Open AccessPrognostic and clinicopathological significance of C-reactive protein/albumin ratio (CAR) in patients with gastric cancer: A meta-analysis
Author(s) -
Junhua Yu,
Huiling Liu,
Xueyun Zeng,
Yujun Zhao,
Dejun Jiang,
Hongyan Lü,
Jun Qian
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0250295
Subject(s) - meta analysis , medicine , hazard ratio , cochrane library , confidence interval , gastroenterology , cancer , oncology , subgroup analysis
Background In recent years, many studies have explored the potential prognostic utility of C-reactive protein/albumin ratio (CAR) in patients with gastric cancer (GC), however, the results remain conflicting. We thus performed a meta-analysis to determine the association of CAR and prognosis of GC. Methods This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. PubMed, Web of science, Embase, and Cochrane Library were searched. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) and cancer-specific survival (CSS) of included studies were pooled to estimate the prognostic value of CAR. Results Eight studies with a total of 3,216 patients were included in this meta-analysis. High CAR was significantly associated with poor OS (HR = 1.59, 95%CI = 1.36–1.85, p<0.001) and worse CSS (HR = 1.65, 95%CI = 1.21–2.25, p = 0.002). In addition, high CAR was significantly associated with male sex (OR = 1.80, 95%CI = 1.31–2.47, p<0.001), advanced tumor stage (OR = 2.14, 95%CI = 1.48–3.09, p<0.001), and tumor size ≥3cm (OR = 2.69, 95%CI = 1.84–3.93, p<0.001). Conclusion Elevated pretreatment CAR is a prognostic marker of poor OS and CSS in patients with GC. Furthermore, high CAR levels are associated with clinicopathological features reflecting tumor progression.