Preoperative C-Reactive Protein/Albumin Ratio Predicts The Prognosis Of Patients With Resectable Pancreatic Cancer

OBJECTIVE To evaluate the influence of preoperative C-reactive protein/albumin ratio on the overall survival of pancreatic cancer patients,and explore the potential clinical value of CRP/Alb on the prognosis of pancreatic cancer.METHODS The clinical date on 97 patients with pancreatic cancer who underwent pancreatic cancer surgery in the third Affiliated Hospital of Soochow University from January 2005 to December 2013 was reviewed and analyzed retrospectively.We determined the cut-off value CRP/Alb ratio by using the receiver operating characteristic(ROC)curve.According to the cut-off value of CRP/Alb ratio,the patients were divided into two groups named as high group(CRP/Alb ratio≥0.109)and low group(CRP/Alb ratio<0.109)respectively.We used the Chi-square test to analyze the relationships between CRP/Alb ratio and clinical characteristics.Median overall survival(OS)and overall survival rate was evaluated by using the Kaplan-meier method.The risk factors of poor prognosis for patients were analyzed by univariate and multivariate COX regression analysis model.RESULTS The results of correlation analysis indicated that high TNM stage、poor tumor differentiation、the level CRP and Alb have significant relation with CRP/Alb ratio(P<0.05).The median overall survival(OS)of higher CRP/Alb ratio group and lower CRP/Alb ratio group was 15 months and 23 months respectively,and compared with lower CRP/Alb ratio group,the overall survival rate of higher CRP/Alb ratio group decreased remarkablely,and the difference was statistically significant(P<0.05).Moreover,median OS were decreased in patients with advanced age(≥65)、high TNM stage(IIB-III)、poor tumor differentiation、vascular invasion and positive surgical margin(P<0.05).A high CRP/Alb ratio was identified as an independent risk factor of poor prognosis for patients with pancreatic cancer(HR:1.832;95%CI:1.067-3.144;P=0.028),and advanced age、high TNM stage、poor tumor differentiation、vascular invasion and positive surgical margin were also included.CONCLUSION Preoperative CRP/Alb ratio can be an important clinical factor for assessing the prognosis of patients with resectable pancreatic cancer,and high CRP/Alb ratio suggests unfavourable prognosis.