C-reactive protein/albumin ratio as prognostic score in oral squamous cell carcinoma

J Korean Assoc Oral Maxillofac Surg. 2016 Oct;42(5):243-250. doi: 10.5125/jkaoms.2016.42.5.243. Epub 2016 Oct 25.

Abstract

Objectives: Many studies have examined histopathological factors and various prognostic scores related to inflammation to predict outcomes. Here, we examined the prognostic value of the C-reactive protein/albumin (CRP/alb) ratio in oral squamous cell carcinoma (OSCC).

Materials and methods: This retrospective study included 40 patients with OSCC. Using univariate and multivariate analyses, we focused on the correlation of the CRP/alb ratio with clinicopathological characteristics and with overall survival. We then compared five inflammation-based prognostic scores, CRP/alb ratio, modified Glasgow Prognostic Score (mGPS), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and prognostic nutritional index (PNI), based on receiver operating characteristic (ROC) curves.

Results: The optimal cut-off value for the CRP/alb ratio was 0.085. The group with a high CRP/alb ratio had a high TNM clinical stage (P=0.002) and larger primary tumors (P=0.029), with statistically significant differences in lymph node metastasis and distant metastasis. In addition, when the CRP/alb ratio was high, multivariate analysis showed a lower survival rate (P=0.002; hazard ratio=6.078), and the ROC curve showed more outstanding discriminatory ability regarding overall survival compared to other inflammation-based prognostic scores.

Conclusion: The CRP/alb ratio can be an independent prognostic factor when predicting prognosis in OSCC and has good prognostic ability.

Keywords: Albumin; C-reactive protein; Squamous cell carcinoma.