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. 2016 Dec 4;7(15):2360-2366.
doi: 10.7150/jca.16443. eCollection 2016.

C-Reactive Protein/Albumin Ratio (CAR) as a Prognostic Factor in Patients with Non-Metastatic Nasopharyngeal Carcinoma

ShaSha He  1 , Yan Wang  1 , HaiYang Chen  2 , Lin Yang  1 , ShaoBo Liang  3 , LiXia Lu  1 , Yong Chen  1
Affiliations

C-Reactive Protein/Albumin Ratio (CAR) as a Prognostic Factor in Patients with Non-Metastatic Nasopharyngeal Carcinoma

ShaSha He et al. J Cancer. .

Abstract

Background: The C-reactive protein/albumin (CRP/ALB) ratio has recently been associated with clinical outcomes in patients suffering various types of cancer. In this retrospective study, we investigated the prognostic value of the pre-treatment CRP/ALB ratio (CAR) in non-metastatic nasopharyngeal carcinoma (NPC) patients. Methods: The cohort included 2685 patients with non-metastatic NPC. Univariate and multivariate COX proportional hazards analyses were applied to evaluate the associations of CAR with overall survival (OS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and locoregional recurrence-free survival (LRRFS) in patients with NPC. Kaplan-Meier survival analyses was used to compare groups classified by CAR. Results: Patients were categorised by the CAR using a cut-off value of 0.064. Multivariate Cox proportional hazard analysis verified that high CAR level was a significant predictor for inferior OS (P = 0.003), DMFS (P = 0.035), and LRRFS (P = 0.024), but not for DFS (P = 0.093). CAR was also an independent prognostic factor for OS when stratified by Epstein-Barr virus DNA level ( ≥ 2560 or < 2560 copies ml-1). Conclusions: High CAR provides prognostication regarding OS, DMFS, DFS, and LRRFS in patients with NPC. CAR is a valuable coadjutant for Epstein-Barr virus DNA levels for identifying survival differences.

Keywords: C-reactive protein; Epstein-Barr virus DNA; Nasopharyngeal carcinoma; albumin; prognosis..

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Conflict of interest statement

All authors have declared no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier survival curves for patients with CRP/ALB ≥ 0.064 and patients with CRP/ALB < 0.064. (A) Overall survival. (B) Distant metastasis-free survival. (C) Disease-free survival. (D) Locoregional relapse-free survival.
Figure 2
Figure 2
Kaplan-Meier curves of overall survival (OS) by combining pre-treatment EBV DNA and CAR levels in patients with NPC. (A) EBV DNA < 2560 copies ml-1. (B) EBV DNA ≥ 2560 copies ml-1.
See this image and copyright information in PMC

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