Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct 28:11:737155.
doi: 10.3389/fonc.2021.737155. eCollection 2021.

Prognostic Role of the C-Reactive Protein/Albumin Ratio in Patients With Gynecological Cancers: A Meta-Analysis

Yingji Fang  1 , Tingting Zheng  1 , Chengling Zhang  1
Affiliations

Prognostic Role of the C-Reactive Protein/Albumin Ratio in Patients With Gynecological Cancers: A Meta-Analysis

Yingji Fang et al. Front Oncol. .

Abstract

Background: Many studies have investigated the prognostic role of the C-reactive protein/albumin ratio (CRP/Alb ratio) in patients with gynecological cancers; however, there is lack of consensus owing to conflicting results across studies. We performed a meta-analysis to determine the prognostic role of the CRP/Alb ratio in gynecological cancers.

Methods: We searched the PubMed, Embase, the Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang electronic databases since inception to April 2021. Combined hazard ratios (HRs) and 95% confidence intervals (CIs) were used to estimate the prognostic effect of the CRP/Alb ratio in gynecological cancers. Pooled odds ratios (ORs) and 95% CIs were used to investigate the association between the CRP/Alb ratio and clinicopathological features.

Results: The meta-analysis included seven studies with 1,847 patients. The pooled results showed that a high pretreatment CRP/Alb ratio was associated with poor overall survival (HR, 1.84; 95% CI, 1.41-2.40; p < 0.001) and progression-/disease-free survival (HR, 2.58; 95% CI, 1.42-4.68; p = 0.002). Additionally, a high CRP/Alb ratio was significantly associated with stages III-IV disease (the International Federation of Gynecology and Obstetrics classification) (OR, 2.98; 95% CI, 1.45-6.14; p = 0.003). However, we observed a non-significant correlation between the CRP/Alb ratio and lymph node metastasis, tumor size, and histopathological grade.

Conclusions: The CRP/Alb ratio is a convenient and accurate predictor of survival outcomes in gynecological cancers. A high CRP/Alb ratio also predicts tumor progression.

Keywords: CRP/Alb ratio; gynecological cancers; meta-analysis; prognostic; risk factors.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart describing the literature search and study selection.
Figure 2
Figure 2
Forest plots of studies evaluating the hazard ratio for overall survival (OS) of patients with gynecological cancers of a high CRP/Alb ratio.
Figure 3
Figure 3
Forest plots of studies evaluating the hazard ratio for progression-free survival (PFS)/disease-free survival (DFS) of patients with gynecological cancers of a high CRP/Alb ratio.
Figure 4
Figure 4
The association between CRP/Alb ratio and clinicopathological features in patients with gynecological cancers. (A) Lymph node metastasis (yes vs. no), (B) tumor size (≥4 vs. <4 cm), (C) histological grade (G3 vs. G1/G2), and (D) FIGO stage (III–IV vs. I–II).
Figure 5
Figure 5
Publication bias tested by funnel plots in this meta-analysis. (A) OS; (B) PFS/DFS.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: Cancer J Clin (2018) 68(6):394–424. doi: 10.3322/caac.21492 - DOI - PubMed
    1. Gultekin M, Kucukyildiz I, Karaca MZ, Dundar S, Boztas G, Turan SH, et al. . Trends of Gynecological Cancers in Turkey: Toward Europe or Asia? Int J Gynecol Cancer (2017) 27(8S Suppl 1):S1–s9. doi: 10.1097/igc.0000000000001026 - DOI - PubMed
    1. Lu JJ, Gu Y, Li Q, Zhong HX, Wang XX, Zheng ZX, et al. . Wilms' Tumor 1 (WT1) as a Prognosis Factor in Gynecological Cancers A Meta-Analysis. Medicine (2018) 97(28):e11485. doi: 10.1097/md.0000000000011485 - DOI - PMC - PubMed
    1. McDonald ME, Bender DP. Endometrial Cancer: Obesity, Genetics, and Targeted Agents. Obstet Gynecol Clinics North Am (2019) 46(1):89–105. doi: 10.1016/j.ogc.2018.09.006 - DOI - PubMed
    1. Diakos CI, Charles KA, McMillan DC, Clarke SJ. Cancer-Related Inflammation and Treatment Effectiveness. Lancet Oncol (2014) 15(11):e493–503. doi: 10.1016/s1470-2045(14)70263-3 - DOI - PubMed

Publication types