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The prognostic value of C-reactive protein/albumin ratio in human malignancies: an updated meta-analysis

Authors Xu H, Ma Y, Deng F, Ju W, Sun X, Wang H

Received 14 March 2017

Accepted for publication 29 April 2017

Published 19 June 2017 Volume 2017:10 Pages 3059—3070


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 2

Editor who approved publication: Dr William Cho

Hong-jun Xu, Yan Ma, Fang Deng, Wen-bo Ju, Xin-yi Sun, Hua Wang

Department of Gastroenterology, Affiliated Hospital of Beihua University, Jilin, Jilin province, China

Purpose: This study aims to investigate the prognostic value of pretreatment C-reactive protein/albumin ratio (CAR) in human malignancies by an updated meta-analysis.
Methods: PubMed, Web of Science, Cochrane Library and Wanfang databases were searched. Pooled hazard ratios (HRs) and odds ratios (ORs) with their corresponding 95% confidence intervals (CIs) were used as effective values.
Results: A total of 25 studies with 12,097 patients were included in this meta-analysis. Pooled results showed that high pretreatment CAR was associated with poor overall survival (OS) (HR =1.99, 95% CI: 1.65–2.40, P=0.000) and poor disease-free survival (HR =1.55, 95% CI: 1.34–1.79, P=0.000). In addition, high pretreatment CAR was associated with increased 5-year mortality (OR =2.74, 95% CI: 2.11–3.55, P=0.000). Moreover, subgroup analysis demonstrated that high CAR was associated with poor OS despite variations in publication year, country, sample size, CAR cut-off value and treatment. However, high CAR was associated with poor OS in human malignancies except colorectal cancer (HR =1.64, 95% CI: 0.96–2.80, P=0.069).
Conclusion: High pretreatment CAR indicates poor prognosis in human malignancies except colorectal cancer. Thus, pretreatment CAR serves as a prognostic marker in human malignancies and could be used in the evaluation of prognosis in clinical work.

Keywords: human malignancies, C-reactive protein/albumin ratio, prognosis, meta-analysis

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