title: A novel inflammation-based prognostic score for patients with esophageal squamous cell carcinoma: the c-reactive protein/prognostic nutritional index ratio.
abstract: BACKGROUND
  Inflammation plays a critical role in cancer prognosis. In the current study, we proposed a novel inflammation-based prognostic score, named c-reactive protein/prognostic nutritional index ratio (CRP/PNI ratio), for predicting the prognosis for patients with resectable esophageal squamous cell carcinoma (ESCC).
  
  
  RESULTS
  The optimal cut-off value was 0.10 for CRP/PNI ratio according to the ROC curve. Patients with CRP/PNI ratio ≤0.10 had a significantly better 5-year CSS compared to CRP/PNI ratio >0.10 (44.5% vs. 15.7%, P<0.001). On multivariate analyses, we revealed that CRP/PNI ratio was a significant predictive factor of CSS (P=0.009). A nomogram could be more accuracy for CSS. The Harrell's c-index for CSS prediction was 0.688.
  
  
  METHODS
  A total of 308 patients with resectable ESCC were enrolled in this retrospective study. The optimal cuf-off value for CRP/PNI ratio was calculated by a receiver operating characteristic (ROC) curve. Kaplan-Meier methods were used to analyse the cancer-specific survival (CSS). Univariate and multivariate analyses were evaluated for CSS. A nomogram was also established to predict the prognosis for CSS.
  
  
  CONCLUSIONS
  The CRP/PNI ratio is a novel and useful prognostic score for CSS in patients with resectable ESCC.
authors.affiliation: Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, P.R.China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Chen
authors.affiliation: Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, P.R.China.
authors.forename: Xun
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, P.R.China.|Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou, P.R.China.
authors.forename: Ji-Feng
authors.initials: JF
authors.lastname: Feng
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000378:metabolism; D004938:Esophageal Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D000077277:Esophageal Squamous Cell Carcinoma; D005260:Female; D006801:Humans; D007249:Inflammation; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D049451:Nomograms; D015596:Nutrition Assessment; D009752:Nutritional Status; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein
keywords: c-reactive protein (CRP); cancer-specific survival (CSS); esophageal squamous cell carcinoma (ESCC); prognostic nutritional index (PNI)