Research Papers:

A novel inflammation-based prognostic score for patients with esophageal squamous cell carcinoma: the c-reactive protein/prognostic nutritional index ratio

Sheng Chen, Xun Yang and Ji-Feng Feng _

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Oncotarget. 2016; 7:62123-62132. https://doi.org/10.18632/oncotarget.11389

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Sheng Chen1, Xun Yang1, Ji-Feng Feng1,2

1Department of Thoracic Surgery, Zhejiang Cancer Hospital, Hangzhou, P.R.China

2Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou, P.R.China

Correspondence to:

Ji-Feng Feng, email: [email protected]

Keywords: esophageal squamous cell carcinoma (ESCC), c-reactive protein (CRP), prognostic nutritional index (PNI), cancer-specific survival (CSS)

Received: March 09, 2016    Accepted: August 09, 2016    Published: August 19, 2016


Background: Inflammation plays a critical role in cancer prognosis. In the current study, we proposed a novel inflammation-based prognostic score, named c-reactive protein/prognostic nutritional index ratio (CRP/PNI ratio), for predicting the prognosis for patients with resectable esophageal squamous cell carcinoma (ESCC).

Results: The optimal cut-off value was 0.10 for CRP/PNI ratio according to the ROC curve. Patients with CRP/PNI ratio ≤0.10 had a significantly better 5-year CSS compared to CRP/PNI ratio >0.10 (44.5% vs. 15.7%, P<0.001). On multivariate analyses, we revealed that CRP/PNI ratio was a significant predictive factor of CSS (P=0.009). A nomogram could be more accuracy for CSS. The Harrell’s c-index for CSS prediction was 0.688.

Materials and Methods: A total of 308 patients with resectable ESCC were enrolled in this retrospective study. The optimal cuf-off value for CRP/PNI ratio was calculated by a receiver operating characteristic (ROC) curve. Kaplan-Meier methods were used to analyse the cancer-specific survival (CSS). Univariate and multivariate analyses were evaluated for CSS. A nomogram was also established to predict the prognosis for CSS.

Conclusion: The CRP/PNI ratio is a novel and useful prognostic score for CSS in patients with resectable ESCC.

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