Effect of C‐reactive protein/albumin ratio on prognosis in advanced non–small‐cell lung cancer

• Published in: Asia-Pacific journal of clinical oncology Vol. 14; no. 6; pp. 402 - 409
• Main Authors: Ni, Xue‐Feng, Wu, Jun, Ji, Mei, Shao, Ying‐Jie, Xu, Bin, Jiang, Jing‐Ting, Wu, Chang‐Ping
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.12.2018
• Subjects: Adult; advanced stage, CRP/Alb ratio, non–small cell lung cancer; Aged; Aged, 80 and over; Albumin; Albumins - metabolism; Biomarkers - analysis; Blood Platelets - pathology; C-Reactive Protein - metabolism; Carcinoma, Non-Small-Cell Lung - metabolism; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - therapy; Female; Health risk assessment; Humans; Inflammation; Lung cancer; Lung Neoplasms - metabolism; Lung Neoplasms - pathology; Lung Neoplasms - therapy; Lymphocytes; Lymphocytes - pathology; Male; Medical prognosis; Middle Aged; Monocytes; Neutrophils - pathology; Non-small cell lung carcinoma; Patients; Prognosis; Retrospective Studies; Risk Factors; ROC Curve; Survival Rate; prognosis; advanced stage, CRP/Alb ratio, non-small cell lung cancer
• ISSN: 1743-7555; 1743-7563
• DOI: 10.1111/ajco.13055

Aim Systemic inflammatory response is closely related to tumor progression. We retrospectively investigated relationships between systemic inflammatory scores, C‐reactive protein/albumin (CRP/Alb) ratio (CAR) and clinical characteristics in advanced non–small‐cell lung cancer (NSCLC) in 436 patients to find better clinical predictors of NSCLC prognosis. Methods Blood specimens were collected 1 week before treatment to test for systemic inflammatory scores and albumin. Patients’ overall survival (OS) was calculated via Kaplan–Meier method. Single‐factor log‐rank and multivariate Cox regression analyses and receiver operating characteristic curves were used to evaluate the prognostic significance of CAR and other systemic inflammatory indexes in predicting OS. Results Kaplan–Meier method showed that Glasgow prognosis score (GPS), modified GPS (mGPS), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) were reliable prognostic factors for advanced NSCLC. CAR was positively correlated with GPS, mGPS, NLR, PLR and MLR in these patients. CAR was an independent risk factor for OS in advanced NSCLC, and was more closely associated with prognosis than were GPS, mGPS, NLR, PLR or MLR. Conclusion In advanced NSCLC patients, CAR may be a better predictor of prognosis compared with other inflammatory markers. A prospective multicenter study is needed to verify these findings.