Clinical significance of the C‑reactive protein‑to‑albumin ratio for the prognosis of patients with esophageal squamous cell carcinoma

Kunizaki,Masaki; Tominaga,Tetsuro; Wakata,Kouki; Miyazaki,Takuro; Matsumoto,Keitaro; Sumida,Yorihisa; Hidaka,Shigekazu; Yamasaki,Takuya; Yasutake,Toru; Sawai,Terumitu; Hamamoto,Ryuji; Nanashima,Atsushi; Nagayasu,Takeshi

doi:10.3892/mco.2017.1527

Clinical significance of the C‑reactive protein‑to‑albumin ratio for the prognosis of patients with esophageal squamous cell carcinoma

Authors:
- Masaki Kunizaki
- Tetsuro Tominaga
- Kouki Wakata
- Takuro Miyazaki
- Keitaro Matsumoto
- Yorihisa Sumida
- Shigekazu Hidaka
- Takuya Yamasaki
- Toru Yasutake
- Terumitu Sawai
- Ryuji Hamamoto
- Atsushi Nanashima
- Takeshi Nagayasu
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Affiliations: Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Hospital, Nagasaki, Nagasaki 852‑8501, Japan, Division of Radiology, Nagasaki University Hospital, Nagasaki, Nagasaki 852‑8501, Japan, Division of Molecular Modification and Cancer Biology, National Cancer Center Research Institute, Tokyo 104‑0045, Japan
Published online on: December 8, 2017 https://doi.org/10.3892/mco.2017.1527
Pages: 370-374

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Abstract

The aim of the present study was to investigate the prognostic value of the C-reactive protein-to-albumin ratio (CAR) and compare it with other inflammation‑based prognostic scores (Glasgow prognostic score, modified Glasgow prognostic score, neutrophil‑to‑lymphocyte ratio, platelet‑to‑lymphocyte ratio, prognostic nutritional index and prognostic index) in patients with esophageal squamous cell cancer (ESCC). A database of 116 patients with primary ESCC who underwent treatment at the Division of Surgical Oncology at Nagasaki University Hospital between January 2007 and August 2014 was retrospectively reviewed and the correlations between CAR and overall survival (OS) were investigated. Kaplan‑Meier and Cox regression analyses were used to assess independent prognostic factors. The area under the curve (AUC) was used to compare the prognostic value of different scores. According to the receiver operator characteristics analysis, the recommended cut‑off value for CAR was 0.042, with an AUC of 0.678 (sensitivity 31.1%, specificity 66.7%). Thus, patients were dichotomized into low (<0.042) and high (≥0.042) CAR groups. On multivariate analysis, CAR was found to be significantly associated with OS in patients with ESCC [hazard ratio (HR)=2.350; 95% confidence interval (CI): 1.189‑4.650; P=0.014], as was tumor‑node‑metastasis stage (HR=3.059; 95% CI: 1.422‑6.582; P=0.004). In addition, CAR had a higher AUC value (0.678) compared with several other systemic inflammation‑based prognostic scores (P<0.001). This study suggested that CAR is a novel and promising inflammation‑based prognostic score in patients with ESCC. Due to its simplicity, affordability and availability, CAR may be important for improving clinical decision‑making and may contribute to more rational study design and analyses.

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