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BMC Cancer
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Research article

The prognostic value of the preoperative c-reactive protein/albumin ratio in ovarian cancer

Authors: Yubo Liu, Shengfu Chen, Chengyu Zheng, Miao Ding, Lan Zhang, Liangan Wang, Meiqing Xie, Jianhua Zhou

Published in: BMC Cancer | Issue 1/2017

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Abstract

Background

Inflammation plays an important role in the pathogenesis of ovarian cancer. This study sought to investigate the association between the preoperative c-reactive protein/albumin ratio (CRP/Alb) and oncological outcomes in ovarian cancer patients.

Methods

Two hundred patients with histologically verified ovarian cancer between June 2006 and July 2012 were retrospectively reviewed. Overall survival was evaluated by the Kaplan–Meier method and log-rank test. The significance of risk factors for overall survival was evaluated with the Cox proportional hazards model. Additionally, area under the receiver operating characteristic curve (AUC) was used to compare the predictive ability of CRP/Alb, Glasgow Prognostic Score (GPS), modified GPS (mGPS), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), prognostic index (PI) and prognostic nutritional index (PNI).

Results

The optimal cutoff value of CRP/Alb was 0.68. Increased CRP/Alb (≥0.68) was associated with advanced stage, residual tumor, ascites, elevated serum carbohydrate antigen(CA)-125 level, GPS, and mGPS (all p < 0.05). Patients with high CRP/Alb had poor overall survival compared to those with low CRP/Alb (p < 0.001). Multivariable analysis showed that CRP/Alb (Hazard Ratio (HR) 1.330, 95% confidence interval (CI) 1.131–1.564, p = 0.001), tumor stage (HR 1.577, 95% CI 1.189–2.091, p = 0.002), residual tumor (HR 2.337, 95% CI 1.518–3.597, p < 0.001) and age (HR 1.017, 95% CI 1.000–1.035, p = 0.046) were independent prognostic factors for overall survival. Additionally, the CRP/Alb showed greater AUC values at 1 year (0.692), 3 years (0.659), and 5 years (0.682) than GPS, mGPS and PNI.

Conclusions

The CRP/Alb is a novel independent marker of poor prognosis among ovarian cancer patients and shows superior prognostic ability compared to the established inflammation-based prognostic indices.
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Metadata
Title
The prognostic value of the preoperative c-reactive protein/albumin ratio in ovarian cancer
Authors
Yubo Liu
Shengfu Chen
Chengyu Zheng
Miao Ding
Lan Zhang
Liangan Wang
Meiqing Xie
Jianhua Zhou
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3220-x

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