J Korean Assoc Oral Maxillofac Surg.  2016 Oct;42(5):243-250. 10.5125/jkaoms.2016.42.5.243.

C-reactive protein/albumin ratio as prognostic score in oral squamous cell carcinoma

• Park HC
• Kim MY
• Kim CH

• KMID: 2356249
• DOI: http://doi.org/10.5125/jkaoms.2016.42.5.243

Abstract

OBJECTIVES
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).
MATERIALS AND 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.
CONCLUSION
The CRP/alb ratio can be an independent prognostic factor when predicting prognosis in OSCC and has good prognostic ability.

Keyword

Squamous cell carcinoma; C-reactive protein; Albumin

MeSH Terms

C-Reactive Protein
Carcinoma, Squamous Cell*
Epithelial Cells*
Humans
Inflammation
Lymph Nodes
Multivariate Analysis
Neoplasm Metastasis
Nutrition Assessment
Prognosis
Retrospective Studies
ROC Curve
Survival Rate
C-Reactive Protein

Figure

• 

  Fig. 1 The overall survival curves according to the pretreatment C-reactive protein/albumin (CRP/alb) ratio. Compared with a lower CRP/alb ratio, a ratio of >0.085 was associated with significantly worse overall survival (P<0.001).

• 

  Fig. 2 Comparison of area under the curve (AUC) for outcome prediction among the five inflammation-based prognostic scores at 6 months (A), 12 months (B), and 24 months (C) of follow-up. The overall survival curves according to the pretreatment CRP/alb ratio. Compared with a lower CRP/alb ratio, a ratio of >0.085 was associated with significantly worse overall survival (P<0.001). (NLR: neutrophil-lymphocyte ratio, PLR: platelet-lymphocyte ratio, CRP/alb: C-reactive protein/albumin, PNI: prognostic nutritional index, mGPS: modified Glasgow Prognostic Score)

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