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Prognostic Value of the CRP/Alb Ratio, a Novel Inflammation-Based Score in Pancreatic Cancer

  • Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The C-reactive protein/albumin (CRP/Alb) ratio is associated with outcome in septic patients. However, as an inflammation-based score, its prognostic value for cancer has scarcely been investigated.

Methods

Between February 2010 and January 2015, we enrolled 386 patients with pancreatic ductal adenocarcinoma. Univariate and multivariate survival analysis between the groups were evaluated. Receiver operating characteristics curves were generated and areas under the curve (AUC) were compared to evaluate the discriminatory ability of the inflammation-based prognostic scoring systems, including CRP/Alb ratio, neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR) and modified Glasgow prognostic score (mGPS).

Results

The optimal cutoff level of the CRP/Alb ratio was defined as 0.180. The prognosis of patients with CRP/Alb ratio ≥0.180 was significantly worse than CRP/Alb ratio <0.180 in univariate analysis (p < 0.001). In multivariate analysis, the CRP/Alb ratio was still associated with overall survival (p < 0.001). In addition, the CRP/Alb ratio had significantly higher AUC values compared with PLR (6, 12, and 24 months: p < 0.001, 0.017, 0.012) and mGPS (6, 12, and 24 months: p = 0.002, 0.020, 0.046) and had similar AUC values to NLR (6, 12, and 24 months: p = 0.052, 0.139, 0.041).

Conclusions

The current study demonstrated the CRP/Alb ratio may serve as a significant and promising inflammatory prognostic score in pancreatic cancer. An elevated CRP/Alb ratio is an independent factor for poor prognosis with the cutoff value of 0.180.

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Acknowledgment

This study was supported in part by the Sino-German Center (GZ857), by the Science Foundation of Shanghai (13ZR1407500), by the Shanghai Rising Star Extension Program (12QH1400600), by the Fudan University Young Investigator promoting Program (20520133403), by the Prospective Clinical Trial Project, Shanghai Cancer Center (YJLC201403) and by the National Science Foundation of China (Grant Nos. 81101807, 81001058, 81372649, 81372653, 81172276).

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    Authors and Affiliations

    1. Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China

      Zuqiang Liu MD, Kaizhou Jin MD, Jiang Long MD, Liang Liu MD, Chen Liu MD, Jin Xu MD, Quanxing Ni MD, Guopei Luo MD, PhD & Xianjun Yu MD, PhD

    2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China

      Kaizhou Jin MD, Jiang Long MD, Liang Liu MD, Chen Liu MD, Jin Xu MD, Quanxing Ni MD, Guopei Luo MD, PhD & Xianjun Yu MD, PhD

    3. Pancreatic Cancer Institute, Fudan University, Shanghai, People’s Republic of China

      Meng Guo PhD, Jiang Long MD, Liang Liu MD, Chen Liu MD, Jin Xu MD, Quanxing Ni MD, Guopei Luo MD, PhD & Xianjun Yu MD, PhD

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    1. Zuqiang Liu MD
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    2. Kaizhou Jin MD
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    Correspondence to Guopei Luo MD, PhD or Xianjun Yu MD, PhD.

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    Conflict of interest

    No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. The authors declare no conflict of interest.

    Ethical approval

    This study was approved by the Ethics Board, Shanghai Cancer Center, Fudan University.

    Additional information

    Zuqiang Liu and Kaizhou Jin have contributed equally to this work.

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    Liu, Z., Jin, K., Guo, M. et al. Prognostic Value of the CRP/Alb Ratio, a Novel Inflammation-Based Score in Pancreatic Cancer. Ann Surg Oncol 24, 561–568 (2017). https://doi.org/10.1245/s10434-016-5579-3

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    • DOI: https://doi.org/10.1245/s10434-016-5579-3

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