Prognostic Value Of Preoperative C-reactive Protein/albumin Ratio In Patients With Locally Advanced Renal Carcinom

Objective:C-reactive protein(CRP),as a kind of acute phase protein in serum.It is used as an inflammatory indicator for the diagnosis and evaluation of inflammation.Serum albumin(Alb)can represent the body's current nutritional status or the depletion status of the body in patients with malignant tumors.It has been reported that the ratio of serum c-reactive protein(CRP)to albumin(Alb)is correlated with the prognosis of cancer patients,which can be used as an effective predictor of the prognosis of malignant tumors.At present,there are few studies on the prognostic effect of CRP/Alb in renal carcinoma,especially in locally advanced renal carcinoma.Therefore,in this retrospective study,we wanted to study the value of preoperative c-reactive protein/albumin(CRP/Alb)ratio in the prognosis of patients with locally advanced clear cell carcinoma of the kidney,so as to provide theoretical basis and research ideas for the preoperative treatment of locally advanced patients.Method:Through retrospective collection of clinical case data,78 patients with locally advanced renal cancer who were admitted to the affiliated hospital of Qingdao university and underwent radical nephrectomy from January 2008 to September 2018were analyzed.According to the ROC curve,the optimal critical value of CRP/Alb was calculated.Patients were divided into the high-level CRP/Alb group and the low-level CRP/Alb group according to the optimal critical value of CRP/Alb.The?~2test was used to compare the clinicopathological differences between the high-level CRP/Alb group and the low-ratio CRP/Alb group.Total survival time was defined as the time from the day of surgery to patient death or termination of follow-up,and kaplan-meier survival analysis and univariate and multivariate Cox proportional risk models were used to analyze the role of CRP/Alb ratio in predicting the prognosis of patients with locally advanced renal cancer.Result:There were significant differences in Fuhrman classification(P=0.001)and T stage(P=0.022)in the CRP/Alb ratio group between the two groups.There was no significant difference in age,gender,BMI,hypertension,diabetes,smoking,and lymphatic metastasis.(P>0.05);Kaplan-Meier survival analysis showed that the overall survival time of the high-level CRP/Alb group was significantly lower than that of the low-level CRP/Alb group(P=0.039);the univariate regression analysis showed that the T stage of the tumor(P=0.003)and CRP/Alb ratio(P=0.047)were correlated with prognosis.The results of multivariate regression analysis showed that T stage(P=0.002),CRP/Alb ratio(P=0.026)and overall survival rate of renal cancer(Overall survival,OS)is an independent prognostic factor for patients with locally advanced renal cell carcinoma.Conclusion:The preoperative CRP/Alb ratio was correlated with the survival of patients with locally advanced clear cell carcinoma of the kidney.The higher the CRP/Alb ratio was,the worse the prognosis of patients with locally advanced renal cancer was.CRP/Alb ratio can be used as a basis for preoperative adjuvant treatment of patients with locally advanced kidney cancer.Targeted treatment with preoperative detection of CRP/Alb can reduce the stimulation of inflammatory cells to tumor growth,improve the tumor microenvironment,and improve the nutritional status of patients with locally advanced kidney cancer,thus extending the postoperative survival of patients with locally advanced kidney cancer.