J Cancer 2016; 7(15):2360-2366. doi:10.7150/jca.16443 This issue

Research Paper

C-Reactive Protein/Albumin Ratio (CAR) as a Prognostic Factor in Patients with Non-Metastatic Nasopharyngeal Carcinoma

ShaSha He1,2,3*, Yan Wang1,2,3*, HaiYang Chen4, Lin Yang1,2,3, ShaoBo Liang5, LiXia Lu1,2,3✉, Yong Chen1, 2,3✉

1. Sun Yat-sen University Cancer Center, No.651 Dongfeng Road East, Guangzhou, China.
2. State Key Laboratory of Oncology in Southern China, Guangzhou, China.
3. Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
4. The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
5. The First Hospital of Foshan, Foshan, China.
*These authors contributed equally to this work.

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He S, Wang Y, Chen H, Yang L, Liang S, Lu L, Chen Y. C-Reactive Protein/Albumin Ratio (CAR) as a Prognostic Factor in Patients with Non-Metastatic Nasopharyngeal Carcinoma. J Cancer 2016; 7(15):2360-2366. doi:10.7150/jca.16443. Available from https://www.jcancer.org/v07p2360.htm

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Background: The C-reactive protein/albumin (CRP/ALB) ratio has recently been associated with clinical outcomes in patients suffering various types of cancer. In this retrospective study, we investigated the prognostic value of the pre-treatment CRP/ALB ratio (CAR) in non-metastatic nasopharyngeal carcinoma (NPC) patients.

Methods: The cohort included 2685 patients with non-metastatic NPC. Univariate and multivariate COX proportional hazards analyses were applied to evaluate the associations of CAR with overall survival (OS), distant metastasis-free survival (DMFS), disease-free survival (DFS), and locoregional recurrence-free survival (LRRFS) in patients with NPC. Kaplan-Meier survival analyses was used to compare groups classified by CAR.

Results: Patients were categorised by the CAR using a cut-off value of 0.064. Multivariate Cox proportional hazard analysis verified that high CAR level was a significant predictor for inferior OS (P = 0.003), DMFS (P = 0.035), and LRRFS (P = 0.024), but not for DFS (P = 0.093). CAR was also an independent prognostic factor for OS when stratified by Epstein-Barr virus DNA level ( ≥ 2560 or < 2560 copies ml-1).

Conclusions: High CAR provides prognostication regarding OS, DMFS, DFS, and LRRFS in patients with NPC. CAR is a valuable coadjutant for Epstein-Barr virus DNA levels for identifying survival differences.

Keywords: Nasopharyngeal carcinoma, C-reactive protein, albumin, Epstein-Barr virus DNA, prognosis.