:
© 2017, Société Internationale de Chirurgie.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Background: The ratio of C-reactive protein to albumin (CRP/Alb) is a biochemical marker of systemic inflammatory response and has been associated with poor survival in cancer. This study retrospectively investigated the relationship between the CRP/Alb ratio and prognosis in gastric cancer patients. Methods: This study enrolled 453 patients with a histopathological diagnosis of gastric adenocarcinoma who underwent curative surgery. Results: A statistically significant weak correlation was observed between CRP/Alb ratio and neutrophil/lymphocyte ratio (NLR) (r = 0.19; P < 0.0001). There were statistically significant correlations between high CRP/Alb ratio and age (P = 0.0004), tumor size (P = 0.02), depth of invasion (P = 0.012), and lymph node metastasis (P = 0.022). A high NLR was significantly correlated with age (P = 0.0027), tumor size (P = 0.0006), depth of invasion (P < 0.0001), lymphatic involvement (P = 0.0031), venous involvement (P = 0.0022), and stage of disease (P = 0.0024). Based on results by receiver operating characteristic analysis, patients were divided as follows: CRP/Alb ratio ≥ 0.0232 (CARHigh), CRP/Alb ratio < 0.0232 (CARLow), NLR ≥ 2.43 (NLRHigh), and NLR < 2.43 (NLRLow). Five-year survival rates of patients with both CARHigh and NLRHigh, either CARHigh or NLRHigh, and both CARLow and NLRLow were 59.6, 75.8, and 87.5%, respectively, with statistically significant differences (P < 0.0001). Multivariate analysis revealed that the combination of CRP/Alb ratio and NLR was an independent prognostic indicator. Conclusions: The combination of CRP/Alb ratio and NLR may be useful in predicting prognosis in gastric cancer patients.
AB - Background: The ratio of C-reactive protein to albumin (CRP/Alb) is a biochemical marker of systemic inflammatory response and has been associated with poor survival in cancer. This study retrospectively investigated the relationship between the CRP/Alb ratio and prognosis in gastric cancer patients. Methods: This study enrolled 453 patients with a histopathological diagnosis of gastric adenocarcinoma who underwent curative surgery. Results: A statistically significant weak correlation was observed between CRP/Alb ratio and neutrophil/lymphocyte ratio (NLR) (r = 0.19; P < 0.0001). There were statistically significant correlations between high CRP/Alb ratio and age (P = 0.0004), tumor size (P = 0.02), depth of invasion (P = 0.012), and lymph node metastasis (P = 0.022). A high NLR was significantly correlated with age (P = 0.0027), tumor size (P = 0.0006), depth of invasion (P < 0.0001), lymphatic involvement (P = 0.0031), venous involvement (P = 0.0022), and stage of disease (P = 0.0024). Based on results by receiver operating characteristic analysis, patients were divided as follows: CRP/Alb ratio ≥ 0.0232 (CARHigh), CRP/Alb ratio < 0.0232 (CARLow), NLR ≥ 2.43 (NLRHigh), and NLR < 2.43 (NLRLow). Five-year survival rates of patients with both CARHigh and NLRHigh, either CARHigh or NLRHigh, and both CARLow and NLRLow were 59.6, 75.8, and 87.5%, respectively, with statistically significant differences (P < 0.0001). Multivariate analysis revealed that the combination of CRP/Alb ratio and NLR was an independent prognostic indicator. Conclusions: The combination of CRP/Alb ratio and NLR may be useful in predicting prognosis in gastric cancer patients.
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U2 - 10.1007/s00268-017-4400-1
DO - 10.1007/s00268-017-4400-1
M3 - Article
C2 - 29270656
AN - SCOPUS:85038612968
SN - 0364-2313
VL - 42
SP - 1819
EP - 1825
JO - World Journal of Surgery
JF - World Journal of Surgery
IS - 6
ER -