Prognostic value of the C-reactive protein to albumin ratio in patients with colorectal cancer undergoing adjuvant chemotherapy / 中国综合临床

ABSTRACT

Objective:To evaluate the prognostic value of C-reactive protein (CRP) to albumin ratio (CAR) before and after adjuvant chemotherapy for colorectal cancer.Methods:From February 2013 to March 2014, the clinical data of 248 patients underwent radical resection of colorectal cancer combined with postoperative adjuvant chemotherapy in Department of Gastroenterology Surgery of the Affiliated Hospital of Southwest Medical University were retrospectively analyzed.The patients were followed up every 3 months within 2 years, once every six months after three years, and the deadline for follow-up was March 2019.Receiver operating characteristic (ROC) and Cox risk assessment were analyzed before, after and after chemotherapy.The optimal cut-off points of CAR before and after adjuvant chemotherapy were obtained by ROC curve. According to the optimal cut-off point, the patients were divided into high CAR group before chemotherapy and low CAR group before chemotherapy, high CAR group after chemotherapy and low CAR group after chemotherapy. The relationship between CAR and clinicopathological features and survival was compared before and after chemotherapy.Results:There was a positive correlation between CAR before adjuvant chemotherapy(0.23±0.05) and after chemotherapy (0.31±0.07) (r 0.382, P<0.001). Combined analysis of car before and after adjuvant chemotherapy the ROC curve area of CAR was 0.808, the sensitivity and specificity were 79.3% and 78.5%, respectively, which was higher than those of CAR before chemotherapy alone (the area under the curve was 0.776, the sensitivity and specificity were 78.1% and 66.2%, respectively, z=1.675, P<0.001) and CAR after chemotherapy (the area under the curve was 0.699, the sensitivity and specificity were 76.5% and 53.8%, Z=3.361, P<0.001). Cox risk assessment model single factor analysis and multivariate analysis showed that high CAR before chemotherapy ( HR=2.853, 95% CI 2.021-4.029, P<0.001) and and after chemotherapy ( HR=2.165, 95% CI 1.890-2.565, P<0.001) were independent risk factors for colorectal cancer prognosis. Conclusion:The combined detection of CAR before and after adjuvant chemotherapy is valuable in evaluating the prognosis of colorectal cancer.