BACKGROUND Over the years,programmed cell death-1(PD-1)inhibitors have been routinely used for hepatocellular carcinoma(HCC)treatment and yielded improved survival outcomes.Nonetheless,significant heterogeneity surrou...BACKGROUND Over the years,programmed cell death-1(PD-1)inhibitors have been routinely used for hepatocellular carcinoma(HCC)treatment and yielded improved survival outcomes.Nonetheless,significant heterogeneity surrounds the outcomes of most studies.Therefore,it is critical to search for biomarkers that predict the efficacy of PD-1 inhibitors in patients with HCC.AIM To investigate the role of the C-reactive protein to albumin ratio(CAR)in evaluating the efficacy of PD-1 inhibitors for HCC.METHODS The clinical data of 160 patients with HCC treated with PD-1 inhibitors from January 2018 to November 2022 at the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed.RESULTS The optimal cut-off value for CAR based on progression-free survival(PFS)was determined to be 1.20 using x-tile software.Cox proportional risk model was used to determine the factors affecting prognosis.Eastern Cooperative Oncology Group performance status[hazard ratio(HR)=1.754,95%confidence interval(95%CI)=1.045-2.944,P=0.033],CAR(HR=2.118,95%CI=1.057-4.243,P=0.034)and tumor number(HR=2.932,95%CI=1.246-6.897,P=0.014)were independent prognostic factors for overall survival.CAR(HR=2.730,95%CI=1.502-4.961,P=0.001),tumor number(HR=1.584,95%CI=1.003-2.500,P=0.048)and neutrophil to lymphocyte ratio(HR=1.120,95%CI=1.022-1.228,P=0.015)were independent prognostic factors for PFS.Two nomograms were constructed based on independent prognostic factors.The C-index index and calibration plots confirmed that the nomogram is a reliable risk prediction tool.The ROC curve and decision curve analysis confirmed that the nomogram has a good predictive effect as well as a net clinical benefit.CONCLUSION Overall,we reveal that the CAR is a potential predictor of short-and long-term prognosis in patients with HCC treated with PD-1 inhibitors.If further verified,CAR-based nomogram may increase the number of markers that predict individualized prognosis.展开更多
Objective C-reactive protein(CRP)/albumin ratio(CAR)is a new inflammation-based index for predicting the prognosis of various diseases.The CAR determined on admission may help to predict the prognostic value of multip...Objective C-reactive protein(CRP)/albumin ratio(CAR)is a new inflammation-based index for predicting the prognosis of various diseases.The CAR determined on admission may help to predict the prognostic value of multiple trauma patients.Methods A total of 264 adult patients with severe multiple trauma were included for the present retrospective study,together with the collection of relevant clinical and laboratory data.CAR,CRP,albumin,shock index and ISS were incorporated into the prognostic model,and the receiver operating characteristic(ROC)curve was drawn.Then,the shock index for patients with different levels of CAR was analyzed.Finally,univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for the 28-day mortality of multiple trauma patients.Results A total of 36 patients had poor survival outcomes,and the mortality rate reached 13.6%.Furthermore,after analyzing the shock index for patients with different levels of CAR,it was revealed that the shock index was significantly higher when CAR was≥4,when compared to CAR<2 and 2≤CAR<4,in multiple trauma patients.The multivariate logistic analysis helped to identify the independent association between the variables CAR(P=0.029)and shock index(P=0.019),and the 28-day mortality of multiple trauma patients.Conclusion CAR is higher in patients with severe multiple trauma.Furthermore,CAR serves as a risk factor for independently predicting the 28-day mortality of multiple trauma patients.The shock index was significantly higher when CAR was≥4 in multiple trauma patients.展开更多
Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Metho...Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Methods One hundred and fourteen patients diagnosed with extranodal NK/T cell lymphoma at Sichuan Cancer Hospital from September 2011 to November 2016 were retrospectively reviewed. An optimal cutoff value of CRP/Alb for overall survival rate as an endpoint was obtained using the receiver operating curve (ROC). Results The optimal cutoff value of CRP/Alb was 0.15. For the low CRP/Alb group, the 3-year progression-free survival (PFS) was 78.6% and the 3-year overall survival (OS) was 80.7%. The 3-year PFS and OS values for the high CRP/Alb group were 41.6% and 45.2%, respectively. Differences for PFS (P < 0.001) and OS (P < 0.001) between the two groups were statistically significant. Univariate analysis showed that ECOG, IPI, CRP, GPS, and CRP/Alb were significantly associated with PFS. Similarly, all five were also significantly associated with OS. Multivariate analysis further confirmed that ECOG and CRP/ Alb were independent prognostic factors for both PFS and OS. Moreover, the cutoff value of CRP/Alb showed superior prognostic ability in discriminating between patients with different outcomes in low-risk group based on GPS, IPI, and KPI scores. Conclusion CRP/Alb is a promising prognostic marker for early-stage extranodal NK/T cell lymphoma.展开更多
Objective:To investigate the application of heparin-binding protein along with albumin(HBP+ALB)in evaluating the severity of community-acquired pneumonia(CAP)and compares it with single HBP,white blood cells(WBCs),C-r...Objective:To investigate the application of heparin-binding protein along with albumin(HBP+ALB)in evaluating the severity of community-acquired pneumonia(CAP)and compares it with single HBP,white blood cells(WBCs),C-reactive protein(CRP),and procalcitonin(PCT).Methods:A total of 226 patients with CAP admitted to the Emergency Department of Zhujiang Hospital,Southern Medical University,Guangdong,China,between March 1,2021,and March 1,2022,were enrolled.The patients were grouped into two groups:mild CAP(n=175)and severe CAP(sCAP)(n=51).Patients'characteristics and laboratory data were obtained.ROC curve and the value of the area under the curve(AUC)were used to evaluate the predictive values of HBP,ALB,WBC,CRP,and PCT.Results:WBC count,CRP,PCT,HBP,creatinine,and D-dimer were higher in the sCAP group,while ALB was lower in the sCAP group(P<0.05)than those in the mild CAP group.The AUCs of WBC,CRP,PCT,HBP,and HBP+ALB were 0.633(95%CI:0.545-0.722,P<0.05),0.635(95%CI:0.542-0.729,P<0.05),0.705(95%CI:0.619-0.791,P<0.05),0.809(95%CI:0.736-0.883,P<0.05),and 0.889(95%CI:0.842-0.936,P<0.05),respectively.Conclusions:HBP+ALB has a higher predictive value than single HBP,PCT,CRP and WBC used alone for the early assessment of CAP.展开更多
Background: C-reactive protein to albumin ratio(CRP/Alb ratio,CAR)has been suggested as a potential prognostic biomarker in lung cancer.This updated systematic review and meta-analysis aimed to assess the association ...Background: C-reactive protein to albumin ratio(CRP/Alb ratio,CAR)has been suggested as a potential prognostic biomarker in lung cancer.This updated systematic review and meta-analysis aimed to assess the association between CAR and lung cancer prognosis in current literature.Methods: A systematic search of databases was conducted to identify relevant studies published up to April 2023.Pooled hazard ratios(HRs)and 95%confidence intervals(CIs)were calculated to assess the association between CAR and overall survival(OS)and progression-free survival(PFS)and recurrence-free survival(RF)in lung cancer patients.Results: This meta-analysis includes 16 studies with a total of 5337 patients,indicating a significant association between higher CAR and poorer OS,PFS,and RFS in lung cancer patients,with a pooled HR of 1.78(95%CI=1.60-1.99),1.57(95%CI=1.36-1.80),and 1.97(95%CI=1.40-2.77),respectively.Conclusions: This updated meta-analysis provides evidence for the potential prognostic role of CAR in lung cancer,suggesting its utility as an effective and noninvasive biomarker for identifying high-risk patients and informing treatment decisions in a cost-effective manner.However,further large-scale studies will be necessary to establish the optimal cut-off value for CAR in lung cancer and confirm the present findings.展开更多
Background Serum high sensitive C-reactive protein （hs-CRP）, adiponectin levels and urine albumin excretion rate （UAER） are probably associated with inflammation and atherosclerosis. The aim of this study was to d...Background Serum high sensitive C-reactive protein （hs-CRP）, adiponectin levels and urine albumin excretion rate （UAER） are probably associated with inflammation and atherosclerosis. The aim of this study was to determine the three markers in coronary artery disease （CAD） subjects with different glucose tolerance status in a Chinese population and further explore the levels of the three markers in these subjects and the possible association of these markers with CAD risk factors and the severity of CAD as well. Methods A total of 242 subjects with angiographically documented CAD were recruited, and then assigned to three groups： the normal glucose tolerance （NGT） ＋ CAD group, including 100 CAD patients with NGT; the impaired glucose tolerance （IGT） ＋ CAD group, 40 CAD patients with IGT; the type 2 diabetes mellitus （T2DM） ＋ CAD group, 102 CAD patients with T2DM. Serum hs-CRP, adiponectin levels as well as UAER were measured in all subjects. Results Serum hs-CRP levels were increased in the T2DM ＋ CAD group compared with the NGT ＋ CAD group （4.71±2.59） vs （3.60±2.46） mg/L, P=0.037. Serum adiponectin levels were gradually decreased from the NGT ＋ CAD to IGT ＋ CAD to T2DM ＋ CAD groups, （5.99±1.84）, （5.82±1.72） and （4.65±1.71） mg/L, P=0.002 and 0.040 for NGT ＋ CAD and IGT ＋ CAD groups vs T2DM ＋ CAD group, respectively. While the UAER was gradually increased from the NGT ＋ CAD to IGT ＋ CAD to T2DM ＋ CAD groups, （6.42±2.51）, （6.89±2.94） and （15.03±4.22） μg/min （P 〈0.001） for NGT ＋ CAD and IGT ＋ CAD groups vs T2DM ＋ CAD group. Multiple linear stepwise regression analysis showed that waist-hip ratio （WHR） and low density lipoprotein cholesterol （LDL-C） were the significant determinants of serum hs-CRP levels; triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, age, WHR, T2DM, 2-hour serum insulin （2hINS）, sex, and apolipoprotein B were the significant determinants of serum adiponectin levels; and systolic blood pressure （SBP）, T2DM and hemoglobin A1c （HbA1c） were the significant determinants of UAER in all subjects （R^2= 0.070, 0.352, and 0.214, respectively）. However, no significant correlation was seen for hs-CRP, adiponectin and UAER with the severity of CAD. Hs-CRP levels were significantly correlated with UAER. Conclusions There was a trend of increased serum hs-CRP levels from the NGT ＋ CAD to IGT ＋ CAD to T2DM ＋ CAD groups, though it only showed significance in the T2DM ＋ CAD group compared with the NGT ＋ CAD group. Serum adiponectin levels were decreased and UAER was increased from the NGT ＋ CAD to IGT ＋ CAD to T2DM ＋ CAD groups Increased UAER and serum hs-CRP, and decreased adiponectin levels were associated with traditional CAD risk factors but failed to be correlated with the severity of CAD. Hs-CRP levels were significantly correlated with UAER.展开更多
Background Evidences show that subclinical chronic inflammation is involved in the pathogenesis of diabetic nephropathy. The aim of this study was to examine the relationship between serum C-reactive protein （CRP）, ...Background Evidences show that subclinical chronic inflammation is involved in the pathogenesis of diabetic nephropathy. The aim of this study was to examine the relationship between serum C-reactive protein （CRP）, serum uric acid, and albuminuria in Chinese type 2 diabetic patients.展开更多
Background Syntax score(SS),an angiographic tool to grade the complexity of coronary artery disease,has prognostic importance for this disease. C-reactive protein(CRP)and albumin are indicators of inflammation.And bot...Background Syntax score(SS),an angiographic tool to grade the complexity of coronary artery disease,has prognostic importance for this disease. C-reactive protein(CRP)and albumin are indicators of inflammation.And both of them are associated with high SS. Hence,we aimed to investigate whether baseline CRP to albumin ratio(CAR)is associated with SS. Method A total of 312 consecutive patients with stable angina pectoris,who underwent coronary angiography for suspected coronary artery disease(CAD)from January 2018 to May 2019,were classified into two groups,low score group(syntax score≤22)and high score group(syntax group>22).The Multivariate logistic analysis and ROC curve were performed to detect the predictive effect of CAR for higher SS. Results There are 163 cases in the low score group while 149 cases in the high score group. CAR in the high score group was significantly higher than the other group(5.6[2.8-9.6]vs. 2.5[1.7-5.2],P<0.01). In multivariate logistic regression analysis,CAR was proved to be an independent predictor for high syntax score. ROC curve analyses reveal the good predictive values of CAR(AUC 0.731,95% CI:0.608-0.814,P<0.01)for high syntax score and statistical significant better than CRP or albumin alone. Conclusions CAR is independently associated with the complexity and severity of CAD,which has better predictive value than CRP or albumin alone.展开更多
BACKGROUND Colon cancer is one of the most common malignant tumors of the digestive system.Liver metastasis after colon cancer surgery is the primary cause of death in patients with colon cancer.AIM To construct a nov...BACKGROUND Colon cancer is one of the most common malignant tumors of the digestive system.Liver metastasis after colon cancer surgery is the primary cause of death in patients with colon cancer.AIM To construct a novel nomogram model including various factors to predict liver metastasis after colon cancer surgery.METHODS We retrospectively analyzed 242 patients with colon cancer who were admitted and underwent radical resection for colon cancer in Zhejiang Provincial People’s Hospital from December 2019 to December 2022.Patients were divided into liver metastasis and non-liver metastasis groups.Sex,age,and other general and clinicopathological data(preoperative blood routine and biochemical test indexes)were compared.The risk factors for liver metastasis were analyzed using singlefactor and multifactorial logistic regression.A predictive model was then constructed and evaluated for efficacy.RESULTS Systemic inflammatory index(SII),C-reactive protein/albumin ratio(CAR),red blood cell distribution width(RDW),alanine aminotransferase,preoperative carcinoembryonic antigen level,and lymphatic metastasis were different between groups(P<0.05).SII,CAR,and RDW were risk factors for liver metastasis after colon cancer surgery(P<0.05).The area under the curve was 0.93 for the column-line diagram prediction model constructed based on these risk factors to distinguish whether liver metastasis occurred postoperatively.The actual curve of the column-line diagram predicting the risk of postoperative liver metastasis was close to the ideal curve,with good agreement.The prediction model curves in the decision curve analysis showed higher net benefits for a larger threshold range than those in extreme cases,indicating that the model is safer.CONCLUSION Liver metastases after colorectal cancer surgery could be well predicted by a nomogram based on the SII,CAR,and RDW.展开更多
AIM: To evaluate the value of systemic inflammationbased markers as prognostic factors for advanced pancreatic cancer(PC). METHODS: Data from 82 patients who underwent combination chemotherapy with gemcitabine and erl...AIM: To evaluate the value of systemic inflammationbased markers as prognostic factors for advanced pancreatic cancer(PC). METHODS: Data from 82 patients who underwent combination chemotherapy with gemcitabine and erlotinib for PC from 2011 to 2014 were collected retrospectively. Data that included the neutrophil-to-lymphocyte ratio(NLR), the platelet-to-lymphocyte ratio, and the C-reactive protein(CRP)-to-albumin(CRP/Alb) ratio were analyzed. Kaplan-Meier curves, and univariate and multivariate Cox proportional hazards regression analyses were used to identify the prognostic factors associated with progression-free survival(PFS) and overall survival(OS). RESULTS: The univariate analysis demonstrated the prognostic value of the NLR(P = 0.049) and the CRP/Alb ratio(P = 0.047) in relation to PFS, and a positiverelationship between an increase in inflammation-based markers and a poor prognosis in relation to OS. The multivariate analysis determined that an increased NLR(hazard ratio = 2.76, 95%CI: 1.33-5.75, P = 0.007) is an independent prognostic factor for poor OS. There was no association between the PLR and the patients' prognoses in those who had received chemotherapy that comprised gemcitabine and erlotinib in combination. The Kaplan-Meier method and the log-rank test determined significantly worse outcomes in relation to PFS and OS in patients with an NLR > 5 or a CRP/Alb ratio > 5.CONCLUSION: Systemic inflammation-based markers, including increases in the NLR and the CRP/Alb ratio, may be useful for predicting PC prognoses.展开更多
Objective:The purpose of this study was to investigate the relationship between preoperative C-reactive protein/albumin ratio(CRP/ALB),platelet count and C-reactive protein product(P-CRP)and clinical prognosis in pati...Objective:The purpose of this study was to investigate the relationship between preoperative C-reactive protein/albumin ratio(CRP/ALB),platelet count and C-reactive protein product(P-CRP)and clinical prognosis in patients with non-small cell lung cancer.Methods:From January 2015 to December 2015,284 patients who underwent surgery for lung cancer in the First Affiliated Hospital of Bengbu Medical College were selected.According to their 3-year and 5-year survival conditions,ROC curves were drawn and the best cut-off value was determined.According to the cut-off value,the patients were divided into high CRP/ALB group,low CRP/ALB group,high P-CRP group and low P-CRP group.Survival curves were described by Kaplan-Meier method and compared by Log-rank test.The univariate and multivariate analyses were performed with the Cox proportional hazard model to evaluate the prognostic factors.Results:Survival analysis showed that there was no significant difference in 3-year survival rate between high CRP/ALB and P-CRP groups and low CRP/ALB and P-CRP groups,while the 5-year survival rate in high CRP/ALB and P-CRP groups was significantly lower than that in low CRP/ALB and P-CRP groups.Cox proportional hazard model showed that CRP/ALB,age,smoking history,lymph node metastasis and TNM stage were risk factors for 5-year survival rate.Conclusion:as a prognostic index based on inflammation,preoperative CRP/ALB level can better reflect the prognosis of patients than P-CRP.展开更多
<strong>Objective:</strong> To evaluate the clinical diagnostic value of C-reactive protein/albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR) and D-dimer (D-D) in patients with pulmonary thromboemboli...<strong>Objective:</strong> To evaluate the clinical diagnostic value of C-reactive protein/albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR) and D-dimer (D-D) in patients with pulmonary thromboembolism (PTE). <strong>Methods:</strong> We conducted a retrospective analysis comparing hematology and coagulation in 362 PTCA-confirmed PTE patients with the control group and analyzing their relationships with CAR, NLR, and D-D. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic threshold, area under the curve (AUC), diagnostic sensitivity and specificity of CAR, NLR and D-D for PTE. <strong>Results:</strong> 1) CAR, NLR and D-D levels in PTE patients were 2.13 ± 2.08, 8.96 ± 1.94 and 9.69 ± 8.61 respectively, significantly higher than those in control group (CAR = 0.03 ± 0.01, t = 20.7736, P < 0.01;NLR = 1.76 ± 0.53, t = 2.4281, P < 0.05 and PTE = 0.20 ± 0.11, t = 3.0066, P < 0.01 respectively). 2) NLR was positively correlated with CAR (r = 0.2111, t = 4.0971, P < 0.01) and D-D (r = 0.1065, t = 2.0481, P < 0.05), but CAR was not correlated with D-D (r = 0.0975, P > 0.05). 3) The levels of HB, LY, PLT and AT in PTE patients were significantly lower than those in control group, while WBC, NE and FB were significantly higher than those in control group. 4) CAR was negatively correlated with Hb and AT (P all < 0.01), but positively correlated with WBC, NE, MO and FB (P all < 0.01). NLR was negatively correlated with LY and AT (P all < 0.01), but positively correlated with WBC, NE and FB (P all < 0.01). DD was negatively correlated with Hb and PLT (P all < 0.05), but positively correlated with WBC, NE and MO (P all < 0.01). <strong>Conclusion:</strong> The levels of Hb, LY, PLT and AT were significantly decreased in PTE patients, while WBC, NE and FB were significantly increased. CAR, NLR and D-D were highly expressed in PTE patients, and were closely correlated with Hb, AT and FB. Combined detection of CAR, NLR and D-D can improve the diagnostic value of PTE.展开更多
Background:Studies investigating the nutritional status of patients with leprosy and plantar ulcers are sparse.Therefore,the objective of this study was to describe the protein profile of leprosy patients with plantar...Background:Studies investigating the nutritional status of patients with leprosy and plantar ulcers are sparse.Therefore,the objective of this study was to describe the protein profile of leprosy patients with plantar ulcers from the Eastern Amazon region.Methods:A case record form was created for 75 patients with leprosy(31 with plantar ulcers and 44 without plantar ulcers)with the following data:sociodemographic characteristics,clinical form of leprosy,presence or absence of plantar ulcers,and nutritional assessment using anthropometry consisting of the measurement of body mass index,arm circumference,arm muscle circumference,and triceps skinfold.Levels of blood albumin,transferrin,and C-reactive protein(CRP)were also measured.Data regarding protein intake were obtained using a Food Frequency Questionnaire.Results:Plantar ulcers occurred more frequently in male patients(67.7%),patients aged 40-49 years(mean±SD:47.3±8.0 years),and patients receiving 300 or 600 USD(71.0%).The mean weight and height of patients were 71.6±11.4 kg and 1.62±0.1 m,respectively.High levels of CRP were detected in 51.6%of leprosy patients with plantar ulcers and only 9.1%of patients without plantar ulcers(P<0.001).Nutritional depletion of transferrin was observed in 14.3%of patients with paucibacillary leprosy and 44.3%of patients with multibacillary leprosy(P=0.0447).Most patients had normal levels of serum albumin(74.2%with plantar ulcers and 77.3%without plantar ulcers).Conclusions:Most leprosy patients with plantar ulcers have normal levels of serum albumin and transferrin and high CRP levels,which indicates the presence of an inflammatory process.Our findings suggest the need to monitor patients with leprosy to prevent the occurrence of plantar ulcers and to provide adequate treatment for patients with existing plantar ulcers.展开更多
基金Supported by the Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor (Guangxi Medical University),Ministry of Education,No.GKE-ZZ202117 and No.GKE-ZZ202334.
文摘BACKGROUND Over the years,programmed cell death-1(PD-1)inhibitors have been routinely used for hepatocellular carcinoma(HCC)treatment and yielded improved survival outcomes.Nonetheless,significant heterogeneity surrounds the outcomes of most studies.Therefore,it is critical to search for biomarkers that predict the efficacy of PD-1 inhibitors in patients with HCC.AIM To investigate the role of the C-reactive protein to albumin ratio(CAR)in evaluating the efficacy of PD-1 inhibitors for HCC.METHODS The clinical data of 160 patients with HCC treated with PD-1 inhibitors from January 2018 to November 2022 at the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed.RESULTS The optimal cut-off value for CAR based on progression-free survival(PFS)was determined to be 1.20 using x-tile software.Cox proportional risk model was used to determine the factors affecting prognosis.Eastern Cooperative Oncology Group performance status[hazard ratio(HR)=1.754,95%confidence interval(95%CI)=1.045-2.944,P=0.033],CAR(HR=2.118,95%CI=1.057-4.243,P=0.034)and tumor number(HR=2.932,95%CI=1.246-6.897,P=0.014)were independent prognostic factors for overall survival.CAR(HR=2.730,95%CI=1.502-4.961,P=0.001),tumor number(HR=1.584,95%CI=1.003-2.500,P=0.048)and neutrophil to lymphocyte ratio(HR=1.120,95%CI=1.022-1.228,P=0.015)were independent prognostic factors for PFS.Two nomograms were constructed based on independent prognostic factors.The C-index index and calibration plots confirmed that the nomogram is a reliable risk prediction tool.The ROC curve and decision curve analysis confirmed that the nomogram has a good predictive effect as well as a net clinical benefit.CONCLUSION Overall,we reveal that the CAR is a potential predictor of short-and long-term prognosis in patients with HCC treated with PD-1 inhibitors.If further verified,CAR-based nomogram may increase the number of markers that predict individualized prognosis.
基金supported by Jiangsu Provincial Medical Innovation Center of Jiangsu Province Capability Improvement Project through Science,Technology and Education(No.CXZX202231)the Special Research Topic on Innovation of Hospital Management,Jiangsu Provincial Hospital Association(No.JSYGY-3-2021-JZ71).
文摘Objective C-reactive protein(CRP)/albumin ratio(CAR)is a new inflammation-based index for predicting the prognosis of various diseases.The CAR determined on admission may help to predict the prognostic value of multiple trauma patients.Methods A total of 264 adult patients with severe multiple trauma were included for the present retrospective study,together with the collection of relevant clinical and laboratory data.CAR,CRP,albumin,shock index and ISS were incorporated into the prognostic model,and the receiver operating characteristic(ROC)curve was drawn.Then,the shock index for patients with different levels of CAR was analyzed.Finally,univariate and multivariate logistic regression analyses were performed to identify the independent risk factors for the 28-day mortality of multiple trauma patients.Results A total of 36 patients had poor survival outcomes,and the mortality rate reached 13.6%.Furthermore,after analyzing the shock index for patients with different levels of CAR,it was revealed that the shock index was significantly higher when CAR was≥4,when compared to CAR<2 and 2≤CAR<4,in multiple trauma patients.The multivariate logistic analysis helped to identify the independent association between the variables CAR(P=0.029)and shock index(P=0.019),and the 28-day mortality of multiple trauma patients.Conclusion CAR is higher in patients with severe multiple trauma.Furthermore,CAR serves as a risk factor for independently predicting the 28-day mortality of multiple trauma patients.The shock index was significantly higher when CAR was≥4 in multiple trauma patients.
基金Supported by a grant from the Sichuan Health and Family Planning Commission(No.16PJ041)
文摘Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Methods One hundred and fourteen patients diagnosed with extranodal NK/T cell lymphoma at Sichuan Cancer Hospital from September 2011 to November 2016 were retrospectively reviewed. An optimal cutoff value of CRP/Alb for overall survival rate as an endpoint was obtained using the receiver operating curve (ROC). Results The optimal cutoff value of CRP/Alb was 0.15. For the low CRP/Alb group, the 3-year progression-free survival (PFS) was 78.6% and the 3-year overall survival (OS) was 80.7%. The 3-year PFS and OS values for the high CRP/Alb group were 41.6% and 45.2%, respectively. Differences for PFS (P < 0.001) and OS (P < 0.001) between the two groups were statistically significant. Univariate analysis showed that ECOG, IPI, CRP, GPS, and CRP/Alb were significantly associated with PFS. Similarly, all five were also significantly associated with OS. Multivariate analysis further confirmed that ECOG and CRP/ Alb were independent prognostic factors for both PFS and OS. Moreover, the cutoff value of CRP/Alb showed superior prognostic ability in discriminating between patients with different outcomes in low-risk group based on GPS, IPI, and KPI scores. Conclusion CRP/Alb is a promising prognostic marker for early-stage extranodal NK/T cell lymphoma.
文摘Objective:To investigate the application of heparin-binding protein along with albumin(HBP+ALB)in evaluating the severity of community-acquired pneumonia(CAP)and compares it with single HBP,white blood cells(WBCs),C-reactive protein(CRP),and procalcitonin(PCT).Methods:A total of 226 patients with CAP admitted to the Emergency Department of Zhujiang Hospital,Southern Medical University,Guangdong,China,between March 1,2021,and March 1,2022,were enrolled.The patients were grouped into two groups:mild CAP(n=175)and severe CAP(sCAP)(n=51).Patients'characteristics and laboratory data were obtained.ROC curve and the value of the area under the curve(AUC)were used to evaluate the predictive values of HBP,ALB,WBC,CRP,and PCT.Results:WBC count,CRP,PCT,HBP,creatinine,and D-dimer were higher in the sCAP group,while ALB was lower in the sCAP group(P<0.05)than those in the mild CAP group.The AUCs of WBC,CRP,PCT,HBP,and HBP+ALB were 0.633(95%CI:0.545-0.722,P<0.05),0.635(95%CI:0.542-0.729,P<0.05),0.705(95%CI:0.619-0.791,P<0.05),0.809(95%CI:0.736-0.883,P<0.05),and 0.889(95%CI:0.842-0.936,P<0.05),respectively.Conclusions:HBP+ALB has a higher predictive value than single HBP,PCT,CRP and WBC used alone for the early assessment of CAP.
文摘Background: C-reactive protein to albumin ratio(CRP/Alb ratio,CAR)has been suggested as a potential prognostic biomarker in lung cancer.This updated systematic review and meta-analysis aimed to assess the association between CAR and lung cancer prognosis in current literature.Methods: A systematic search of databases was conducted to identify relevant studies published up to April 2023.Pooled hazard ratios(HRs)and 95%confidence intervals(CIs)were calculated to assess the association between CAR and overall survival(OS)and progression-free survival(PFS)and recurrence-free survival(RF)in lung cancer patients.Results: This meta-analysis includes 16 studies with a total of 5337 patients,indicating a significant association between higher CAR and poorer OS,PFS,and RFS in lung cancer patients,with a pooled HR of 1.78(95%CI=1.60-1.99),1.57(95%CI=1.36-1.80),and 1.97(95%CI=1.40-2.77),respectively.Conclusions: This updated meta-analysis provides evidence for the potential prognostic role of CAR in lung cancer,suggesting its utility as an effective and noninvasive biomarker for identifying high-risk patients and informing treatment decisions in a cost-effective manner.However,further large-scale studies will be necessary to establish the optimal cut-off value for CAR in lung cancer and confirm the present findings.
文摘目的研究外周血C反应蛋白(C-reactive protein,CRP)、白蛋白(Albumin,ALB)比值(CRP to ALB ratio,CAR)、血清白介素-17(Interleukin-17,IL-17)水平与肺炎支原体肺炎(Mycoplasma pneumoniae pneumonia,MPP)患儿病情严重程度及预后的关系。方法以2022年1月-2023年12月于中国人民解放军空军军医大学第一附属医院西京医院儿科就诊并治疗的118例MPP患儿为研究对象,以同期体检的120名健康儿童为对照组。于入院当天采集患者空腹外周血,检测血清CRP、ALB和IL-17水平,计算CRP与ALB比值(CRP to ALB ratio,CAR)。对所有患儿的病情严重程度进行评估,治疗后评估患儿预后。结果与对照组比较,病例组外周血CAR和IL-17水平均升高,差异有统计学意义(P<0.05)。MPP患儿外周血CAR和IL-17水平呈显著正相关关系(r=0.374,P=0.006)。118例MPP患儿中,重症患儿51例,轻症患儿67例。与轻症组比较,重症组患儿外周血CAR和IL-17水平上升,差异有统计学意义(P<0.05)。外周血CAR诊断不同严重程度MPP的曲线下面积(AUC)为0.756(0.667~0.845),灵敏度和特异度分别为62.7%和85.1%;外周血IL-17水平诊断不同严重程度MPP的AUC为0.745(0.654~0.835),灵敏度和特异度分别为51.0%和99.1%;外周血CAR联合IL-17水平诊断不同严重程度MPP的AUC为0.913(0.862~0.964),灵敏度和特异度分别为84.3%和80.6%。51例重症MPP患儿中,14例预后不良,37例预后良好。与预后良好组比较,预后不良组外周血CAR和IL-17水平上升,差异有统计学意义(P<0.05)。外周血CAR预测重症MPP患儿不同预后的AUC为0.685(0.512~0.859),灵敏度和特异度分别为57.1%和75.4%;外周血IL-17水平预测重症MPP患儿不同预后的AUC为0.722(0.548~0.896),灵敏度和特异度分别为78.6%和78.4%;外周血CAR联合IL-17水平预测重症MPP患儿不同预后的AUC为0.764(0.620~0.909),灵敏度和特异度分别为78.6%和70.3%。结论外周血CAR、IL-17水平与MPP患儿严重程度及预后有关,且对MPP患儿不同严重程度的诊断具有一定价值。
基金This study was supported by grants from the National Natural Science Foundation of China （No. 30570880）, 973 Project （No. 2006CB503904）, and Science and Technology Foundation of the Science and Technology Commission of Shanghai （No. 04DZ19502）.
文摘Background Serum high sensitive C-reactive protein （hs-CRP）, adiponectin levels and urine albumin excretion rate （UAER） are probably associated with inflammation and atherosclerosis. The aim of this study was to determine the three markers in coronary artery disease （CAD） subjects with different glucose tolerance status in a Chinese population and further explore the levels of the three markers in these subjects and the possible association of these markers with CAD risk factors and the severity of CAD as well. Methods A total of 242 subjects with angiographically documented CAD were recruited, and then assigned to three groups： the normal glucose tolerance （NGT） ＋ CAD group, including 100 CAD patients with NGT; the impaired glucose tolerance （IGT） ＋ CAD group, 40 CAD patients with IGT; the type 2 diabetes mellitus （T2DM） ＋ CAD group, 102 CAD patients with T2DM. Serum hs-CRP, adiponectin levels as well as UAER were measured in all subjects. Results Serum hs-CRP levels were increased in the T2DM ＋ CAD group compared with the NGT ＋ CAD group （4.71±2.59） vs （3.60±2.46） mg/L, P=0.037. Serum adiponectin levels were gradually decreased from the NGT ＋ CAD to IGT ＋ CAD to T2DM ＋ CAD groups, （5.99±1.84）, （5.82±1.72） and （4.65±1.71） mg/L, P=0.002 and 0.040 for NGT ＋ CAD and IGT ＋ CAD groups vs T2DM ＋ CAD group, respectively. While the UAER was gradually increased from the NGT ＋ CAD to IGT ＋ CAD to T2DM ＋ CAD groups, （6.42±2.51）, （6.89±2.94） and （15.03±4.22） μg/min （P 〈0.001） for NGT ＋ CAD and IGT ＋ CAD groups vs T2DM ＋ CAD group. Multiple linear stepwise regression analysis showed that waist-hip ratio （WHR） and low density lipoprotein cholesterol （LDL-C） were the significant determinants of serum hs-CRP levels; triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, age, WHR, T2DM, 2-hour serum insulin （2hINS）, sex, and apolipoprotein B were the significant determinants of serum adiponectin levels; and systolic blood pressure （SBP）, T2DM and hemoglobin A1c （HbA1c） were the significant determinants of UAER in all subjects （R^2= 0.070, 0.352, and 0.214, respectively）. However, no significant correlation was seen for hs-CRP, adiponectin and UAER with the severity of CAD. Hs-CRP levels were significantly correlated with UAER. Conclusions There was a trend of increased serum hs-CRP levels from the NGT ＋ CAD to IGT ＋ CAD to T2DM ＋ CAD groups, though it only showed significance in the T2DM ＋ CAD group compared with the NGT ＋ CAD group. Serum adiponectin levels were decreased and UAER was increased from the NGT ＋ CAD to IGT ＋ CAD to T2DM ＋ CAD groups Increased UAER and serum hs-CRP, and decreased adiponectin levels were associated with traditional CAD risk factors but failed to be correlated with the severity of CAD. Hs-CRP levels were significantly correlated with UAER.
文摘Background Evidences show that subclinical chronic inflammation is involved in the pathogenesis of diabetic nephropathy. The aim of this study was to examine the relationship between serum C-reactive protein （CRP）, serum uric acid, and albuminuria in Chinese type 2 diabetic patients.
基金supported by the Chaozhou City Science and Technology Program (No. 180817101833093)
文摘Background Syntax score(SS),an angiographic tool to grade the complexity of coronary artery disease,has prognostic importance for this disease. C-reactive protein(CRP)and albumin are indicators of inflammation.And both of them are associated with high SS. Hence,we aimed to investigate whether baseline CRP to albumin ratio(CAR)is associated with SS. Method A total of 312 consecutive patients with stable angina pectoris,who underwent coronary angiography for suspected coronary artery disease(CAD)from January 2018 to May 2019,were classified into two groups,low score group(syntax score≤22)and high score group(syntax group>22).The Multivariate logistic analysis and ROC curve were performed to detect the predictive effect of CAR for higher SS. Results There are 163 cases in the low score group while 149 cases in the high score group. CAR in the high score group was significantly higher than the other group(5.6[2.8-9.6]vs. 2.5[1.7-5.2],P<0.01). In multivariate logistic regression analysis,CAR was proved to be an independent predictor for high syntax score. ROC curve analyses reveal the good predictive values of CAR(AUC 0.731,95% CI:0.608-0.814,P<0.01)for high syntax score and statistical significant better than CRP or albumin alone. Conclusions CAR is independently associated with the complexity and severity of CAD,which has better predictive value than CRP or albumin alone.
基金reviewed and approved by the Institutional Review Board of Zhejiang Provincial People’s Hospital(Approval No.2023-338).
文摘BACKGROUND Colon cancer is one of the most common malignant tumors of the digestive system.Liver metastasis after colon cancer surgery is the primary cause of death in patients with colon cancer.AIM To construct a novel nomogram model including various factors to predict liver metastasis after colon cancer surgery.METHODS We retrospectively analyzed 242 patients with colon cancer who were admitted and underwent radical resection for colon cancer in Zhejiang Provincial People’s Hospital from December 2019 to December 2022.Patients were divided into liver metastasis and non-liver metastasis groups.Sex,age,and other general and clinicopathological data(preoperative blood routine and biochemical test indexes)were compared.The risk factors for liver metastasis were analyzed using singlefactor and multifactorial logistic regression.A predictive model was then constructed and evaluated for efficacy.RESULTS Systemic inflammatory index(SII),C-reactive protein/albumin ratio(CAR),red blood cell distribution width(RDW),alanine aminotransferase,preoperative carcinoembryonic antigen level,and lymphatic metastasis were different between groups(P<0.05).SII,CAR,and RDW were risk factors for liver metastasis after colon cancer surgery(P<0.05).The area under the curve was 0.93 for the column-line diagram prediction model constructed based on these risk factors to distinguish whether liver metastasis occurred postoperatively.The actual curve of the column-line diagram predicting the risk of postoperative liver metastasis was close to the ideal curve,with good agreement.The prediction model curves in the decision curve analysis showed higher net benefits for a larger threshold range than those in extreme cases,indicating that the model is safer.CONCLUSION Liver metastases after colorectal cancer surgery could be well predicted by a nomogram based on the SII,CAR,and RDW.
基金Supported by A grant of the Korea Health Technology R and D Project through the Korea Health Industry Development Institute(KHIDI)the Ministry of Health and Welfare,Republic of Korea,No.HI14C3477
文摘AIM: To evaluate the value of systemic inflammationbased markers as prognostic factors for advanced pancreatic cancer(PC). METHODS: Data from 82 patients who underwent combination chemotherapy with gemcitabine and erlotinib for PC from 2011 to 2014 were collected retrospectively. Data that included the neutrophil-to-lymphocyte ratio(NLR), the platelet-to-lymphocyte ratio, and the C-reactive protein(CRP)-to-albumin(CRP/Alb) ratio were analyzed. Kaplan-Meier curves, and univariate and multivariate Cox proportional hazards regression analyses were used to identify the prognostic factors associated with progression-free survival(PFS) and overall survival(OS). RESULTS: The univariate analysis demonstrated the prognostic value of the NLR(P = 0.049) and the CRP/Alb ratio(P = 0.047) in relation to PFS, and a positiverelationship between an increase in inflammation-based markers and a poor prognosis in relation to OS. The multivariate analysis determined that an increased NLR(hazard ratio = 2.76, 95%CI: 1.33-5.75, P = 0.007) is an independent prognostic factor for poor OS. There was no association between the PLR and the patients' prognoses in those who had received chemotherapy that comprised gemcitabine and erlotinib in combination. The Kaplan-Meier method and the log-rank test determined significantly worse outcomes in relation to PFS and OS in patients with an NLR > 5 or a CRP/Alb ratio > 5.CONCLUSION: Systemic inflammation-based markers, including increases in the NLR and the CRP/Alb ratio, may be useful for predicting PC prognoses.
基金Natural Science Research Project of Colleges and Universities in Anhui Province(No.KJ2019A0372)。
文摘Objective:The purpose of this study was to investigate the relationship between preoperative C-reactive protein/albumin ratio(CRP/ALB),platelet count and C-reactive protein product(P-CRP)and clinical prognosis in patients with non-small cell lung cancer.Methods:From January 2015 to December 2015,284 patients who underwent surgery for lung cancer in the First Affiliated Hospital of Bengbu Medical College were selected.According to their 3-year and 5-year survival conditions,ROC curves were drawn and the best cut-off value was determined.According to the cut-off value,the patients were divided into high CRP/ALB group,low CRP/ALB group,high P-CRP group and low P-CRP group.Survival curves were described by Kaplan-Meier method and compared by Log-rank test.The univariate and multivariate analyses were performed with the Cox proportional hazard model to evaluate the prognostic factors.Results:Survival analysis showed that there was no significant difference in 3-year survival rate between high CRP/ALB and P-CRP groups and low CRP/ALB and P-CRP groups,while the 5-year survival rate in high CRP/ALB and P-CRP groups was significantly lower than that in low CRP/ALB and P-CRP groups.Cox proportional hazard model showed that CRP/ALB,age,smoking history,lymph node metastasis and TNM stage were risk factors for 5-year survival rate.Conclusion:as a prognostic index based on inflammation,preoperative CRP/ALB level can better reflect the prognosis of patients than P-CRP.
文摘<strong>Objective:</strong> To evaluate the clinical diagnostic value of C-reactive protein/albumin ratio (CAR), neutrophil/lymphocyte ratio (NLR) and D-dimer (D-D) in patients with pulmonary thromboembolism (PTE). <strong>Methods:</strong> We conducted a retrospective analysis comparing hematology and coagulation in 362 PTCA-confirmed PTE patients with the control group and analyzing their relationships with CAR, NLR, and D-D. Receiver operating characteristic curve (ROC) was used to analyze the diagnostic threshold, area under the curve (AUC), diagnostic sensitivity and specificity of CAR, NLR and D-D for PTE. <strong>Results:</strong> 1) CAR, NLR and D-D levels in PTE patients were 2.13 ± 2.08, 8.96 ± 1.94 and 9.69 ± 8.61 respectively, significantly higher than those in control group (CAR = 0.03 ± 0.01, t = 20.7736, P < 0.01;NLR = 1.76 ± 0.53, t = 2.4281, P < 0.05 and PTE = 0.20 ± 0.11, t = 3.0066, P < 0.01 respectively). 2) NLR was positively correlated with CAR (r = 0.2111, t = 4.0971, P < 0.01) and D-D (r = 0.1065, t = 2.0481, P < 0.05), but CAR was not correlated with D-D (r = 0.0975, P > 0.05). 3) The levels of HB, LY, PLT and AT in PTE patients were significantly lower than those in control group, while WBC, NE and FB were significantly higher than those in control group. 4) CAR was negatively correlated with Hb and AT (P all < 0.01), but positively correlated with WBC, NE, MO and FB (P all < 0.01). NLR was negatively correlated with LY and AT (P all < 0.01), but positively correlated with WBC, NE and FB (P all < 0.01). DD was negatively correlated with Hb and PLT (P all < 0.05), but positively correlated with WBC, NE and MO (P all < 0.01). <strong>Conclusion:</strong> The levels of Hb, LY, PLT and AT were significantly decreased in PTE patients, while WBC, NE and FB were significantly increased. CAR, NLR and D-D were highly expressed in PTE patients, and were closely correlated with Hb, AT and FB. Combined detection of CAR, NLR and D-D can improve the diagnostic value of PTE.
基金National Council for Scientific and Technological Development-Brazil(CNPq),grant number 481020/2012-8.
文摘Background:Studies investigating the nutritional status of patients with leprosy and plantar ulcers are sparse.Therefore,the objective of this study was to describe the protein profile of leprosy patients with plantar ulcers from the Eastern Amazon region.Methods:A case record form was created for 75 patients with leprosy(31 with plantar ulcers and 44 without plantar ulcers)with the following data:sociodemographic characteristics,clinical form of leprosy,presence or absence of plantar ulcers,and nutritional assessment using anthropometry consisting of the measurement of body mass index,arm circumference,arm muscle circumference,and triceps skinfold.Levels of blood albumin,transferrin,and C-reactive protein(CRP)were also measured.Data regarding protein intake were obtained using a Food Frequency Questionnaire.Results:Plantar ulcers occurred more frequently in male patients(67.7%),patients aged 40-49 years(mean±SD:47.3±8.0 years),and patients receiving 300 or 600 USD(71.0%).The mean weight and height of patients were 71.6±11.4 kg and 1.62±0.1 m,respectively.High levels of CRP were detected in 51.6%of leprosy patients with plantar ulcers and only 9.1%of patients without plantar ulcers(P<0.001).Nutritional depletion of transferrin was observed in 14.3%of patients with paucibacillary leprosy and 44.3%of patients with multibacillary leprosy(P=0.0447).Most patients had normal levels of serum albumin(74.2%with plantar ulcers and 77.3%without plantar ulcers).Conclusions:Most leprosy patients with plantar ulcers have normal levels of serum albumin and transferrin and high CRP levels,which indicates the presence of an inflammatory process.Our findings suggest the need to monitor patients with leprosy to prevent the occurrence of plantar ulcers and to provide adequate treatment for patients with existing plantar ulcers.
