title: Prognostic Value of the CRP/Alb Ratio, a Novel Inflammation-Based Score in Pancreatic Cancer.
abstract: BACKGROUND
  The C-reactive protein/albumin (CRP/Alb) ratio is associated with outcome in septic patients. However, as an inflammation-based score, its prognostic value for cancer has scarcely been investigated.
  
  
  METHODS
  Between February 2010 and January 2015, we enrolled 386 patients with pancreatic ductal adenocarcinoma. Univariate and multivariate survival analysis between the groups were evaluated. Receiver operating characteristics curves were generated and areas under the curve (AUC) were compared to evaluate the discriminatory ability of the inflammation-based prognostic scoring systems, including CRP/Alb ratio, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and modified Glasgow prognostic score (mGPS).
  
  
  RESULTS
  The optimal cutoff level of the CRP/Alb ratio was defined as 0.180. The prognosis of patients with CRP/Alb ratio ≥0.180 was significantly worse than CRP/Alb ratio <0.180 in univariate analysis (p < 0.001). In multivariate analysis, the CRP/Alb ratio was still associated with overall survival (p < 0.001). In addition, the CRP/Alb ratio had significantly higher AUC values compared with PLR (6, 12, and 24 months: p < 0.001, 0.017, 0.012) and mGPS (6, 12, and 24 months: p = 0.002, 0.020, 0.046) and had similar AUC values to NLR (6, 12, and 24 months: p = 0.052, 0.139, 0.041).
  
  
  CONCLUSIONS
  The current study demonstrated the CRP/Alb ratio may serve as a significant and promising inflammatory prognostic score in pancreatic cancer. An elevated CRP/Alb ratio is an independent factor for poor prognosis with the cutoff value of 0.180.
authors.affiliation: Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.
authors.forename: Zuqiang
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.
authors.forename: Kaizhou
authors.initials: K
authors.lastname: Jin
authors.affiliation: Pancreatic Cancer Institute, Fudan University, Shanghai, People's Republic of China.
authors.forename: Meng
authors.initials: M
authors.lastname: Guo
authors.affiliation: Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.|Pancreatic Cancer Institute, Fudan University, Shanghai, People's Republic of China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Long
authors.affiliation: Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.|Pancreatic Cancer Institute, Fudan University, Shanghai, People's Republic of China.
authors.forename: Liang
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.|Pancreatic Cancer Institute, Fudan University, Shanghai, People's Republic of China.
authors.forename: Chen
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.|Pancreatic Cancer Institute, Fudan University, Shanghai, People's Republic of China.
authors.forename: Jin
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China.|Pancreatic Cancer Institute, Fudan University, Shanghai, People's Republic of China.
authors.forename: Quanxing
authors.initials: Q
authors.lastname: Ni
authors.affiliation: Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. luoguopei@hotmail.com.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China. luoguopei@hotmail.com.|Pancreatic Cancer Institute, Fudan University, Shanghai, People's Republic of China. luoguopei@hotmail.com.
authors.forename: Guopei
authors.initials: G
authors.lastname: Luo
authors.affiliation: Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China. yuxianjun@fudanpci.org.|Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China. yuxianjun@fudanpci.org.|Pancreatic Cancer Institute, Fudan University, Shanghai, People's Republic of China. yuxianjun@fudanpci.org.
authors.forename: Xianjun
authors.initials: X
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D021441:Carcinoma, Pancreatic Ductal / Q000150:complications* / Q000556:secondary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D008207:Lymphatic Metastasis; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000473:pathology; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism*; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D012709:Serum Albumin; D002097:C-Reactive Protein