Relation of C-reactive protein-to-albumin ratio and systemic immune-inflammation index with pathological characteristics and prognosis of serous ovarian cancer patients

doi:10.3969/j.issn.1673-8640.2024.04.009

Abstract

Abstract:

Objective To investigate the relation of C-reactive protein（CRP）-to-albumin（Alb） ratio（CAR） and systemic immune-inflammation index（SII） with pathological characteristics and prognosis of serous ovarian cancer patients. Methods A total of 132 patients with serous ovarian cancer were enrolled from Luoyang Central Hospital from January 2017 to January 2021. The general clinical data and preoperative platelet（PLT） count，neutrophil（NEUT） count，lymphocyte（LY） count，CRP，Alb determination results were collected，and CAR and SII were calculated. According to the medians of CAR and SII，the patients were classified into low CAR group，high CAR group and low SII group，high SII group，respectively. The differences of pathological characteristics，recurrence free survival（RFS） and overall survival（OS） among different CAR and SII groups were analyzed. Both univariate and multivariate Cox regression models were used to analyze the influencing factors of RFS and OS in patients with serous ovarian cancer. Results The International Federation of Gynecology and Obstetrics（FIGO） stage，histological grade and lymphatic metastasis in high CAR group and high SII group had statistical significance with those in low CAR group and low SII group，respectively（P<0.05）. The proportions of residual tumor diameter <1 cm in high CAR group and high SII group were lower than those in low CAR group and low SII group，respectively（P<0.05）. The RFS and OS of high CAR group and high SII group were lower than those of low CAR group and low SII group，respectively（P<0.05）. FIGO stage（Ⅲ+Ⅳ），high CAR and high SII were independent risk factors for postoperative RFS in patients with serous ovarian cancer [hazard ratios（HR） were 2.258，2.665 and 4.432，95% confidence intervals（CI） were 1.125-4.534，1.401-5.069 and 2.227-8.821，respectively]. FIGO stage（Ⅲ+Ⅳ），carbohydrate antigen 125（CA125）（≥35 U/L），high CAR and high SII were independent risk factors for postoperative OS in patients with serous ovarian cancer（HR were 4.574，4.417，3.167 and 5.500，95%CI 1.660-12.607，1.426-13.686，1.392-7.206 and 2.254-13.424，respectively）. Conclusions CAR and SII in patients with serous ovarian cancer are related to FIGO stage，histological grade and lymphatic metastasis，and preoperative high CAR and SII are independent risk factors for poor prognosis of patients with serous ovarian cancer，which can be used as reference indexes for the prognosis evaluation of patients with serous ovarian cancer.

Key words: C-reactive protein-to-albumin ratio, Systemic immune-inflammation index, Serous ovarian cancer, Prognosis

CLC Number:

R446.1

ZHOU Yufei, LI Yunhui, LI Bingyi, HOU Qingxia. Relation of C-reactive protein-to-albumin ratio and systemic immune-inflammation index with pathological characteristics and prognosis of serous ovarian cancer patients[J]. Laboratory Medicine, 2024, 39(4): 363-368.

Figures/Tables 7

References 20

[1]	刘蓉, 王德刚. 卵巢癌组织中SIRT-1、CD44的表达及临床意义[J]. 检验医学, 2022, 37(7):632-635. DOI
[2]	YANG Y, QI S, SHI C, et al. Identification of metastasis and prognosis-associated genes for serous ovarian cancer[J]. Biosci Rep, 2020, 40(6):BSR20194324.
[3]	何旻, 陈观美, 程其会, 等. 血清CEA和Cyfra21-1水平及其与卵巢癌患者临床病理参数和预后的关系研究[J]. 中国妇产科临床杂志, 2021, 22(1):20-22.
[4]	何永梅, 金海红, 陈思思, 等. 外周血纤维蛋白原与白蛋白比值对卵巢癌预后的评估[J]. 中国妇产科临床杂志, 2021, 22(4):413-415.
[5]	ZHANG Y, XIAO G, WANG R. Clinical significance of systemic immune-inflammation index(SII)and C-reactive protein-to-albumin ratio(CAR)in patients with esophageal cancer:a meta-analysis[J]. Cancer Manag Res, 2019,11:4185-4200.
[6]	张辉, 施仲义, 胡一迪, 等. 术前系统免疫炎症指数和反应蛋白/血清白蛋白比值与非小细胞肺癌预后的相关性[J]. 中国卫生检验杂志, 2019, 29(5):573-576.
[7]	林仲秋, 谢玲玲, 李晶. FIGO 2013卵巢癌、输卵管癌、腹膜癌新分期解读[J]. 中国实用妇科与产科杂志, 2013, 29(12):921-923.
[8]	YEH Y C, LEI H J, CHEN M H, et al. C-reactive protein(CRP)is a promising diagnostic immunohistochemical marker for intrahepatic cholangiocarcinoma and is associated with better prognosis[J]. Am J Surg Pathol, 2017, 41(12):1630-1641. DOI URL
[9]	KATSURAHARA K, SHIOZAKI A, FUJIWARA H, et al. Relationship between postoperative CRP and prognosis in thoracic esophageal squamous cell carcinoma[J]. Anticancer Res, 2018, 38(11):6513-6518. DOI PMID
[10]	叶宗伟, 杨毅宁. 血清C反应蛋白、白蛋白及其比值在炎症相关性疾病中的进展[J]. 医学综述, 2017, 23(20):3979-3983.
[11]	YAMAGATA K, FUKUZAWA S, ISHIBASHI-KANNO N, et al. Association between the C-reactive protein/albumin ratio and prognosis in patients with oral squamous cell carcinoma[J]. Sci Rep, 2021, 11(1):5446. DOI PMID
[12]	KUDOU K, SAEKI H, NAKASHIMA Y, et al. C-reactive protein/albumin ratio is a poor prognostic factor of esophagogastric junction and upper gastric cancer[J]. J Gastroenterol Hepatol, 2019, 34(2):355-363. DOI URL
[13]	杜学峰, 徐永富, 戴启强, 等. C-反应蛋白/血清白蛋白比值与原发性肝癌临床病理特征及预后的关系[J]. 中国卫生检验杂志, 2019, 29(10):1189-1193.
[14]	LIU Y, CHEN S, ZHENG C, et al. The prognostic value of the preoperative C-reactive protein/albumin ratio in ovarian cancer[J]. BMC Cancer, 2017, 17(1):285. DOI PMID
[15]	YANG Y L, WU C H, HSU P F, et al. Systemic immune-inflammation index(SII)predicted clinical outcome in patients with coronary artery disease[J]. Eur J Clin Invest, 2020, 50(5):e13230. DOI URL
[16]	高娴, 范红星, 吴博, 等. 术前系统免疫炎症指数对远端胆管癌患者术后预后的评估价值[J]. 中国普通外科杂志, 2022, 31(2):217-224.
[17]	李健, 孟赛赛, 柏凯, 等. 系统免疫炎症指数与肝门部胆管癌患者术后预后的关系[J]. 中华肝胆外科杂志, 2021, 27(2):106-109.
[18]	WANG C, JIN S, XU S, et al. High systemic immune-inflammation index(SII)represents an unfavorable prognostic factor for small cell lung cancer treated with etoposide and platinum-based chemotherapy[J]. Lung, 2020, 198(2):405-414. DOI
[19]	万梦园, 刘书娟, 刘晶晶, 等. 术前系统免疫炎症指数与胰腺癌患者预后的关系[J]. 实用医学杂志, 2021, 37(19):2482-2486.
[20]	NIE D, GONG H, MAO X, et al. Systemic immune-inflammation index predicts prognosis in patients with epithelial ovarian cancer:a retrospective study[J]. Gynecol Oncol, 2019, 152(2):259-264. DOI URL

组别	例数	年龄				绝经		FIGO分期				组织学分级			腹水
组别	例数	≤65岁/例	>65 岁/例			是/例	否/例	Ⅰ+Ⅱ期/例		Ⅲ+Ⅳ期/例		低级别/例		高级别/例	有/例	无/例
低CAR组	66	47	19			43	23	34		32		38		28	41	25
高CAR组	66	45	21			43	23	22		44		22		44	30	36
统计值		0.143				0.000		4.466				7.822			3.688
P值		0.705				1.000		0.035				0.005			0.055
组别	肿瘤直径			淋巴转移			CA125				CAR		SII
组别	<6 cm/例	≥6 cm/例		是/例	否/例		<35 U·L^-1/例		≥35 U·L^-1/例		CAR		SII
低CAR组	40	26		26	40		26		40		0.18±0.08		572.52±340.61
高CAR组	40	26		43	23		17		49		0.61±0.11		534.48±330.84
统计值	0.000			8.776			2.794				26.572		0.651
P值	1.000			0.003			0.095				<0.001		0.516

组别	例数	年龄				绝经		FIGO分期				组织学分级			腹水
组别	例数	≤65岁/例	>65 岁/例			是/例	否/例	Ⅰ+Ⅱ期/例		Ⅲ+Ⅳ期/例		低级别/例		高级别/例	有/例	无/例
低CAR组	66	47	19			43	23	34		32		38		28	41	25
高CAR组	66	45	21			43	23	22		44		22		44	30	36
统计值		0.143				0.000		4.466				7.822			3.688
P值		0.705				1.000		0.035				0.005			0.055
组别	肿瘤直径			淋巴转移			CA125				CAR		SII
组别	<6 cm/例	≥6 cm/例		是/例	否/例		<35 U·L^-1/例		≥35 U·L^-1/例		CAR		SII
低CAR组	40	26		26	40		26		40		0.18±0.08		572.52±340.61
高CAR组	40	26		43	23		17		49		0.61±0.11		534.48±330.84
统计值	0.000			8.776			2.794				26.572		0.651
P值	1.000			0.003			0.095				<0.001		0.516

组别	例数	年龄			绝经			FIGO分期				组织学分级			腹水
组别	例数	≤65岁/例	>65岁/例		是/例	否/例		Ⅰ+Ⅱ期/例		Ⅲ+Ⅳ期/例		低级别/例		高级别/例	有/例	无/例
低SII组	66	46	20		43	23		34		32		36		30	38	28
高SII组	66	46	20		43	23		22		44		24		42	33	33
统计值		0.000			0.000			4.466				4.400			0.762
P值		1.000			1.000			0.035				0.036			0.383
组别	肿瘤直径			淋巴转移			CA125				CAR		SII
组别	<6 cm/例	≥6 cm/例		是/例	否/例		<35 U·L^-1/例		≥35 U·L^-1/例		CAR		SII
低SII组	45	21		26	40		27		39		0.38±0.24		268.54±134.04
高SII组	35	31		43	23		16		50		0.40±0.23		838.46±208.19
统计值	3.173			8.776			4.174				0.470		18.699
P值	0.075			0.003			0.041				0.639		<0.001

组别	例数	年龄			绝经			FIGO分期				组织学分级			腹水
组别	例数	≤65岁/例	>65岁/例		是/例	否/例		Ⅰ+Ⅱ期/例		Ⅲ+Ⅳ期/例		低级别/例		高级别/例	有/例	无/例
低SII组	66	46	20		43	23		34		32		36		30	38	28
高SII组	66	46	20		43	23		22		44		24		42	33	33
统计值		0.000			0.000			4.466				4.400			0.762
P值		1.000			1.000			0.035				0.036			0.383
组别	肿瘤直径			淋巴转移			CA125				CAR		SII
组别	<6 cm/例	≥6 cm/例		是/例	否/例		<35 U·L^-1/例		≥35 U·L^-1/例		CAR		SII
低SII组	45	21		26	40		27		39		0.38±0.24		268.54±134.04
高SII组	35	31		43	23		16		50		0.40±0.23		838.46±208.19
统计值	3.173			8.776			4.174				0.470		18.699
P值	0.075			0.003			0.041				0.639		<0.001

组别	例数	术后并发症/[例（%）]	术后残留肿瘤直径<1 cm/[例（%）]	术后肠道恢复时间/d	住院时间/d
低CAR组	66	6（9.1）	53（80.3）	2.2±0.9	16.3±3.2
高CAR组	66	12（18.2）	42（63.6）	2.2±0.9	17.1±3.8
统计值		2.316	4.544	0.571	1.446
P值		0.126	0.033	0.569	0.151