scholarly journals Predictive impact of C-reactive protein to albumin ratio for recurrent or metastatic head and neck squamous cell carcinoma receiving nivolumab

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kenro Tanoue ◽  
Shingo Tamura ◽  
Hitoshi Kusaba ◽  
Yudai Shinohara ◽  
Mamoru Ito ◽  
...  
Keyword(s):  
Head And Neck ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Progression Free Survival ◽  
C Reactive Protein ◽  
Optimal Cutoff ◽  
Poor Overall Survival ◽  
Albumin Ratio ◽  
Cutoff Value ◽  
Reactive Protein

AbstractAlthough the neutrophil to lymphocyte ratio (NLR) was reported to be a predictive biomarker for clinical outcomes in various types of cancer, including recurrent or metastatic head and neck cancer (R/M HNSCC) treated with nivolumab, the usefulness of the pretreatment C-reactive protein/albumin ratio (CAR) as a prognostic marker remains to be clarified. This study aimed to analyze the clinical usability of the CAR in comparison with that of the NLR. 46 R/M HNSCC patients treated with nivolumab were retrospectively analyzed. The optimal cutoff value for the CAR was calculated using receiver operating characteristic curve analysis. The optimal cutoff value for the CAR was set to 0.30. On multivariate analyses, a high CAR was significantly associated with poor overall survival (adjusted HR, 2.19; 95% CI, 1.42–3.47; p < 0.01) and progression-free survival (adjusted HR, 1.98; 95% CI, 1.38–2.80; p < 0.01). The overall response rate and disease control rate for the high CAR patients were lower than for the low CAR patients. The CAR had significantly higher area under the curve values than the NLR at 2 and 4 months. The pretreatment CAR might be an independent marker for prognosis and efficacy in R/M HNSCC patients treated with nivolumab.

scholarly journals C-Reactive Protein to Albumin Ratio Predicts Survival in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib: A Multicenter Analysis

2021 ◽  
Author(s):  
Toshifumi Tada ◽  
Takashi Kumada ◽  
Atsushi Hiraoka ◽  
Masashi Hirooka ◽  
Kazuya Kariyama ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Multivariate Analysis ◽  
Progression Free Survival ◽  
C Reactive Protein ◽  
Free Survival ◽  
Albumin Ratio ◽  
Cutoff Value ◽  
Reactive Protein ◽  
Unresectable Hepatocellular Carcinoma

Abstract We investigated the impact of C-reactive protein to albumin ratio (CAR) on predicting outcomes in 522 patients with unresectable hepatocellular carcinoma (HCC) treated with lenvatinib. We determined the optimal CAR cutoff value with time-dependent receiver operating characteristic curve analysis. Additionally, we clarified the relationship between CAR and liver function or HCC progression. Median overall survival was 20.0 (95% confidence interval (CI), 17.2–22.6) months. The optimal CAR cutoff value was determined to be 0.108. Multivariate analysis showed that high CAR (≥0.108) (hazard ratio (HR), 1.915; 95% CI, 1.495–2.452), Eastern Cooperative Oncology Group performance status ≥1 (HR, 1.429), and α-fetoprotein ≥400 ng/mL (HR, 1.604) were independently associated with overall survival. Cumulative overall survival differed significantly between patients with low versus high CAR (p<0.001). Median progression-free survival was 7.5 (95% CI, 6.7–8.1) months. Multivariate analysis showed that age, CAR ≥0.108 (HR, 1.644; 95% CI, 1.324–2.043), and non-hepatitis B, non-hepatitis C etiology (HR, 0.726) were independently associated with progression-free survival. Cumulative progression-free survival differed significantly between patients with low versus high CAR (p<0.001). CAR values were significantly higher as Japan Integrated Staging score increased (p<0.001). In conclusion, CAR can predict outcomes in patients with unresectable HCC treated with lenvatinib.

Assessment of the Relationship Between C-Reactive Protein-to-Albumin Ratio and the Presence and Severity of Isolated Coronary Artery Ectasia

Angiology ◽  
2020 ◽  
Vol 71 (9) ◽  
pp. 840-846
Author(s):  
Seçkin Dereli ◽  
İdris Buğra Çerik ◽  
Ahmet Kaya ◽  
Osman Bektaş
Keyword(s):  
Coronary Artery ◽  
Characteristic Curve ◽  
Obstructive Coronary Artery Disease ◽  
Area Under The Curve ◽  
Coronary Artery Ectasia ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Cholesterol Ratio ◽  
Reactive Protein ◽  
The Relationship

We investigated the relationship between C-reactive protein-to-albumin ratio (CAR) and coronary artery ectasia (CAE). The retrospective study population included 150 patients with isolated CAE, 150 with obstructive coronary artery disease (CAD), and 150 with a normal coronary artery angiogram (NCA). The severity of isolated CAE was determined according to the Markis classification. C-reactive protein-to-albumin ratio was significantly higher in patients with isolated CAE than in those with obstructive CAD and NCA (10.5 [5.9-30.9], 5.7 [1.8-13.2] and 3.0 [0.9-8.9], respectively). Logistic regression analysis showed that CAR (odds ratio [OR]: 3.054, 95% CI: 1.021-9.165, P = .001), platelet-to-lymphocyte ratio (PLR; OR: 1.330, 95% CI: 1.025-1.694, P = .044), and monocyte-to-high density cholesterol ratio (MHR; OR: 1.031, 95% CI: 1.009-1.054, P = .006) were independently associated with the presence of isolated CAE. Receiver operating characteristic curve analysis showed that CAR (area under the curve [AUC] ± standard error [SE] = 0.838 ± 0.016; P < .001) had a stronger diagnostic value for detecting significant CAE than PLR (AUC ± SE = 0.632 ± 0.023) and MHR (AUC ± SE = 0.726 ± 0.022). C-reactive protein-to-albumin ratio had a significantly strong correlation with the severity of isolated CAE (r = 0.536, P < .001). To the best of our knowledge, this study showed for the first time that CAR was significantly associated with CAE presence and severity.

scholarly journals C -reactive protein and albumin ratio for the diagnosis of complicated appendicitis in children

2020 ◽  
Author(s):  
Wei Feng ◽  
Qian-Yu Yang ◽  
Xu-Feng Zhao ◽  
Miao-Miao Li ◽  
Hua-Lei Cui
Keyword(s):  
Characteristic Curve ◽  
Prognostic Score ◽  
Area Under The Curve ◽  
Complicated Appendicitis ◽  
Symptom Duration ◽  
Specific Marker ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Independent Risk Factors

Abstract Background: No reliably specific marker for complicated appendicitis has been identified. Serum C-reactive protein (CRP) and albumin (ALB) ratio (CRP/ALB ratio) has been a new inflammation-based prognostic score which is associated with the severity of inflammation. However, its value in the diagnosis of complicated appendicitis has not been studied. The aim of this study was to evaluate the predictive value of CRP/ALB ratio for complicated appendicitis in children. Methods: A retrospective study of 232 children with acute appendicitis was conducted with assessment of age, gender, symptom duration, albumin and blood routine indexes on admission. According to intraoperative findings and postoperative pathological results, patients were divided into the simple appendicitis group (127 cases) and complicated appendicitis group (105 cases). SPSS version 17 was used to analyse the data. Results: Of the 232 patients, 118 (50.9%) were male and 114 (49.1%) were female. The CRP/ALB ratio was higher in complicated appendicitis compared with simple appendicitis (p<0.05). Logistic regression analysis showed that the higher levels of mononuclear cell count (MC), CRP, procalcitonin (PCT) and CRP/ALB ratio were independent risk factors for complicated appendicitis in children. Receiver operating characteristic curve analysis showed that the area under the curve of CRP/ALB ratio (0.946) was was bigger than MC (0.619), CRP (0.906) and PCT (0.843). CRP/ALB ratio >1.43 was found to be a significant marker in predicting complicatedappendicitis with 91.4% sensitivity and 90.6% specificity. Compared with CRP/ALB ratio =<1.43, patients with CRP/ALB ratio >1.43 had a 102.22 times higher chance of complicated appendicitis (95% CI: 41.322 - 252.874). Conclusion: Admission CRP/ALB ratio was significantly higher in children with acute complicated appendicitis. It is a novel but promising hematological marker that aids the differentiation of acute complicated and simple appendicitis.

scholarly journals Prognostic Value of C-Reactive Protein-to-Albumin Ratio in Head and Neck Cancer: A Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 403
Author(s):  
Chih-Wei Luan ◽  
Hsin-Yi Yang ◽  
Yao-Te Tsai ◽  
Meng-Chiao Hsieh ◽  
Hsin-Hsu Chou ◽  
...  
Keyword(s):  
Head And Neck ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Head And Neck Cancers ◽  
C Reactive Protein ◽  
Free Survival ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Distant Metastasis Free Survival ◽  
Disease Free

The C-reactive protein-to-albumin ratio is a proven prognostic predictor of nasopharyngeal carcinoma. However, the role of the C-reactive protein-to-albumin ratio in other head and neck cancers remains unclear. This meta-analysis explored the prognostic value of the C-reactive protein-to-albumin ratio in head and neck cancers. A systematic search was conducted. Outcomes of interest included overall survival, disease-free survival, and distant metastasis–free survival. The hazard ratio with 95% confidence interval was pooled using a random-effects model. A total of 11 publications from the literature were included, allowing for the analysis of 7080 participants. Data pooling demonstrated that pretreatment C-reactive protein-to-albumin ratio had a hazard ratio of 1.88 (95% CI: 1.49−2.37, p < 0.001) for predicting overall survival, 1.91 (95% CI: 1.18−3.08, p = 0.002) for disease-free survival, and 1.46 (95% CI: 1.08−1.96, p = 0.001) for distant metastasis–free survival. Subgroup analysis showed that the C-reactive protein-to-albumin ratio is a significant prognostic marker for various head and neck cancers. An elevated pretreatment C-reactive protein-to-albumin ratio predicts a worse prognosis for patients with head and neck cancers. Therefore, the C-reactive protein-to-albumin ratio could serve as a potential prognostic biomarker facilitating treatment stratification.

scholarly journals D-dimer as a biomarker for assessment of COVID-19 prognosis: D-dimer levels on admission and its role in predicting disease outcome in hospitalized patients with COVID-19

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256744
Author(s):  
Ayusha Poudel ◽  
Yashasa Poudel ◽  
Anurag Adhikari ◽  
Barun Babu Aryal ◽  
Debika Dangol ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Respiratory Illness ◽  
Immunofluorescence Assay ◽  
Cox Proportional Hazards ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Potential Biomarker ◽  
D Dimer

Introduction Coronavirus Disease 2019 is a primarily respiratory illness that can cause thrombotic disorders. Elevation of D-dimer is a potential biomarker for poor prognosis in COVID-19, though optimal cutoff value for D-dimer to predict mortality has not yet been established. This study aims to assess the accuracy of admission D-dimer in the prognosis of COVID-19 and to establish the optimal cutoff D-dimer value to predict hospital mortality. Methods Clinical and laboratory parameters and outcomes of confirmed COVID-19 cases admitted to four hospitals in Kathmandu were retrospectively analyzed. Admitted COVID-19 cases with recorded D-dimer and definitive outcomes were included consecutively. D-dimer was measured using immunofluorescence assay and reported in Fibrinogen Equivalent Unit (μg/ml). The receiver operating characteristic curve was used to determine the accuracy of D-dimer in predicting mortality, and to calculate the optimal cutoff value, based on which patients were divided into two groups and predictive value of D-dimer for mortality was measured. Results 182 patients were included in the study out of which 34(18.7%) died during the hospital stay. The mean admission D-dimer among surviving patients was 1.067 μg/ml (±1.705 μg/ml), whereas that among patients who died was 3.208 μg/ml (±2.613 μg/ml). ROC curve for D-dimer and mortality gave an area under the curve of 0.807 (95% CI 0.728–0.886, p<0.001). Optimal cutoff value for D-dimer was 1.5 μg/ml (sensitivity 70.6%, specificity 78.4%). On Cox proportional hazards regression analysis, the unadjusted hazard ratio for high D-dimer was 6.809 (95% CI 3.249–14.268, p<0.001), and 5.862 (95% CI 2.751–12.489, p<0.001) when adjusted for age. Conclusion D-dimer value on admission is an accurate biomarker for predicting mortality in patients with COVID-19. 1.5 μg/ml is the optimal cutoff value of admission D-dimer for predicting mortality in COVID-19 patients.

scholarly journals The Optimal Cutoff Value of D-dimer Levels to Predict in Hospital Mortality in Severe Cases of Coronavirus Disease 2019

2021 ◽  
Vol 9 (B) ◽  
pp. 1561-1564
Author(s):  
Ngakan Ketut Wira Suastika ◽  
Ketut Suega
Keyword(s):  
Hospital Mortality ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Optimal Cutoff ◽  
Cutoff Value ◽  
Operating Characteristic Curve ◽  
D Dimer

Introduction: Coronavirus disease 2019 (Covid-19) can cause coagulation parameters abnormalities such as an increase of D-dimer levels especially in severe cases. The purpose of this study is to determine the differences of D-dimer levels in severe cases of Covid-19 who survived and non-survived and determine the optimal cut-off value of D-dimer levels to predict in-hospital mortality. Method: Data were obtained from confirmed Covid-19 patients who were treated from June to September 2020. The Mann-Whitney U test was used to determine differences of D-dimer levels in surviving and non-surviving patients. The optimal cut-off value and area under the curve (AUC) of the D-dimer level in predicting mortality were obtained by the receiver operating characteristic curve (ROC) method. Results: A total of 80 patients were recruited in this study. Levels of D-dimer were significantly higher in non-surviving patients (median 3.346 mg/ml; minimum – maximum: 0.939 – 50.000 mg/ml) compared to surviving patients (median 1.201 mg/ml; minimum – maximum: 0.302 – 29.425 mg/ml), p = 0.012. D-dimer levels higher than 1.500 mg/ml are the optimal cut-off value for predicting mortality in severe cases of Covid-19 with a sensitivity of 80.0%; specificity of 64.3%; and area under the curve of 0.754 (95% CI 0.586 - 0.921; p = 0.010). Conclusions: D-dimer levels can be used as a predictor of mortality in severe cases of Covid-19.

Prognostic value of C-reactive protein/albumin ratio in renal cell carcinoma: a systematic review and meta-analysis

2019 ◽  
Author(s):  
hualin song ◽  
Peng xiang ◽  
Zhifu liu ◽  
shuai hu ◽  
Jie Jin
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Clinicopathological Features ◽  
C Reactive Protein ◽  
Poor Overall Survival ◽  
Albumin Ratio ◽  
Reactive Protein

Abstract Background: There are a mass of studies declared the prognostic significance of C-reactive protein/albumin ratio (CRP/Alb) in renal cell carcinoma (RCC). Nevertheless, these works are controversial. In our study, we investigate the expression of CRP/Alb in RCC and its role in prognosis and clinicopathological features. Methods: The PubMed, Embase and Cochrane databases were searched systematically for correlative articles published before August 1, 2019. Hazard ratios (HRs) and 95% confidence intervals (CIs) were determined according to eligible studies. And we use fixed and random effects models to calculate on the basis of heterogeneity. Results: Six relevant studies were identified in this study, 1959 participants included in total. Our results showed that CRP/Alb was related to poor overall survival (HR=1.86, 95% CI: 1.56-2.21). In addition, CRP/Alb was also associated with tumor stage (OR=3.29, 95% CI: 1.66-6.50), lymph node involvement (OR=3.76, 95% CI: 2.57-5.51), metastasis (OR=5.69, 95% CI: 2.40-13.51), Fuhrman nuclear grade (OR=4.21, 95% CI: 3.14-5.64), pTNM (OR=4.34, 95% CI: 1.94-9.70) and tumor size (WMD=2.26, 95% CI: 1.86–2.67). However, CRP/Alb was not associated with necrosis. Conclusion: Our study illustrates that the higher CRP/Alb expression was correlated with poorer prognosis and more advanced clinicopathological features in RCC patients. High CRP/Alb expression may act as a valuable predictive biomarker for poor prognosis in RCC patients.

scholarly journals Usefulness of Lymphocyte ratio and CRP Level for Early Detection of Surgical Site Infection Following spinal surgery

2019 ◽  
Author(s):  
Wenbo Wei ◽  
Shajie Dang ◽  
Dapeng Duan ◽  
Liqun Gong ◽  
Jue Wang ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Spinal Surgery ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Site Infection ◽  
C Reactive Protein ◽  
Lymphocyte Ratio ◽  
Reactive Protein ◽  
Operating Characteristic Curve

Abstract Background: To investigate the significant laboratory markers for early diagnosis of surgical site infection after spinal surgery. And determine the diagnostic cut-off values of these markers Methods: A total of 67 patients participated in the study: 11 patients who developed surgical site infection after spinal surgery (SSI Group) and 56 patients were compared with the infected group in terms of age，gender, operating time and intraoperative blood loss (Non-SSI Group). The white blood cell (WBC) count , WBC differential , C-reactive protein (CRP) and erythrocyte sedimentation rate(ESR) were determined before and 1, 3 and 7 days postoperatively . Then, we determine the diagnostic cutoff for these markers by using the receiver operating characteristic curve. Results: The CRP, ESR and WBC were significantly higher in the SSI group at 3 and 7 days postoperatively. The lymphocyte ratio at 3 days postoperatively was significantly lower in the SSI Group. Using the receiver operating characteristic curve，lymphocyte ratio <11.5% at 3 days postoperatively (sensitivity 90.9%, specificity 75.4%, area under the curve [AUC] 0.919), and C-reactive protein level >26 mg/dL at 7 days postoperatively (sensitivity 90.9%, specificity 87.7%, area under the curve [AUC] 0.954) were the significant laboratory marker for early detection of SSI Conclusion: Lymphocyte ratio<11.5% at 3 days and C-reactive protein levels>26.5mg/dl at 7 days after spinal surgery are reliable markers of SSI.

scholarly journals Hypersensitive C-Reactive Protein-Albumin Ratio Predicts Symptomatic Intracranial Hemorrhage After Endovascular Therapy in Acute Ischemic Stroke Patients

2020 ◽  
Author(s):  
Qiang Peng ◽  
Jiankang Hou ◽  
Siyu Wang ◽  
Feng Zhou ◽  
Yan E ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Intracranial Hemorrhage ◽  
Endovascular Therapy ◽  
Characteristic Curve ◽  
C Reactive Protein ◽  
Anterior Circulation ◽  
Discriminative Ability ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Symptomatic Intracranial Hemorrhage

Abstract Background and purpose: A fraction of patients would develop symptomatic intracranial hemorrhage (sICH) after endovascular therapy. The aim of our study was to explore the ability of hypersensitive C-reactive protein-albumin ratio (HAR) in predicting sICH after endovascular therapy.Methods: From April 2016 to December 2018, 334 consecutive patients with anterior circulation infarction undergoing endovascular therapy were enrolled in our study. sICH was defined as a National Institutes of Health Stroke Scale score increase of ≥ 4 points within 24 hours after endovascular therapy. Multiple regression analysis was used to investigate the potential risk factors of sICH after endovascular therapy. We used receiver operating characteristic curve analysis and nomogram analysis to assess the overall discriminative ability of the HAR in predicting sICH after endovascular therapy.Results: Among these 334 patients enrolled, 37 (11.1%) patients with anterior circulation infarction were identified with sICH after endovascular therapy. Univariate logistic regression analysis demonstrated that patients with higher levels of HAR may be inclined to develop sICH [odds ratio, 10.994; 95% confidence interval (CI), 4.567–26.463; P = 0.001]. This association remained significant even after adjustment for potential confounders. Also, a cutoff value of 0.526×10-3 for HAR was detected in predicting sICH (area under curve, 0.763). Furthermore, nomogram analysis also suggested that HAR was an indicator of sICH (c-index was 0.890, P<0.001).Conclusions: This study showed that high levels of HAR may predict sICH after endovascular therapy.

scholarly journals C -reactive protein and albumin ratio for the diagnosis of complicated appendicitis in children

2019 ◽  
Author(s):  
Wei Feng ◽  
Qian-Yu Yang ◽  
Xu-Feng Zhao ◽  
Miao-Miao Li ◽  
Hua-Lei Cui
Keyword(s):  
Acute Appendicitis ◽  
Area Under The Curve ◽  
Complicated Appendicitis ◽  
Symptom Duration ◽  
Specific Marker ◽  
C Reactive Protein ◽  
Roc Curve Analysis ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Age Range

Abstract Background: No reliably specific marker for complicated appendicitis has been identified. Serum C-reactive protein (CRP) increases and albumin (ALB) decreases in patients with inflammation and infection. C-reactive protein and albumin ratio (CRP/ALB ratio) has been found associated with neonatal septicemia, inflammatory bowel disease and pancreatitis. However, its value in the diagnosis of complicated appendicitis has not been studied. The aim of this study was to evaluate the value of CRP/ALB ratio for predicting complicated appendicitis in children.Methods: A retrospective study of 232 children with acute appendicitis was conducted with assessment of age, gender, weight, symptom duration, albumin and blood routine indexes. According to intraoperative findings and postoperative pathological results, patients were divided into the simple appendicitis group (127 cases) and complicated appendicitis group (105 cases). SPSS version 17 was used to analyse the data.Results: Of the 232 patients, 118 (50.9%) were male and 114 (49.1%) were female. The age range was 1 to 15 years, the mean age of the patients was 8.30 ± 3.25 years. The CRP/ALB ratio was higher in complicated appendicitis compared with simple appendicitis(p<0.05). Logistic regression analysis showed that mononuclear cell (MC), CRP, procalcitonin (PCT) and CRP/ALB ratio were independent risk factors for complicated appendicitis in children. Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of CRP/ALB ratio was higher than MC, PCT and CRP (0.946 vs 0.619 vs 0.843 vs 0.906). CRP/ALB ratio >1.43 was found to be a significant marker in predicting complicated appendicitis with 91.4 % sensitivity and 90.6 % specificity. Compared with CRP/ALB ratio=<1.43, patients with CRP/ALB ratio >1.43 had a 102.22 times higher chance of complicated appendicitis (95% CI:41.322 - 252.874).Conclusion: The CRP/ALB ratio is a novel and promising indicator to predict complicated appendicitis in children before operation，which is easy-to-measure and repeatable. Therefore, CRP/ALB ratio can provide a reference for the choice of surgical treatment for acute appendicitis in children.

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