C-Reactive Protein to Albumin ratio is an Indicator of Poor Prognosis for Patients with Biliary Tract Cancer

244 Background: Age is a mirror for pathogenesis in some of biliary tract cancer (BTC) as liver fluke- or pancreaticobiliary maljunction-associated BTCs. However, the age effects including prognosis in BTC were not fully understood. The identification of the age effects might be helpful for the management of BTC. Methods: For the years 1992-2014, 1287 patients receiving initial treatment for BTC in our institution were reviewed. According to age at diagnosis of BTC, patients were divided into the five age groups as <50, 50-59, 60-69, 70-79, and ≥80. The relationships between overall survival time (OS) and the five age groups were analyzed using wilcoxon test to choose a prognostic cut-off of age. On the basis of a prognostic cut-off of age, the prognostic age classification was constructed. The multivariate analysis with logistic regression modeling was performed to determine the influence of gender, Eastern Cooperative Oncology Group performance status scale [ECOG-PS], primary site, and metastatic site on the prognostic age classification. Results: Median age was 67 years with male 59%. ECOG PS of 0 was 63.7%.The sites of primary tumor included intrahepatic (25.2%) and extrahepatic bile duct (34.0%), gallbladder (31.9%) and ampulla of Vater (8.9%). The prognostic cut-off of age was age less than 60 (21.8% of all). Median OS in younger patients (age<60, median OS: 7.9mo) was shorter than that in elder patients (age≥60, median OS 12.4mo, P<0.01). In univariate analysis, the prevalence of bone metastasis, distal lymph node metastasis and peritoneal dissemination was higher in younger BTC than elder patients. Multivariate analysis revealed that peritoneal dissemination was an independent younger BTC related-factor (OR=1.9, P<0.01). Conclusions: Younger BTC patients (age<60) showed poor prognosis and the high frequency of peritoneal dissemination, compared to elder BTC patients. The relationship between age and peritoneal dissemination of BTC might be a key to elucidate the age effect concomitant with poor prognosis.

Download Full-text

Genomic alterations in biliary tract cancer predict prognosis and immunotherapy outcomes

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2021-003214 ◽

2021 ◽

Vol 9 (11) ◽

pp. e003214

Author(s):

Xiaofeng Chen ◽

Deqiang Wang ◽

Jing Liu ◽

Jingrong Qiu ◽

Jun Zhou ◽

...

Keyword(s):

Biliary Tract ◽

Biliary Tract Cancer ◽

Poor Prognosis ◽

Immune Cell ◽

Checkpoint Inhibitors ◽

Early Stage ◽

Chinese Patients ◽

Genomic Alterations ◽

Early Stage Disease ◽

Tract Cancer

BackgroundRecently, immunotherapy with immune checkpoint inhibitors (ICIs) has shown promising efficacy in biliary tract cancer (BTC), which includes gallbladder cancer (GBC) and cholangiocarcinoma (CHOL). Understanding the association between immunotherapy outcomes and the genomic profile of advanced BTC may further improve the clinical benefits from immunotherapy.MethodsGenomic tumor DNA was isolated from 98 Chinese patients with advanced BTC and used for targeted next-generation sequencing of 416 cancer-related genes to identify the genomic alterations common to advanced BTC. Thirty-four patients had received ICI camrelizumab plus gemcitabine and oxaliplatin (from the NCT03486678 trial) as a first-line treatment. Tumor-infiltrating immune cells were evaluated using immunofluorescence staining.ResultsKRAS and TP53 mutations were much more frequent in the advanced-stage BTC cohort than in other cohorts with mostly early stage disease. Specifically, KRAS-TP53 co-mutations were favored in advanced CHOL, with a favorable response to immunotherapy, while single KRAS mutations predicted poor prognosis and immunotherapy outcomes for CHOL. Compared with GBC, CHOL had more mutations in genes involved in KRAS signaling; a high mutation load in these genes correlated with poor immunotherapy outcomes and may subsequently cause inferior immunotherapy outcomes for CHOL relative to GBC. Furthermore, a genomic signature including 11 genes was developed; their mutated subtype was associated with poor prognosis and immunotherapy outcomes in both CHOL and GBC. Transcriptome analyses suggested immune dysfunction in the signature mutated subtype, which was validated by tumor microenvironment (TME) evaluation based on detection of immune cell infiltration. Importantly, the signature wild-type subtype with favorable TME may be an advantageous population of immunotherapy.ConclusionsGenomic alterations in advanced BTC were associated with specific prognosis and immunotherapy outcomes. Combining genomic classification with TME evaluation further improved the stratification of immunotherapy outcomes.

Download Full-text

Hyperfibrinogenemia predicts poor prognosis in patients with advanced biliary tract cancer

Tumor Biology ◽

10.1007/s13277-015-4184-6 ◽

2015 ◽

Vol 37 (3) ◽

pp. 3535-3542 ◽

Cited By ~ 8

Author(s):

Heming Li ◽

Tong Zhao ◽

Xuening Ji ◽

Shanshan Liang ◽

Zhe Wang ◽

...

Keyword(s):

Biliary Tract ◽

Biliary Tract Cancer ◽

Poor Prognosis ◽

Tract Cancer

Download Full-text

Significance of Pretreatment C-Reactive Protein, Albumin, and C-Reactive Protein to Albumin Ratio in Predicting Poor Prognosis in Epithelial Ovarian Cancer Patients

Nutrition and Cancer ◽

10.1080/01635581.2020.1798479 ◽

2020 ◽

pp. 1-8

Author(s):

Naoko Komura ◽

Seiji Mabuchi ◽

Kotaro Shimura ◽

Mahiru Kawano ◽

Yuri Matsumoto ◽

...

Keyword(s):

Ovarian Cancer ◽

Epithelial Ovarian Cancer ◽

Cancer Patients ◽

Poor Prognosis ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein

Download Full-text

The C-reactive protein to albumin ratio is a novel prognostic factor in patients with stable coronary artery disease following percutaneous coronary intervention

10.21203/rs.3.rs-38791/v1 ◽

2020 ◽

Author(s):

Yang Zou ◽

Mingchun Zhong ◽

Hui Zeng ◽

Xiaohua Chen ◽

Guotai Sheng

Keyword(s):

Poor Prognosis ◽

Prognostic Value ◽

Inflection Point ◽

Stable Coronary Artery Disease ◽

Coronary Intervention ◽

C Reactive Protein ◽

Albumin Ratio ◽

Reactive Protein ◽

Percutaneous Coronary ◽

Artery Disease

Abstract Background Previous studies have shown that both C-reactive protein (CRP) and albumin (Alb) are the prognostic factors of cardiovascular. However, the prognostic value of C-reactive protein to albumin ratio (CAR) in patients with stable coronary artery disease (SCAD) is unclear. Methods This was a retrospective cohort study that continuously enrolled 204 patients with newly diagnosed SCAD between October 2014 and October 2017; the mean follow-up time was 793.75 ± 430.26 days. The Cox proportional hazard model was used to evaluate the prognostic value of CAR in patients with SCAD. Results In the Kaplan–Meier analysis, the long-term MACE (major adverse cardiac events) free survival rate of patients with high CAR levels decreased significantly (P = 0.015). Of the note, after adjusting for other covariates in multivariate analysis, CAR was still independently positively correlated with poor prognosis in SCAD patients (HR = 1.03, 95% CI:1.01–1.06, P = 0.02, P for trend = 0.024). Additionally, we identified a nonlinear association between CAR and poor prognosis of SCAD by the generalized additive model (GAM). Then, through the two-piecewise linear regression model, we calculated that the inflection point of CAR was 3.933 (log-likelihood ratio test P = 0.02). When CAR ≤ 3.933, there was a positive correlation between CAR and MACE in patients with SCAD (HR:1.48, 95% CI:1.10–1.99, P = 0.009). While on the right hand of the inflection point (CAR > 3.933), the positive correlation between the two tends to be saturated (HR:1.01, 95% CI:0.97–1.05, P = 0.64). Conclusions This study indicated an association between higher CAR levels and increased risk of MACE in patients with SCAD for the first time, and measurement of CAR at admission may be a valuable predictor of the prognostic outcome in patients with SCAD treated by the percutaneous coronary intervention.

Download Full-text