Abstract
PurposeTo investigate the association between C-reactive protein/albumin ratio (CAR), an inflammation-based prognostic score, and clinicopathological factors, as well as its association with long-term outcomes in patients with operable non-small cell lung cancer (NSCLC).MethodsA total of 617 operable NSCLC patients were retrospectively evaluated and the data of preoperative serum CRP and serum albumin was collected. The correlation between the CAR and clinicopathological factors was analyzed using the chi-square test. A Cox proportional hazards regression model was performed to evaluate the association between the CAR and outcome.ResultsThe CAR was significantly related to sex, smoking status, BMI, histology type and clinical stage (p = 0.05). The patients with characteristic of male, smoker, BMI under 18.5, squamous cell carcinoma or clinical stage III had a high level of CAR. Additionally, elevated CAR indicated a worse outcome, and the patients with higher CAR had 2.02-fold risk for disease progression (95% CI 1.48-2.74, p < 0.001) and 2.61-fold risk for death (95 % CI 2.02-3.37, p < 0.001). Multivariate analyses showed the similar results after adjusted by clinicopathological factors and another four inflammation-based prognostic scores.ConclusionsThe CAR is a potential independent predictor for disease progression and death in patients with operable NSCLC.
Highlights
As the most common malignant tumor in the world, lung cancer remains a leading cause of cancer-related mortality [1]
The C-reactive protein/albumin ratio (CAR) was significantly related to sex, smoking status, body mass index (BMI), histology type and clinical stage (p ≤ 0.05)
The patients with characteristic of male, smoker, BMI under 18.5, squamous cell carcinoma or clinical stage III had a high level of CAR
Summary
As the most common malignant tumor in the world, lung cancer remains a leading cause of cancer-related mortality [1]. Non-small cell lung cancer (NSCLC) consists of approximately 85 % of primary lung cancer [2]. In spite of advances in early detection and diverse treatments, the outcomes of NSCLC patients are still poor, with the 5-year overall survival rate being 18.2 % [2]. It is important to identify promising prognostic biomarkers to help tailor the most beneficial treatment for NSCLC patients. Growing evidence indicates that the systemic inflammatory response substantially contributes to the tumor initiation and progression, and it is related to a poor prognosis in many tumors [3,4,5,6]. The clinical and prognostic values of a number of inflammation-based prognostic scores, including Glasgow prognostic score (GPS), modified GPS (mGPS), neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR), have been validated in many types of cancer [4, 7, 8]
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