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. 2022 Nov 17;22(1):1183.
doi: 10.1186/s12885-022-10234-x.

Prognostic value of preoperative C-reactive protein to albumin ratio in patients with thymic epithelial tumors: a retrospective study

Yang-Yu Huang #  1   2 , Xuan Liu #  1 , Shen-Hua Liang #  1 , Yu Hu  1 , Guo-Wei Ma  3
Affiliations

Prognostic value of preoperative C-reactive protein to albumin ratio in patients with thymic epithelial tumors: a retrospective study

Yang-Yu Huang et al. BMC Cancer. .

Abstract

Background: The C-reactive protein to albumin ratio (CAR) is associated with poor prognosis in various cancers. However, its value in thymic epithelial tumors remains to be elucidated, we aimed to evaluate the prognostic significance of preoperative CAR in patients with surgically resected thymic epithelial tumors (TETs).

Methods: We retrospectively collected data from 125 patients with TETs who underwent thymoma resection at our center. The best cutoff values ​​for the continuous variable, CAR, were obtained using X-tile software. Univariate and multivariate Cox regression analyses were used to evaluate CAR as an independent predictor of overall survival (OS) and recurrence-free survival (RFS). Kaplan-Meier analysis and log-rank tests were used to present risk stratification of patients based on CAR and the Glasgow-prognostic-score (GPS). The prognostic effect of CAR was assessed using a receiver operating characteristic curve.

Results: Patients were categorized into high (≥ 0.17) and low (< 0.17) CAR groups according to the optimal cutoff value of 0.17. Univariate and multivariate analyses showed that CAR was an independent predictor of prognosis. World health organization stage, CAR level, GPS score, and drinking history were important independent prognostic factors for OS (p < 0.05). T stage, CAR level, and drinking history were important independent prognostic factors for RFS (p < 0.05). The area under the curve value of CAR to predict prognosis was 0.734 for OS and 0.680 for RFS.

Conclusions: Elevated preoperative CAR was independently associated with poor OS and RFS after thymectomy. Therefore, CAR may be a valuable biomarker for the postoperative prognosis of TETs.

Keywords: C-reactive protein to albumin ratio; Overall survival; Prognostic factor; Recurrence free survival; Thymic epithelial tumors.

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Conflict of interest statement

The authors disclose no conflicts of interest.

Figures

Fig. 1
Fig. 1
KM analysis of CAR (A) and GPS (B) based on overall survival
Fig. 2
Fig. 2
KM analysis of CAR (A) and GPS (B) based on relapse-free survival
Fig. 3
Fig. 3
Receiver operating characteristic curve analysis for the sensitivity and specificity of the CAR and GPS based on overall survival (A) and relapse survival (B)
See this image and copyright information in PMC

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Supplementary concepts