Research progress of serum C-reactive protein, prealbumin and their ratio in gastric cancer_West China Medical Journal

Authors：

DU Mingli ¹ ,  LI Guixiang ¹ , ZHAO Lei ¹ , CHEN Hao ² , WANG Likang ³

1. Department of Gamma Knife Therapy, the Second Hospital of Lanzhou University, Lanzhou, Gansu 730030, P. R. China;
2. Department of Oncology, the Second Hospital of Lanzhou University, Lanzhou, Gansu 730030, P. R. China;
3. Department of General Surgery, the First Hospital of Lanzhou University, Lanzhou, Gansu 730030, P. R. China;

Corresponding author：

LI Guixiang, Email: lgx.doctor.007@163.com

Keywords：

Gastric cancer; C-reactive protein; Prealbumin

DOI：

10.7507/1002-0179.202004088

Video：

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In recent years, domestic and foreign scholars have carried out extensive research on the prognostic factors of gastric cancer. Among them, non-specific inflammatory markers and nutritional indicators are the most concentrated in gastric cancer. C-reactive protein, as an acute phase protein, has been widely used to diagnose acute and chronic inflammation throughout the body. Prealbumin is a sensitive indicator of nutrition with a shorter half-life, which can quickly reflect the nutritional status of the body. At present, C-reactive protein and prealbumin as sensitive indicators of inflammation and nutrition, have shown certain predictive value in terms of postoperative complications and prognosis of gastric cancer. This article reviews the use of C-reactive protein, prealbumin and their ratios in predicting postoperative complications and prognosis of gastric cancer, aiming to provide a reference for the diagnosis and treatment of patients after gastric cancer.

Citation： DU Mingli, LI Guixiang, ZHAO Lei, CHEN Hao, WANG Likang. Research progress of serum C-reactive protein, prealbumin and their ratio in gastric cancer. West China Medical Journal, 2021, 36(3): 401-405. doi: 10.7507/1002-0179.202004088 Copy

1.	Thrift AP, El-Serag HB. Burden of gastric cancer. Clin Gastroenterol Hepatol, 2020, 18(3): 534-542.
2.	Singh N, Baby D, Rajguru JP, et al. Inflammation and cancer. Ann Afr Med, 2019, 18(3): 121-126.
3.	Zhou J, Hiki N, Mine S, et al. Role of Prealbumin as a powerful and simple index for predicting postoperative complications after gastric cancer surgery. Ann Surg Oncol, 2017, 24(2): 510-517.
4.	曾繁昌, 曾繁明. 消化道疾病血清 CRP 与肿瘤标志物的联合检测意义. 数理医药学杂志, 2017, 30(2): 201-202.
5.	Kim EY, Yim HW, Park CH, et al. C-reactive protein can be an early predictor of postoperative complications after gastrectomy for gastric cancer. Surg Endosc, 2017, 31(1): 445-454.
6.	Kong F, Gao F, Chen J, et al. Elevated serum C-reactive protein level predicts a poor prognosis for recurrent gastric cancer. Oncotarget, 2016, 7(34): 55765-55770.
7.	Shishido Y, Fujitani K, Yamamoto K, et al. C-reactive protein on postoperative day 3 as a predictor of infectious complications following gastric cancer resection. Gastric Cancer, 2016, 19(1): 293-301.
8.	Davis CJ, Sowa D, Keim KS, et al. The use of prealbumin and C-reactive protein for monitoring nutrition support in adult patients receiving enteral nutrition in an urban medical center. JPEN J Parenter Enteral Nutr, 2012, 36(2): 197-204.
9.	Ablij H, Meinders A. C-reactive protein: history and revival. Eur J Intern Med, 2002, 13(7): 412.
10.	Moutachakkir M, Lamrani Hanchi A, Baraou A, et al. Immunoanalytical characteristics of C-reactive protein and high sensitivity C-reactive protein. Ann Biol Clin (Paris), 2017, 75(2): 225-229.
11.	Lee SH, Kim KH, Choi CW, et al. Reduction rate of C-reactive protein as an early predictor of postoperative complications and a reliable discharge indicator after gastrectomy for gastric cancer. Ann Surg Treat Res, 2019, 97(2): 65-73.
12.	Yamada S, Yagi S, Sato K, et al. Serum C-reactive protein level on first postoperative day can predict occurrence of postoperative pancreatic fistula after laparoscopic gastrectomy. J Med Invest, 2019, 66(3): 285-288.
13.	Tu RH, Lin JX, Zheng CH, et al. Complications and failure to rescue following laparoscopic or open gastrectomy for gastric cancer: a propensity-matched analysis. Surg Endosc, 2017, 31(5): 2325-2337.
14.	Tanaka H, Tamura T, Toyokawa T, et al. C-reactive protein elevation ratio as an early predictor of postoperative severe complications after laparoscopic gastrectomy for gastric cancer: a retrospective study. BMC Surg, 2019, 19(1): 114.
15.	Straatman J, Cuesta MA, Tuynman JB, et al. C-reactive protein in predicting major postoperative complications are there differences in open and minimally invasive colorectal surgery? Substudy from a randomized clinical trial. Surg Endosc, 2018, 32(6): 2877-2885.
16.	Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow?. Lancet, 2001, 357(9255): 539-545.
17.	Shrotriya S, Walsh D, Bennani-Baiti N, et al. C-reactive protein is an important biomarker for prognosis tumor recurrence and treatment response in adult solid tumors: a systematic review. PLoS One, 2015, 10(12): e0143080.
18.	Matsumoto Y, Kosuga T, Konishi T, et al. Prognostic value of preoperative serum C-reactive protein level in gastric cancer. Gan To Kagaku Ryoho, 2019, 46(10): 1623-1625.
19.	Migita K, Matsumoto S, Wakatsuki K, et al. Postoperative serum C-reactive protein level predicts long-term outcomes in stage I gastric cancer. J Surg Res, 2019, 242: 323-331.
20.	Caruso R, Pallone F, Monteleone G. Emerging role of IL-23/IL-17 axis in H pylori-associated pathology. World J Gastroenterol, 2007, 13(42): 5547-5551.
21.	Mantovani A, Allavena P, Sica A, et al. Cancer-related inflammation. Nature, 2008, 454(7203): 436-444.
22.	Zu H, Wang H, Li C, et al. Preoperative prealbumin levels on admission as an independent predictive factor in patients with gastric cancer. Medicine (Baltimore), 2020, 99(11): e19196.
23.	Bae HJ, Lee HJ, Han DS, et al. Prealbumin levels as a useful marker for predicting infectious complications after gastric surgery. J Gastrointest Surg, 2011, 15(12): 2136-2144.
24.	Huang J, Wang Y, Yuan Y, et al. Preoperative serum pre-albumin as an independent prognostic indicator in patients with localized upper tract urothelial carcinoma after radical nephroureterectomy. Oncotarget, 2017, 8(22): 36772-36779.
25.	Shen Q, Liu W, Quan H, et al. Prealbumin and lymphocyte-based prognostic score, a new tool for predicting long-term survival after curative resection of stage II/III gastric cancer. Br J Nutr, 2018, 120(12): 1359-1369.
26.	Liz MA, Gomes CM, Saraiva MJ, et al. ApoA-I cleaved by transthyretin has reduced ability to promote cholesterol efflux and increased amyloidogenicity. J Lipid Res, 2007, 48(11): 2385-2395.
27.	Chong PK, Lee H, Zhou J, et al. Reduced plasma APOA1 level is associated with gastric tumor growth in MKN45 mouse xenograft model. J Proteomics, 2010, 73(8): 1632-1640.
28.	Podrez EA. Anti-oxidant properties of high-density lipoprotein and atherosclerosis. Clin Exp Pharmacol Physiol, 2010, 37(7): 719-725.
29.	Ma MZ, Yuan SQ, Chen YM, et al. Preoperative apolipoprotein B/apolipoprotein A1 ratio: a novel prognostic factor for gastric cancer. Onco Targets Ther, 2018, 11: 2169-2176.
30.	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 Gastroenterol Hepatol, 2019, 34(2): 355-363.
31.	Mao M, Wei X, Sheng H, et al. C-reactive protein/albumin and neutrophil/lymphocyte ratios and their combination predict overall survival in patients with gastric cancer. Oncol Lett, 2017, 14(6): 7417-7424.
32.	Kono Y, Saito H, Murakami Y, et al. Postoperative ratio of the maximum C-reactive protein level to the minimum peripheral lymphocyte count as a prognostic indicator for gastric cancer patients. Surg Today, 2019, 49(3): 206-213.
33.	Zhang L, Chen QG, Li SQ, et al. Preoperative fibrinogen to prealbumin ratio as a novel predictor for clinical outcome of hepatocellular carcinoma. Future Oncol, 2019, 15(1): 13-22.
34.	Lu J, Xu BB, Zheng ZF, et al. CRP/prealbumin, a novel inflammatory index for predicting recurrence after radical resection in gastric cancer patients: post hoc analysis of a randomized phase III trial. Gastric Cancer, 2019, 22(3): 536-545.
35.	Feng JF, Wang L, Jiang YH, et al. C-reactive protein to prealbumin ratio (CPR): a novel inflammatory-nutritional prognostic factor for predicting cancer-specific survival (CSS) and overall survival (OS) in patients with resectable esophageal squamous cell carcinoma. J Oncol, 2019, 2019: 4359103.

1. Thrift AP, El-Serag HB. Burden of gastric cancer. Clin Gastroenterol Hepatol, 2020, 18(3): 534-542.
2. Singh N, Baby D, Rajguru JP, et al. Inflammation and cancer. Ann Afr Med, 2019, 18(3): 121-126.
3. Zhou J, Hiki N, Mine S, et al. Role of Prealbumin as a powerful and simple index for predicting postoperative complications after gastric cancer surgery. Ann Surg Oncol, 2017, 24(2): 510-517.
4. 曾繁昌, 曾繁明. 消化道疾病血清 CRP 与肿瘤标志物的联合检测意义. 数理医药学杂志, 2017, 30(2): 201-202.
5. Kim EY, Yim HW, Park CH, et al. C-reactive protein can be an early predictor of postoperative complications after gastrectomy for gastric cancer. Surg Endosc, 2017, 31(1): 445-454.
6. Kong F, Gao F, Chen J, et al. Elevated serum C-reactive protein level predicts a poor prognosis for recurrent gastric cancer. Oncotarget, 2016, 7(34): 55765-55770.
7. Shishido Y, Fujitani K, Yamamoto K, et al. C-reactive protein on postoperative day 3 as a predictor of infectious complications following gastric cancer resection. Gastric Cancer, 2016, 19(1): 293-301.
8. Davis CJ, Sowa D, Keim KS, et al. The use of prealbumin and C-reactive protein for monitoring nutrition support in adult patients receiving enteral nutrition in an urban medical center. JPEN J Parenter Enteral Nutr, 2012, 36(2): 197-204.
9. Ablij H, Meinders A. C-reactive protein: history and revival. Eur J Intern Med, 2002, 13(7): 412.
10. Moutachakkir M, Lamrani Hanchi A, Baraou A, et al. Immunoanalytical characteristics of C-reactive protein and high sensitivity C-reactive protein. Ann Biol Clin (Paris), 2017, 75(2): 225-229.
11. Lee SH, Kim KH, Choi CW, et al. Reduction rate of C-reactive protein as an early predictor of postoperative complications and a reliable discharge indicator after gastrectomy for gastric cancer. Ann Surg Treat Res, 2019, 97(2): 65-73.
12. Yamada S, Yagi S, Sato K, et al. Serum C-reactive protein level on first postoperative day can predict occurrence of postoperative pancreatic fistula after laparoscopic gastrectomy. J Med Invest, 2019, 66(3): 285-288.
13. Tu RH, Lin JX, Zheng CH, et al. Complications and failure to rescue following laparoscopic or open gastrectomy for gastric cancer: a propensity-matched analysis. Surg Endosc, 2017, 31(5): 2325-2337.
14. Tanaka H, Tamura T, Toyokawa T, et al. C-reactive protein elevation ratio as an early predictor of postoperative severe complications after laparoscopic gastrectomy for gastric cancer: a retrospective study. BMC Surg, 2019, 19(1): 114.
15. Straatman J, Cuesta MA, Tuynman JB, et al. C-reactive protein in predicting major postoperative complications are there differences in open and minimally invasive colorectal surgery? Substudy from a randomized clinical trial. Surg Endosc, 2018, 32(6): 2877-2885.
16. Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow?. Lancet, 2001, 357(9255): 539-545.
17. Shrotriya S, Walsh D, Bennani-Baiti N, et al. C-reactive protein is an important biomarker for prognosis tumor recurrence and treatment response in adult solid tumors: a systematic review. PLoS One, 2015, 10(12): e0143080.
18. Matsumoto Y, Kosuga T, Konishi T, et al. Prognostic value of preoperative serum C-reactive protein level in gastric cancer. Gan To Kagaku Ryoho, 2019, 46(10): 1623-1625.
19. Migita K, Matsumoto S, Wakatsuki K, et al. Postoperative serum C-reactive protein level predicts long-term outcomes in stage I gastric cancer. J Surg Res, 2019, 242: 323-331.
20. Caruso R, Pallone F, Monteleone G. Emerging role of IL-23/IL-17 axis in H pylori-associated pathology. World J Gastroenterol, 2007, 13(42): 5547-5551.
21. Mantovani A, Allavena P, Sica A, et al. Cancer-related inflammation. Nature, 2008, 454(7203): 436-444.
22. Zu H, Wang H, Li C, et al. Preoperative prealbumin levels on admission as an independent predictive factor in patients with gastric cancer. Medicine (Baltimore), 2020, 99(11): e19196.
23. Bae HJ, Lee HJ, Han DS, et al. Prealbumin levels as a useful marker for predicting infectious complications after gastric surgery. J Gastrointest Surg, 2011, 15(12): 2136-2144.
24. Huang J, Wang Y, Yuan Y, et al. Preoperative serum pre-albumin as an independent prognostic indicator in patients with localized upper tract urothelial carcinoma after radical nephroureterectomy. Oncotarget, 2017, 8(22): 36772-36779.
25. Shen Q, Liu W, Quan H, et al. Prealbumin and lymphocyte-based prognostic score, a new tool for predicting long-term survival after curative resection of stage II/III gastric cancer. Br J Nutr, 2018, 120(12): 1359-1369.
26. Liz MA, Gomes CM, Saraiva MJ, et al. ApoA-I cleaved by transthyretin has reduced ability to promote cholesterol efflux and increased amyloidogenicity. J Lipid Res, 2007, 48(11): 2385-2395.
27. Chong PK, Lee H, Zhou J, et al. Reduced plasma APOA1 level is associated with gastric tumor growth in MKN45 mouse xenograft model. J Proteomics, 2010, 73(8): 1632-1640.
28. Podrez EA. Anti-oxidant properties of high-density lipoprotein and atherosclerosis. Clin Exp Pharmacol Physiol, 2010, 37(7): 719-725.
29. Ma MZ, Yuan SQ, Chen YM, et al. Preoperative apolipoprotein B/apolipoprotein A1 ratio: a novel prognostic factor for gastric cancer. Onco Targets Ther, 2018, 11: 2169-2176.
30. 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 Gastroenterol Hepatol, 2019, 34(2): 355-363.
31. Mao M, Wei X, Sheng H, et al. C-reactive protein/albumin and neutrophil/lymphocyte ratios and their combination predict overall survival in patients with gastric cancer. Oncol Lett, 2017, 14(6): 7417-7424.
32. Kono Y, Saito H, Murakami Y, et al. Postoperative ratio of the maximum C-reactive protein level to the minimum peripheral lymphocyte count as a prognostic indicator for gastric cancer patients. Surg Today, 2019, 49(3): 206-213.
33. Zhang L, Chen QG, Li SQ, et al. Preoperative fibrinogen to prealbumin ratio as a novel predictor for clinical outcome of hepatocellular carcinoma. Future Oncol, 2019, 15(1): 13-22.
34. Lu J, Xu BB, Zheng ZF, et al. CRP/prealbumin, a novel inflammatory index for predicting recurrence after radical resection in gastric cancer patients: post hoc analysis of a randomized phase III trial. Gastric Cancer, 2019, 22(3): 536-545.
35. Feng JF, Wang L, Jiang YH, et al. C-reactive protein to prealbumin ratio (CPR): a novel inflammatory-nutritional prognostic factor for predicting cancer-specific survival (CSS) and overall survival (OS) in patients with resectable esophageal squamous cell carcinoma. J Oncol, 2019, 2019: 4359103.

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