title: Prognostic significance of preoperative C-reactive protein: albumin ratio in patients with clear cell renal cell carcinoma.
abstract: We undertook a retrospective analysis to evaluate the C-reactive protein/albumin (CRP/Alb) ratio for its prognostic value in patients with clear cell renal cell carcinoma (CCRCC). The study comprised 406 CCRCC patients undergoing nephrectomy between 2003 and 2012 in our hospital. The correlations among the pretreatment CRP/Alb ratio, clinicopathological parameters, and overall survival (OS) were evaluated. An elevated CRP/Alb ratio was associated with older age at surgery (P=0.007), more advanced TNM stage (P<0.001), more presence of tumor necrosis (P<0.001) and lymphovascular invasion (P<0.001), lower concentration of hemoglobin (P<0.001) and calcium (P=0.005), and shorter OS (P<0.001). The multivariate analysis confirmed that the CRP/Alb ratio independently predicted the OS of patients with CCRCC (P<0.001), the Glasgow Prognostic Score (GPS) (P=0.001) and modified GPS (mGPS) (P=0.019) were independent prognostic factors also. At last, we evaluated the prognostic value of the CRP/Alb ratio compared with the similar inflammation-based prognostic scores GPS and mGPS using the area under the curve (AUC). Although the differences were not statistically significant, the AUC value of the CRP/Alb ratio (continuous, categorical) was higher compared with the GPS and mGPS, except that the AUC value for the CRP/Alb ratio (categorical) at 3 years was lower than that for the GPS. The CRP/Alb ratio could take the place of the GPS and mGPS in terms of predicting prognosis in CCRCC.
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University Changzhou 213003, P. R. China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, The Third Affiliated Hospital of Soochow University Changzhou 213003, P. R. China.
authors.forename: Yingjie
authors.initials: Y
authors.lastname: Shao
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University Changzhou 213003, P. R. China.
authors.forename: Min
authors.initials: M
authors.lastname: Fan
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University Changzhou 213003, P. R. China.
authors.forename: Qianfeng
authors.initials: Q
authors.lastname: Zhuang
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University Changzhou 213003, P. R. China.
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University Changzhou 213003, P. R. China.
authors.forename: Wei
authors.initials: W
authors.lastname: Cao
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University Changzhou 213003, P. R. China.
authors.forename: Xianlin
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Urology, The Third Affiliated Hospital of Soochow University Changzhou 213003, P. R. China.
authors.forename: Xiaozhou
authors.initials: X
authors.lastname: He
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis* / Q000378:metabolism; D002292:Carcinoma, Renal Cell / Q000097:blood / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000473:pathology; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D012709:Serum Albumin; D002097:C-Reactive Protein
keywords: C-reactive protein; Clear cell renal cell carcinoma; albumin; prognosis
references.citation: Br J Cancer. 2012 Jan 17;106(2):279-83
references.pmid: 22166802
references.citation: Urol Oncol. 2014 Jan;32(1):30.e23-8
references.pmid: 23428539
references.citation: Ann Surg Oncol. 2016 Jan;23(1):321-7
references.pmid: 26045392
references.citation: Mol Aspects Med. 2015 Nov;45:28-36
references.pmid: 25936279
references.citation: World J Urol. 2015 Dec;33(12):2045-52
references.pmid: 25894368
references.citation: Urol Oncol. 2011 Nov-Dec;29(6):738-44
references.pmid: 19914106
references.citation: Med Oncol. 2014 Mar;31(3):841
references.pmid: 24477648
references.citation: Br J Cancer. 2015 Aug 11;113(4):626-33
references.pmid: 26135896
references.citation: Cancer. 2005 Aug 1;104(3):511-20
references.pmid: 15973740
references.citation: Br J Cancer. 2011 Feb 15;104(4):726-34
references.pmid: 21266974
references.citation: BMC Cancer. 2015;15:350
references.pmid: 25934640
references.citation: Br J Cancer. 2013 Mar 5;108(4):901-7
references.pmid: 23385728
references.citation: Ann Surg Oncol. 2015 Mar;22(3):803-10
references.pmid: 25190127
references.citation: Clin Med (Lond). 2009 Feb;9(1):30-3
references.pmid: 19271597
references.citation: Nat Rev Cancer. 2013 Nov;13(11):759-71
references.pmid: 24154716
references.citation: Asia Pac J Clin Oncol. 2015 Dec;11(4):288-92
references.pmid: 25871569
references.citation: PLoS One. 2013;8(3):e59321
references.pmid: 23555017
references.citation: PLoS One. 2015;10(6):e0128540
references.pmid: 26075713
references.citation: Lancet. 2001 Feb 17;357(9255):539-45
references.pmid: 11229684
references.citation: Future Oncol. 2010 Jan;6(1):149-63
references.pmid: 20021215
references.citation: Eur Urol. 2011 Oct;60(4):615-21
references.pmid: 21741761
references.citation: Cancer. 2007 Jan 15;109(2):205-12
references.pmid: 17149754
references.citation: Int J Urol. 2013 Feb;20(2):161-71
references.pmid: 22897628
references.citation: World J Surg Oncol. 2015;13:194
references.pmid: 26040932
references.citation: Oncol Lett. 2015 Jan;9(1):125-130
references.pmid: 25435945
references.citation: Nature. 2008 Jul 24;454(7203):436-44
references.pmid: 18650914