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Comparative Study
. 2017 Apr 21;17(1):285.
doi: 10.1186/s12885-017-3220-x.

The prognostic value of the preoperative c-reactive protein/albumin ratio in ovarian cancer

Yubo Liu  1 , Shengfu Chen  2   3 , Chengyu Zheng  2 , Miao Ding  2 , Lan Zhang  2 , Liangan Wang  2 , Meiqing Xie  4 , Jianhua Zhou  5
Affiliations
Comparative Study

The prognostic value of the preoperative c-reactive protein/albumin ratio in ovarian cancer

Yubo Liu et al. BMC Cancer. .

Abstract

Background: Inflammation plays an important role in the pathogenesis of ovarian cancer. This study sought to investigate the association between the preoperative c-reactive protein/albumin ratio (CRP/Alb) and oncological outcomes in ovarian cancer patients.

Methods: Two hundred patients with histologically verified ovarian cancer between June 2006 and July 2012 were retrospectively reviewed. Overall survival was evaluated by the Kaplan-Meier method and log-rank test. The significance of risk factors for overall survival was evaluated with the Cox proportional hazards model. Additionally, area under the receiver operating characteristic curve (AUC) was used to compare the predictive ability of CRP/Alb, Glasgow Prognostic Score (GPS), modified GPS (mGPS), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), prognostic index (PI) and prognostic nutritional index (PNI).

Results: The optimal cutoff value of CRP/Alb was 0.68. Increased CRP/Alb (≥0.68) was associated with advanced stage, residual tumor, ascites, elevated serum carbohydrate antigen(CA)-125 level, GPS, and mGPS (all p < 0.05). Patients with high CRP/Alb had poor overall survival compared to those with low CRP/Alb (p < 0.001). Multivariable analysis showed that CRP/Alb (Hazard Ratio (HR) 1.330, 95% confidence interval (CI) 1.131-1.564, p = 0.001), tumor stage (HR 1.577, 95% CI 1.189-2.091, p = 0.002), residual tumor (HR 2.337, 95% CI 1.518-3.597, p < 0.001) and age (HR 1.017, 95% CI 1.000-1.035, p = 0.046) were independent prognostic factors for overall survival. Additionally, the CRP/Alb showed greater AUC values at 1 year (0.692), 3 years (0.659), and 5 years (0.682) than GPS, mGPS and PNI.

Conclusions: The CRP/Alb is a novel independent marker of poor prognosis among ovarian cancer patients and shows superior prognostic ability compared to the established inflammation-based prognostic indices.

Keywords: C-reactive protein/albumin ratio; Inflammation-based prognostic score; Ovarian cancer; Prognosis.

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Figures

Fig. 1
Fig. 1
Kaplan–Meier curves showing the difference in OS for patients with ovarian cancer categorized according to the optimal cutoff of CRP/Alb
Fig. 2
Fig. 2
The receiver operating curves analysis of CRP/Alb, tumor stage, residual tumor and the combination of them to prediction of overall survival
See this image and copyright information in PMC

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