C-reactive protein/albumin ratio is a poor prognostic factor of esophagogastric junction and upper gastric cancer

J Gastroenterol Hepatol. 2019 Feb;34(2):355-363. doi: 10.1111/jgh.14442. Epub 2018 Sep 6.

Abstract

Background and aim: The C-reactive protein (CRP)/albumin (Alb) ratio has been reported as a novel prognostic marker in several cancers. The objective of this study was to investigate the prognostic value of the CRP/Alb ratio in patients who underwent surgery for adenocarcinoma of the esophagogastric junction (AEG) and upper gastric cancer (UGC).

Methods: Data for 144 patients who underwent surgery for AEG and UGC were reviewed. The CRP/Alb ratio, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, Glasgow Prognostic Score, and controlling nutritional status score were calculated, and the relationship between these biomarkers and postoperative prognosis was analyzed.

Results: The optimal cutoff value of the CRP/Alb ratio was determined to be 0.1. According to the cutoff value of CRP/Alb ratio, patients were divided into two groups (CRP/Alb < 0.1, n = 124; CRP/Alb ≥ 0.1, n = 20). The 5-year recurrence-free survival and overall survival (OS) rates were significantly lower in the patients with the CRP/Alb ratio ≥ 0.1 than in those with the CRP/Alb ratio < 0.1 (recurrence-free survival: 44.9% vs 77.9%, P = 0.0011; OS: 43.4% vs 82.0%, P < 0.0001). In the multivariate analyses, the N-stage, and CRP/Alb ratio ≥ 0.1 were identified as independent predictive factors for OS in patients with AEG and UGC (P = 0.0061 and P = 0.0439, respectively).

Conclusions: The CRP/Alb ratio was strongly associated with poor prognosis in patients who underwent surgery for AEG and UGC.

Keywords: C-reactive protein/albumin ratio; adenocarcinoma of esophagogastric junction; gastric cancer.

MeSH terms

  • Adenocarcinoma / blood*
  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood*
  • C-Reactive Protein / analysis*
  • Esophageal Neoplasms / blood*
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery
  • Esophagogastric Junction* / pathology
  • Esophagogastric Junction* / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Predictive Value of Tests
  • Progression-Free Survival
  • Retrospective Studies
  • Serum Albumin, Human / analysis*
  • Stomach Neoplasms / blood*
  • Stomach Neoplasms / mortality
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery
  • Time Factors

Substances

  • Biomarkers, Tumor
  • C-Reactive Protein
  • Serum Albumin, Human

Supplementary concepts

  • Adenocarcinoma Of Esophagus