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Review
. 2023 Jan 6:9:1056795.
doi: 10.3389/fsurg.2022.1056795. eCollection 2022.

Prognostic significance of preoperative C-reactive protein to albumin ratio in non-small cell lung cancer patients: A meta-analysis

Dingxiu He  1 , Yong Yang  1 , Yi Yang  1 , Xiaoqu Tang  1 , Kaisen Huang  2
Affiliations
Review

Prognostic significance of preoperative C-reactive protein to albumin ratio in non-small cell lung cancer patients: A meta-analysis

Dingxiu He et al. Front Surg. .

Abstract

Objective: We aimed to assess whether C-reactive protein to albumin ratio (CAR) is associated with the clinicopathology and prognosis of patients with non-small cell lung cancer (NSCLC) after surgery.

Methods: Several literature databases were searched for eligible studies in English and Chinese published before September 1, 2022, according to the inclusion and exclusion criteria. The pooled odds ratios (ORs) with 95% confidence interval (CI) were calculated to assess the association of CAR in lung cancer with clinicopathological characteristics including age, sex, smoking status, lymph node metastasis, and American Association of Cancer (AJCC) stage. The pooled hazard ratios (HRs) with 95% CI were calculated to assess the association of CAR with prognosis in lung cancer. Publication bias was assessed using Egger's test.

Results: Overall, 9 studies involving 3,359 NSCLC patients were included in this meta-analysis. The CAR was observed to be higher in males, smokers, and patients with lymph node metastasis and correlated with advanced AJCC stage but not with age. Moreover, a high CAR correlated with poor survival. No publication bias was observed in this meta-analysis.

Conclusions: CAR was observed to be a significant biomarker for prognosis and associated with clinicopathological characteristics in patients with NSCLC after surgery.

Keywords: c-reactive protein to albumin ratio; meta-analysis; non-small cell lung cancer; prognosis; surgery.

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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
Flow diagram of the literature selection process.
Figure 2
Figure 2
Forest plot of the CAR and clinicopathological characteristics. Forest plot evaluating the ORs of the correlation between CAR and (A) age, (B) sex, (C) smoking status, (D) lymph node metastasis, and (E) AJCC stage. OR, odds ratio; CAR, C-reactive protein to albumin ratio; AJCC, American Association of Cancer.
Figure 3
Figure 3
Forest plots evaluating the HRs of CAR in patients with lung cancer for (A) OS and (B) RFS. HR, hazard ratio; CAR, C-reactive protein to albumin ratio; OS, overall survival; RFS, recurrence-free survival.
Figure 4
Figure 4
Sensitivity analysis for (A) age, (B) sex, (C) smoking history, (D) lymph node metastasis, (E) AJCC stage, (F) OS, and (G) RFS. AJCC, American Association of Cancer; OS, overall survival; RFS, recurrence-free survival.
Figure 5
Figure 5
Egger's publication bias plot for (A) age, (B) sex, (C) smoking history, (D) lymph node metastasis, (E) AJCC stage, (F) OS, and (G) RFS. AJCC, American Association of Cancer; OS, overall survival; RFS, recurrence-free survival.
See this image and copyright information in PMC

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