title: C-reactive protein/albumin ratio as prognostic score in oral squamous cell carcinoma.
abstract: OBJECTIVE
  Many studies have examined histopathological factors and various prognostic scores related to inflammation to predict outcomes. Here, we examined the prognostic value of the C-reactive protein/albumin (CRP/alb) ratio in oral squamous cell carcinoma (OSCC).
  
  
  METHODS
  This retrospective study included 40 patients with OSCC. Using univariate and multivariate analyses, we focused on the correlation of the CRP/alb ratio with clinicopathological characteristics and with overall survival. We then compared five inflammation-based prognostic scores, CRP/alb ratio, modified Glasgow Prognostic Score (mGPS), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and prognostic nutritional index (PNI), based on receiver operating characteristic (ROC) curves.
  
  
  RESULTS
  The optimal cut-off value for the CRP/alb ratio was 0.085. The group with a high CRP/alb ratio had a high TNM clinical stage (P=0.002) and larger primary tumors (P=0.029), with statistically significant differences in lymph node metastasis and distant metastasis. In addition, when the CRP/alb ratio was high, multivariate analysis showed a lower survival rate (P=0.002; hazard ratio=6.078), and the ROC curve showed more outstanding discriminatory ability regarding overall survival compared to other inflammation-based prognostic scores.
  
  
  CONCLUSIONS
  The CRP/alb ratio can be an independent prognostic factor when predicting prognosis in OSCC and has good prognostic ability.
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea.
authors.forename: Heung-Chul
authors.identifier: 0000-0003-3821-5149
authors.initials: HC
authors.lastname: Park
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea.
authors.forename: Moon-Young
authors.identifier: 0000-0001-9596-7481
authors.initials: MY
authors.lastname: Kim
authors.affiliation: Department of Oral and Maxillofacial Surgery, College of Dentistry, Dankook University, Cheonan, Korea.
authors.forename: Chul-Hwan
authors.identifier: 0000-0002-5199-2420
authors.initials: CH
authors.lastname: Kim
keywords: Albumin; C-reactive protein; Squamous cell carcinoma