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c-reactive protein to albumin ratio predict responses to programmed cell death-1 inhibitors in hepatocellular carcinoma patients

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World Journal of Gastrointestinal Oncology 2024年第1期16卷 61-78页

作者： Bai-Bei Li Lei-Jie chen Shi-Liu Lu Biao Lei Gui-Lin Yu Shui-Ping Yu Department of Hepatobiliary Surgery The First Affiliated Hospital of Guangxi Medical UniversityNanning 530021Guangxi Zhuang Autonomous RegionChina Key Laboratory of Early Prevention and Treatment for Regional High Frequency Tumor(Guangxi Medical University) Ministry of EducationNanning 530021Guangxi Zhuang Autonomous RegionChina Guangxi Key Laboratory of Immunology and Metabolism for Liver Diseases Guangxi Medical UniversityNanning 530021Guangxi Zhuang Autonomous RegionChina Department of Gastroenterology The Second Xiangya Hospital of Central South UniversityNanning 410011Guangxi Zhuang Autonomous RegionChina Department of Emergency The First Affiliated Hospital of Guangxi Medical UniversityNanning 530021Guangxi Zhuang Autonomous RegionChina

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.

关键词： c-reactive protein to albumin ratio Hepatocellular carcinoma Programmed cell death-1 inhibitors Prognosis Nomogram

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Prognostic role of c-reactive protein to albumin ratio in lung cancer:An updated systematic review and meta-analysis

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chronic Diseases and Translational Medicine 2024年第1期10卷 31-39页

作者： Zhendong Lu Siyun Fu Wei Li Xiang Gao Jinghui Wang Department of Medical Oncology Beijing Tuberculosis and Thoracic Tumor Research InstituteBeijing Chest HospitalCapital Medical UniversityBeijingChina cancer Research center Beijing Chest HospitalBeijing Tuberculosis and Thoracic Tumor Research InstituteCapital Medical UniversityBeijingChina

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.

关键词： c-reactive protein to albumin ratio inflammation:biomarker lung cancer prognosis

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