Clinical value of the ratio of C reactive protein to prealbumin in evaluating the prognosis of gastric cancer patients

ObjectiveTo observe the effects of the ratio of preoperative serum C reactive protein to prealbumin(CRP/PA) on the prognosis of gastric cancer patients.

MethodsThe survival and laboratory indicators in gastric cancer patients treated with radical operation were followed up and recorded.The ratio CRP to ALB and CRP/PA in all patients were calculated, the receiver operating characteristic curves(ROC)were plotted, and the area under the curve(AUC) was compared.The Youden index was calculated to obtain the optimal cutoff value of CRP/PA.The patients were divided into the high CRP/PA(HCP) group and low CRP/PA(LCP) group according to the optimal cutoff value.The clinical and pathological features, postoperative complications and prognosis in two groups were analyzed.

ResultsThe ROC curves of the CRP/PA and CRP/ALB were plotted based on the 5-year survival as the end point, and the AUC of which were 0.704 and 0.656, respectively.When the CRP/PA value was 18.8×10^-3, the Youden index was the largest, the sensitivity was 0.828, and the specificity was 0.562.The age, anemia, tumor diameter, infiltration depth, lymph node metastasis and TNM stage were related to the level of CRP/PA(P < 0.05 to P < 0.01).The incidence rate of complication in 214 patients was 28.9%, and which in HCP group(37.64%)was higher than that in LCP group(23.26%)(P < 0.05).Among the 214 patients with gastric cancer, 125 cases died, the 5-year cumulative survival rate of all patients was 35.5%, and the median survival time was 43 months.The 5-year cumulative survival rate in HCP group and LCP group was 29.4% and 46.3%, respectively.The 5-year survival rate in HCP group was higher than that in LCP group(P < 0.05).The results of Cox proportional hazards model showed that the level of CRP/PA and TNM stage were the independent prognostic factors for postoperative gastric cancer patients(P < 0.01).

ConclusionsThe CRP/PA level and TNM stage are the independent factors affecting the prognosis of gastric cancer patients.The incidence rate of postoperative complications in patients with high CRP/PA level increases, and the prognosis of patients is poor.