Application value of C-reactive protein to albumin ratio combined with grip strength and serum prealbumin in patients with esophageal cancer

PENG Shunxian; TAO Hua; CHEN Xiaofeng; PENG Jifang; JIANG Shudi

doi:10.7619/jcmp.20242187

Journal of Clinical Medicine in Practice > 2024 > 28(17): 15-19, 26. > DOI: 10.7619/jcmp.20242187

PENG Shunxian, TAO Hua, CHEN Xiaofeng, PENG Jifang, JIANG Shudi. Application value of C-reactive protein to albumin ratio combined with grip strength and serum prealbumin in patients with esophageal cancer[J]. Journal of Clinical Medicine in Practice, 2024, 28(17): 15-19, 26. DOI: 10.7619/jcmp.20242187

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Application value of C-reactive protein to albumin ratio combined with grip strength and serum prealbumin in patients with esophageal cancer

1.
Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing, Jiangsu, 210029
2.
Department of Thoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial People's Hospital, Nanjing, Jiangsu, 210029

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Received Date: May 23, 2024
Revised Date: July 21, 2024

Graphical Abstract

Abstract

Abstract

Objective
To investigate the predictive value of the C-reactive protein to albumin ratio (CAR) combined with grip strength and serum prealbumin for survival and malnutritionin patients with esophageal cancer.
Methods
A total of 212 patients with esophageal cancer were selected as study objects, and baseline characteristics, pretreatment CAR, grip strength, and serum prealbumin results were collected. Nutritional status was assessed, and overall survival was followed up. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of pretreatment CAR, grip strength, and serum prealbumin for malnutrition. Kaplan-Meier survival curves and Cox regression models were employed to analyze their predictive value for survival outcomes.
Results
ROC curve analysis revealed that grip strength had the largest area under the curve (0.625) for predicting malnutritionin esophageal cancer patients, followed by serum prealbumin and CAR (0.604, 0.594). Based on the Youden index, the optimal cut-off values for CAR, grip strength, and serum prealbumin were 0.732, 23.1 kg, and 0.190 g/L, respectively. The sensitivity of the combined detection of three indicators was 80.7%. Kaplan-Meier survival curve analysis showed that patients with elevated CAR (≥0.732), reduced grip strength (< 23.1 kg), and decreased serum prealbumin levels (< 0.190 g/L) had shorter overall survival compared to those with CAR < 0.732, grip strength ≥23.1 kg, and serum prealbumin levels ≥0.190 g/L, respectively (P < 0.01). Multivariate Cox regression analysis identified elevated pretreatment CAR (≥0.732), reduced grip strength (< 23.1 kg), and decreased serum prealbumin levels (< 0.190 g/L) as independent risk factors for poor survival prognosis in esophageal cancer patients (P < 0.05).
Conclusion
Pretreatment CAR, grip strength, and serum prealbumin are important indicators for assessing nutritional status and survival prognosis in esophageal cancer patients. Combined detection of these biomarkers may facilitate early diagnosis and timely intervene malnutrition, potentially improving survival outcomes in esophageal cancer patients.
- esophageal cancer,
- C-reactive protein to albumin ratio,
- grip strength,
- serum prealbumin,
- nutritional status,
- prognosis

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References (25)

References

[1]	LAGERGREN J, SMYTH E, CUNNINGHAM D, et al. Oesophageal cancer[J]. Lancet, 2017, 390(10110): 2383-2396. doi: 10.1016/S0140-6736(17)31462-9
[2]	OHASHI S, MIYAMOTO S, KIKUCHI O, et al. Recent advances from basic and clinical studies of esophageal squamous cell carcinoma[J]. Gastroenterology, 2015, 149(7): 1700-1715. doi: 10.1053/j.gastro.2015.08.054
[3]	BRAY F, FERLAY J, SOERJOMATARAM I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394-424. doi: 10.3322/caac.21492
[4]	戴婷婷, 王志墙, 胡雯. 食管癌患者营养治疗对临床结局的影响[J]. 肿瘤代谢与营养电子杂志, 2021, 8(4): 343-348.
[5]	CHIANG H C, LIN M Y, LIN F C, et al. Transferrin and prealbumin identify esophageal cancer patients with malnutrition and poor prognosis in patients with normal albuminemia: a cohort study[J]. Nutr Cancer, 2022, 74(10): 3546-3555. doi: 10.1080/01635581.2022.2079687
[6]	XU H J, MA Y, DENG F, et al. The prognostic value of C-reactive protein/albumin ratio in human malignancies: an updated meta-analysis[J]. Onco Targets Ther, 2017, 10: 3059-3070. doi: 10.2147/OTT.S137002
[7]	WU J Y, TAN W K, CHEN L, et al. Clinicopathologic and prognostic significance of C-reactive protein/albumin ratio in patients with solid tumors: an updated systemic review and meta-analysis[J]. Oncotarget, 2018, 9(17): 13934-13947. doi: 10.18632/oncotarget.24172
[8]	YANG Q X, SHEN A G, CHEN X D, et al. Clinical significance of nutrition and inflammation in esophageal cancer patients with surgery: a meta-analysis[J]. Nutr Cancer, 2022, 74(9): 3128-3139. doi: 10.1080/01635581.2022.2056620
[9]	CEDERHOLM T, BOSAEUS I, BARAZZONI R, et al. Diagnostic criteria for malnutrition - An ESPEN Consensus Statement[J]. Clin Nutr, 2015, 34(3): 335-340. doi: 10.1016/j.clnu.2015.03.001
[10]	CHEN W Q, ZHENG R S, BAADE P D, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2): 115-132. doi: 10.3322/caac.21338
[11]	MENDES N P, BARROS T A, FARIA B S, et al. Hand grip strength as predictor of undernutrition in hospitalized patients with cancer and a proposal of cut-off[J]. Clin Nutr ESPEN, 2020, 39: 210-214. doi: 10.1016/j.clnesp.2020.06.011
[12]	BRETSCHER C, BUERGIN M, GURZELER G, et al. Association between prealbumin, all-cause mortality, and response to nutrition treatment in patients at nutrition risk: secondary analysis of a randomized controlled trial[J]. JPEN J Parenter Enteral Nutr, 2023, 47(3): 408-419. doi: 10.1002/jpen.2470
[13]	MARUYAMA S, OKAMURA A, KANIE Y, et al. C-reactive protein to prealbumin ratio: a useful inflammatory and nutritional index for predicting prognosis after curative resection in esophageal squamous cell carcinoma patients[J]. Langenbeck's Arch Surg, 2022, 407(5): 1901-1909. doi: 10.1007/s00423-022-02508-6
[14]	WANG Y, HU X, HUANG Y, et al. Prognostic value of the C-reactive protein to albumin ratio in esophageal cancer: a systematic review and meta-analysis[J]. Kaohsiung J Med Sci, 2020, 36(1): 54-61. doi: 10.1002/kjm2.12129
[15]	JOMRICH G, PAIREDER M, GLEISS A, et al. Comparison of inflammation-based prognostic scores in a cohort of patients with resectable esophageal cancer[J]. Gastroenterol Res Pract, 2017, 2017: 1678584.
[16]	PEREIRA A A C, ZAIA R D, SOUZA G H G, et al. The correlation between hand grip strength and nutritional variables in ambulatory cancer patients[J]. Nutr Cancer, 2021, 73(2): 221-229. doi: 10.1080/01635581.2020.1750662
[17]	ARENDS J, BODOKY G, BOZZETTI F, et al. ESPEN guidelines on enteral nutrition: non-surgical oncology[J]. Clin Nutr, 2006, 25(2): 245-259. doi: 10.1016/j.clnu.2006.01.020
[18]	ZINELLU A, MANGONI A A. Serum prealbumin concentrations, COVID-19 severity, and mortality: a systematic review and meta-analysis[J]. Front Med, 2021, 8: 638529. doi: 10.3389/fmed.2021.638529
[19]	JIANG Y, XU D, SONG H, et al. Inflammation and nutrition-based biomarkers in the prognosis of oesophageal cancer: a systematic review and meta-analysis[J]. BMJ Open, 2021, 11(9): e048324. doi: 10.1136/bmjopen-2020-048324
[20]	MIYAMOTO T, FUJITANI M, FUKUYAMA H, et al. The C-reactive protein/albumin ratio is useful for predicting short-term survival in cancer and noncancer patients[J]. J Palliat Med, 2019, 22(5): 532-537.
[21]	HUANG H P, LIU Q, ZHU L X, et al. Prognostic value of preoperative systemic immune-inflammation index in patients with cervical cancer[J]. Sci Rep, 2019, 9(1): 3284. doi: 10.1038/s41598-019-39150-0
[22]	MARTIN P, BOTSEN D, BRUGEL M, et al. Association of low handgrip strength with chemotherapy toxicity in digestive cancer patients: a comprehensive observational cohort study (FIGHTDIGOTOX)[J]. Nutrients, 2022, 14(21): 4448. doi: 10.3390/nu14214448
[23]	CHEN F, CHI J T, ZHAO B, et al. Impact of preoperative sarcopenia on postoperative complications and survival outcomes of patients with esophageal cancer: a meta-analysis of cohort studies[J]. Dis Esophagus, 2022, 35(9): doab100. doi: 10.1093/dote/doab100
[24]	KANEMURA T, TAKEOKA T, SUGASE T, et al. Significance of comprehensive analysis of preoperative sarcopenia based on muscle mass, muscle strength, and physical function for the prognosis of patients with esophageal cancer[J]. Ann Surg Oncol, 2024, 31(2): 818-826. doi: 10.1245/s10434-023-14306-5
[25]	王炎, 王东方, 靳红领. 术前预后营养指数、前白蛋白与食管癌患者术后并发症及预后的关系[J]. 现代临床医学, 2023, 49(6): 410-413.

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Application value of C-reactive protein to albumin ratio combined with grip strength and serum prealbumin in patients with esophageal cancer