The C-reactive protein/albumin ratio predicts long-term outcomes of patients with operable non-small cell lung cancer

Oncotarget. 2017 Jan 31;8(5):8835-8842. doi: 10.18632/oncotarget.13053.

Abstract

Purpose: To investigate the association between C-reactive protein/albumin ratio (CAR), an inflammation-based prognostic score, and clinicopathological factors, as well as its association with long-term outcomes in patients with operable non-small cell lung cancer (NSCLC).

Methods: A total of 617 operable NSCLC patients were retrospectively evaluated and the data of preoperative serum CRP and serum albumin was collected. The correlation between the CAR and clinicopathological factors was analyzed using the chi-square test. A Cox proportional hazards regression model was performed to evaluate the association between the CAR and outcome.

Results: The CAR was significantly related to sex, smoking status, BMI, histology type and clinical stage (p ≤ 0.05). The patients with characteristic of male, smoker, BMI under 18.5, squamous cell carcinoma or clinical stage III had a high level of CAR. Additionally, elevated CAR indicated a worse outcome, and the patients with higher CAR had 2.02-fold risk for disease progression (95% CI 1.48-2.74, p < 0.001) and 2.61-fold risk for death (95 % CI 2.02-3.37, p < 0.001). Multivariate analyses showed the similar results after adjusted by clinicopathological factors and another four inflammation-based prognostic scores.

Conclusions: The CAR is a potential independent predictor for disease progression and death in patients with operable NSCLC.

Keywords: C-reactive protein; albumin; inflammation-based prognostic score; prediction; survival.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood*
  • C-Reactive Protein / analysis*
  • Carcinoma, Non-Small-Cell Lung / blood*
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Chi-Square Distribution
  • Decision Support Techniques
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Humans
  • Inflammation Mediators / blood*
  • Lung Neoplasms / blood*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Pneumonectomy* / adverse effects
  • Pneumonectomy* / mortality
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Serum Albumin, Human / analysis*
  • Sex Factors
  • Smoking / adverse effects
  • Time Factors
  • Treatment Outcome

Substances

  • ALB protein, human
  • Biomarkers, Tumor
  • Inflammation Mediators
  • C-Reactive Protein
  • Serum Albumin, Human