The Correlation Between Preoperative C-reactive Protein/prealbumin Ratio And Prognosis Of EGFR-mutant Non-small Cell Lung Cancer

Background and ObjectiveTo investigate the prognostic value of preoperative serum C-reactive protein(CRP)to prealbumin(PA)ratio in patients with non-small cell lung cancer(NSCLC)with mutations in the epidermal growth factor receptor(EGFR)gene.cancer(NSCLC)patients.And to analyze the correlation between CRP/PA and other known clinicopathological features of EGFR mutant NSCLC patients.MethodsRetrospective analysis of 65 patients with EGFR mutant non-small cell lung cancer who underwent preoperative C-reactive protein and prealbumin ratios at our hospital from January 2018 to December 2020.The survival and laboratory parameters of EGFR mutant NSCLC patients treated with radical surgery were followed up and recorded,and CRP/PA values were calculated for all patients,and the subject operating characteristic curves(ROC)were plotted for both separately,and the area under the curves were compared.The Youden index was calculated to find the optimal CRP/PA value.The patients were divided into high CRP/PA(HCP)and low CRP/PA(LCP)groups,and the clinicopathological characteristics,postoperative complications and prognosis of the patients in the two groups were analyzed.ResultsThe Roc curve was plotted according to the 5-year follow-up outcome(relapse,progression or death)as the endpoint,and the Area Under the ROC Curve(AUC)value of CRP/PA was calculated as 0.720(95% CI:0.587-0.853),when CRP/PA was equal to 26.188×10-3,the Youden index was maximum 0.420(95% CI:0.168-0.671),corresponding to a sensitivity of 0.611(95% CI:0.357-0.827)and a specificity of0.809(95% CI:0.667-0.909).The number of hospitalizations,smoking,tumor location,and TNM stage were all associated with the level of CRP/PA values(all p<0.05).During a maximum follow-up period of 63.7 months,a total of 18 patients progressed(4 deaths,11 recurrences,and 3 metastases),resulting in a 5-year cumulative non-progression rate of 25.9% for all patients.The median time to progression for patients was 51.8 months.The 5-year cumulative non-progression rates were 48.8% and 0% for patients in the HCP and LCP groups,respectively.5-year non-progression rates were higher for patients in the LCP group than for patients in the HCP group(χ2 = 6.545,P = 0.011).Further analysis by multifactorial stepwise Cox regression model revealed that CRP/PA was an independent prognostic factor for the prognosis of EGFR mutant NSCLC patients(P < 0.05).ConclusionThe preoperative CRP/PA level is an independent prognostic factor for EGFR mutant NSCLC patients.The prognosis of EGFR mutant NSCLC patients with high preoperative CRP/PA is poor.