The Prognostic Value of C-reactive Protein to Albumin Ratio in Patients with Lung Cancer

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2018 Dec 19

PMID 30558004

Citations 25

Authors

Tai-Bing Deng

Jing Zhang

Yong-Zhao Zhou

Wei-Min Li

Affiliations

Soon will be listed here.

Abstract

Background: To perform a meta-analysis of retrospective studies exploring the association of C-reactive protein to albumin (CAR) with overall survival (OS) in patients with lung cancer.

Methods: Relevant studies were enrolled by searching databases of PubMed, Cochrane Library, Web of Science, and Embase were searched until July 16, 2017. We combined the hazard ratios (HRs) and 95% confidence intervals (CIs) to assess the correlation between CAR and OS in patients with lung cancer RESULTS:: Four studies involving 1257 participants from several countries were involved in the meta-analysis. In a pooled analysis of all studies, elevated CAR predicted poor OS (HR: 2.13; 95% CI: 1.52-2.97; P < .05). Subgroup analysis showed that high level of CAR predicted poor OS in patients with lung cancer though multivariate analyses on 1092 participants (HR: 1.63; 95% CI: 1.24-2.51; P < .001) and the heterogeneity decreased to 45.4%. Moreover, a similar trend was observed in patients receiving surgery (HR: 2.64; 95% CI: 2.08-3.35; P < .001) and chemotherapy (HR: 1.75; 95% CI: 1.93-2.57; P = .004). And the HRs for patients receiving surgery was moderately higher than that for patients receiving chemotherapy.

Conclusion: Our findings indicate that CAR may have a prognostic value in lung cancer as we detected a significant association between elevated CAR and poorer OS. However, further studies are warranted to draw firm conclusions.

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References

Aberle D, Adams A, Berg C, Black W, Clapp J, Fagerstrom R . Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011; 365(5):395-409. PMC: 4356534. DOI: 10.1056/NEJMoa1102873. View

Koh Y, Lee H . Prognostic impact of C-reactive protein/albumin ratio on the overall survival of patients with advanced nonsmall cell lung cancers receiving palliative chemotherapy. Medicine (Baltimore). 2017; 96(19):e6848. PMC: 5428608. DOI: 10.1097/MD.0000000000006848. View

Tomita M, Shimizu T, Ayabe T, Nakamura K, Onitsuka T . Elevated preoperative inflammatory markers based on neutrophil-to-lymphocyte ratio and C-reactive protein predict poor survival in resected non-small cell lung cancer. Anticancer Res. 2012; 32(8):3535-8. View

Li Z, Chen P, Yao K, Wang B, Li J, Mi Q . Development of a new outcome prediction model for Chinese patients with penile squamous cell carcinoma based on preoperative serum C-reactive protein, body mass index, and standard pathological risk factors: the TNCB score group system. Oncotarget. 2016; 7(15):21023-33. PMC: 4991509. DOI: 10.18632/oncotarget.8037. View

Liu X, Sun X, Liu J, Kong P, Chen S, Zhan Y . Preoperative C-Reactive Protein/Albumin Ratio Predicts Prognosis of Patients after Curative Resection for Gastric Cancer. Transl Oncol. 2015; 8(4):339-45. PMC: 4562973. DOI: 10.1016/j.tranon.2015.06.006. View

Tierney J, Stewart L, Ghersi D, Burdett S, Sydes M . Practical methods for incorporating summary time-to-event data into meta-analysis. Trials. 2007; 8:16. PMC: 1920534. DOI: 10.1186/1745-6215-8-16. View

Chen Z, Shao Y, Fan M, Zhuang Q, Wang K, Cao W . Prognostic significance of preoperative C-reactive protein: albumin ratio in patients with clear cell renal cell carcinoma. Int J Clin Exp Pathol. 2016; 8(11):14893-900. PMC: 4713605. View

Li Y, Li Z, Xia Y, Huang J, Huang H, Xia Z . Serum C-reactive protein (CRP) as a simple and independent prognostic factor in extranodal natural killer/T-cell lymphoma, nasal type. PLoS One. 2013; 8(5):e64158. PMC: 3665788. DOI: 10.1371/journal.pone.0064158. View

Miyazaki T, Yamasaki N, Tsuchiya T, Matsumoto K, Kunizaki M, Kamohara R . Ratio of C-reactive protein to albumin is a prognostic factor for operable non-small-cell lung cancer in elderly patients. Surg Today. 2016; 47(7):836-843. DOI: 10.1007/s00595-016-1448-8. View

10.

Gioulbasanis I, Pallis A, Vlachostergios P, Xyrafas A, Giannousi Z, Perdikouri I . The Glasgow Prognostic Score (GPS) predicts toxicity and efficacy in platinum-based treated patients with metastatic lung cancer. Lung Cancer. 2012; 77(2):383-8. DOI: 10.1016/j.lungcan.2012.04.008. View

11.

Zhang Y, Zhou G, Liu X, Chen L, Li W, Tang L . Exploration and Validation of C-Reactive Protein/Albumin Ratio as a Novel Inflammation-Based Prognostic Marker in Nasopharyngeal Carcinoma. J Cancer. 2016; 7(11):1406-12. PMC: 4964124. DOI: 10.7150/jca.15401. View

12.

Ranzani O, Zampieri F, Forte D, Azevedo L, Park M . C-reactive protein/albumin ratio predicts 90-day mortality of septic patients. PLoS One. 2013; 8(3):e59321. PMC: 3595283. DOI: 10.1371/journal.pone.0059321. View

13.

Nikolic I, Kukulj S, Samarzija M, Jelec V, Zarak M, Orehovec B . Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio help identify patients with lung cancer, but do not differentiate between lung cancer subtypes. Croat Med J. 2016; 57(3):287-92. PMC: 4937224. DOI: 10.3325/cmj.2016.57.287. View

14.

Kinoshita A, Onoda H, Takano K, Imai N, Saeki C, Fushiya N . Pretreatment serum C-reactive protein level predicts poor prognosis in patients with hepatocellular carcinoma. Med Oncol. 2012; 29(4):2800-8. DOI: 10.1007/s12032-012-0220-1. View

15.

Bambury R, Teo M, Power D, Yusuf A, Murray S, Battley J . The association of pre-treatment neutrophil to lymphocyte ratio with overall survival in patients with glioblastoma multiforme. J Neurooncol. 2013; 114(1):149-54. DOI: 10.1007/s11060-013-1164-9. View

16.

Eggers H, Seidel C, Schrader A, Lehmann R, Wegener G, Kuczyk M . Serum C-reactive protein: a prognostic factor in metastatic urothelial cancer of the bladder. Med Oncol. 2013; 30(4):705. DOI: 10.1007/s12032-013-0705-6. View

17.

Tolia M, Tsoukalas N, Kyrgias G, Mosa E, Maras A, Kokakis I . Prognostic Significance of Serum Inflammatory Response Markers in Newly Diagnosed Non-Small Cell Lung Cancer before Chemoirradiation. Biomed Res Int. 2015; 2015:485732. PMC: 4538410. DOI: 10.1155/2015/485732. View

18.

Fan H, Shao Z, Xiao Y, Xie Z, Chen W, Xie H . Comparison of the Glasgow Prognostic Score (GPS) and the modified Glasgow Prognostic Score (mGPS) in evaluating the prognosis of patients with operable and inoperable non-small cell lung cancer. J Cancer Res Clin Oncol. 2016; 142(6):1285-97. DOI: 10.1007/s00432-015-2113-0. View

19.

Morris-Stiff G, Gomez D, Prasad K . C-reactive protein in liver cancer surgery. Eur J Surg Oncol. 2008; 34(7):727-9. DOI: 10.1016/j.ejso.2008.01.016. View

20.

Haruki K, Shiba H, Shirai Y, Horiuchi T, Iwase R, Fujiwara Y . The C-reactive Protein to Albumin Ratio Predicts Long-Term Outcomes in Patients with Pancreatic Cancer After Pancreatic Resection. World J Surg. 2016; 40(9):2254-60. DOI: 10.1007/s00268-016-3491-4. View