Correlation between preoperative C-reactive protein/albumin ratio and NIH risk classification in patients with gastric stromal tumor_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

FANG Shixu ^1,2 , ZENG Yujian ¹ , LIN Bin ^1,2 , ZHANG Tong ¹ ,  LUO Huayou ¹

1. Department of Gastroenterology and Hernia Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, P. R. China;
2. The First Clinical College of Kunming Medical University, Kunming 650032, P. R. China;

Corresponding author：

LUO Huayou, Email: km-lhy@qq.com

Keywords：

gastric stromal tumor; C-reactive protein/albumin ratio; National Institutes of Health risk classification

DOI：

10.7507/1007-9424.201901029

Video：

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Objective To investigate the relationship between preoperative C-reactive protein (CRP)/albumin ratio (CAR) and National Institutes of Health (NIH) risk classification in patients with gastric stromal tumors.Methods Clinical data of 108 patients with gastric stromal tumors admitted to the First Affiliated Hospital of Kunming Medical University from February 2010 to November 2016 were retrospectively collected. With the median of CAR as the critical value, patients were divided into high CAR group (CAR>0.048) and low CAR group (CAR≤0.048). Then observed the general clinicopathological characteristics and survival status of patients with higher and lower CAR value.Results There were significant differences in NIH classification, tumor diameter, and mitosis between the high CAR group and low CAR group (P<0.05). Compared with the low CAR group, the tumors in the high CAR group had larger diameter, higher mitotic figure, and higher NIH grade. Survival analysis showed that the prognosis of the low CAR group was better than that of the high CAR group (χ²=15.152, P<0.001).Conclusions CAR is closely related to the malignant index and NIH risk classification of gastric stromal tumors. It can be used as an index for evaluating the malignant degree of gastric stromal tumors, and it is expected to be an important reference factor for clinical NIH risk classification and prognosis.

Citation： FANG Shixu, ZENG Yujian, LIN Bin, ZHANG Tong, LUO Huayou. Correlation between preoperative C-reactive protein/albumin ratio and NIH risk classification in patients with gastric stromal tumor. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(4): 428-431. doi: 10.7507/1007-9424.201901029 Copy

1.	Mazur MT, Clark HB. Gastric stromal tumors. Reappraisal of histogenesis. Am J Surg Pathol, 1983, 7(6): 507-519.
2.	Blay JY, Shen L, Kang YK, et al. Nilotinib versus imatinib as first-line therapy for patients with unresectable or metastatic gastrointestinal stromal tumours (ENESTg1): a randomised phase 3 trial. Lancet Oncol, 2015, 16(5): 550-560.
3.	Cassier PA, Ducimetière F, Lurkin A, et al. A prospective epidemiological study of new incident GISTs during two consecutive years in Rhône Alpes region: incidence and molecular distribution of GIST in a European region. Br J Cancer, 2010, 103(2): 165-170.
4.	Miettinen M, Lasota J. Gastrointestinal stromal tumors. Gastroenterol Clin North Am, 2013, 42(2): 399-415.
5.	谭至柔, 黄雪, 张瑜红. 46例胃间质瘤的临床分析. 中国现代医学杂志, 2011, 21(33): 4186-4187, 4191.
6.	Pisters PW, Blanke CD, von Mehren M, et al. A USA registry of gastrointestinal stromal tumor patients: changes in practice over time and differences between community and academic practices. Ann Oncol, 2011, 22(11): 2523-2529.
7.	Søreide K, Sandvik OM, Søreide JA, et al. Global epidemiology of gastrointestinal stromal tumours (GIST): a systematic review of population-based cohort studies. Cancer Epidemiol, 2016, 40: 39-46.
8.	Wang M, Xu J, Zhang Y, et al. Gastrointestinal stromal tumor: 15-years’ experience in a single center. BMC Surg, 2014, 14: 93.
9.	Yamamoto H, Oda Y. Gastrointestinal stromal tumor: recent advances in pathology and genetics. Pathol Int, 2015, 65(1): 9-18.
10.	Joensuu H, Eriksson M, Sundby Hall K, et al. One vs three years of adjuvant imatinib for operable gastrointestinal stromal tumor: a randomized trial. JAMA, 2012, 307(12): 1265-1272.
11.	Joensuu H, Eriksson M, Sundby Hall K, et al. Adjuvant imatinib for high-risk GI stromal tumor: analysis of a randomized trial. J Clin Oncol, 2016, 34(3): 244-250.
12.	Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol, 2008, 39(10): 1411-1419.
13.	尹晓南, 汤苏敏, 尹源, 等. 胃肠间质瘤患者术前PLR、d-NLR值与预后的关系. 四川大学学报: 医学版, 2017, 48(2): 239-243, 275.
14.	胡根, 李威, 邵国益, 等. 术前血小板和淋巴细胞比值对胃间质瘤患者预后的预测价值. 肿瘤防治研究, 2018, 45(7): 479-482.
15.	金鑫, 冯利, 李福广, 等. 血清中性粒细胞/淋巴细胞比值与胃肠间质瘤患者预后的关系及其临床意义. 中国普外基础与临床杂志, 2013, 20(8): 910-914.
16.	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.
17.	Liu X, Sun X, Liu J, et al. Preoperative C-reactive protein/albumin ratio predicts prognosis of patients after curative resection for gastric cancer. Transl Oncol, 2015, 8(4): 339-345.
18.	Ni XF, Wu J, Ji M, et al. Effect of C-reactive protein/albumin ratio on prognosis in advanced non-small-cell lung cancer. Asia Pac J Clin Oncol, 2018, 14(6): 402-409.
19.	Toiyama Y, Shimura T, Yasuda H, et al. Clinical burden of C-reactive protein/albumin ratio before curative surgery for patients with gastric cancer. Anticancer Res, 2016, 36(12): 6491-6498.
20.	刘恒昌, 陈羽佳, 许永飞, 等. 术前C反应蛋白与白蛋白比值对胃癌患者预后的影响. 中国实验诊断学, 2018, 22(1): 27-29.
21.	乔乐乐, 王公平, 周博, 等. 胃癌患者术前CRP/Alb比与淋巴结转移相关性的研究. 中国肿瘤临床, 2017, 44(5): 210-213.
22.	Morris-Stiff G, Gomez D, Prasad KR. C-reactive protein in liver cancer surgery. Eur J Surg Oncol, 2008, 34(7): 727-729.
23.	Du J, Hu W, Yang C, et al. C-reactive protein is associated with the development of tongue squamous cell carcinoma. Acta Biochim Biophys Sin (Shanghai), 2018, 50(3): 238-245.
24.	Fiala O, Hosek P, Pesek M, et al. Prognostic role of serum C-reactive protein in patients with advanced-stage NSCLC treated with pemetrexed. Neoplasma, 2017, 64(4): 605-610.
25.	Frydenberg H, Thune I, Lofterød T, et al. Pre-diagnostic high-sensitive C-reactive protein and breast cancer risk, recurrence, and survival. Breast Cancer Res Treat, 2016, 155(2): 345-354.
26.	Kim ES, Kim SY, Koh M, et al. C-reactive protein binds to integrin α2 and Fcγ receptor Ⅰ, leading to breast cell adhesion and breast cancer progression. Oncogene, 2018, 37(1): 28-38.
27.	Heneghan HM, Zaborowski A, Fanning M, et al. Prospective study of malabsorption and malnutrition after esophageal and gastric cancer surgery. Ann Surg, 2015, 262(5): 803-807.
28.	Ryan AM, Power DG, Daly L, et al. Cancer-associated mal- nutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later. Proc Nutr Soc, 2016, 75(2): 199-211.
29.	Fairclough E, Cairns E, Hamilton J, et al. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome. Clin Med (Lond), 2009, 9(1): 30-33.

1. Mazur MT, Clark HB. Gastric stromal tumors. Reappraisal of histogenesis. Am J Surg Pathol, 1983, 7(6): 507-519.
2. Blay JY, Shen L, Kang YK, et al. Nilotinib versus imatinib as first-line therapy for patients with unresectable or metastatic gastrointestinal stromal tumours (ENESTg1): a randomised phase 3 trial. Lancet Oncol, 2015, 16(5): 550-560.
3. Cassier PA, Ducimetière F, Lurkin A, et al. A prospective epidemiological study of new incident GISTs during two consecutive years in Rhône Alpes region: incidence and molecular distribution of GIST in a European region. Br J Cancer, 2010, 103(2): 165-170.
4. Miettinen M, Lasota J. Gastrointestinal stromal tumors. Gastroenterol Clin North Am, 2013, 42(2): 399-415.
5. 谭至柔, 黄雪, 张瑜红. 46例胃间质瘤的临床分析. 中国现代医学杂志, 2011, 21(33): 4186-4187, 4191.
6. Pisters PW, Blanke CD, von Mehren M, et al. A USA registry of gastrointestinal stromal tumor patients: changes in practice over time and differences between community and academic practices. Ann Oncol, 2011, 22(11): 2523-2529.
7. Søreide K, Sandvik OM, Søreide JA, et al. Global epidemiology of gastrointestinal stromal tumours (GIST): a systematic review of population-based cohort studies. Cancer Epidemiol, 2016, 40: 39-46.
8. Wang M, Xu J, Zhang Y, et al. Gastrointestinal stromal tumor: 15-years’ experience in a single center. BMC Surg, 2014, 14: 93.
9. Yamamoto H, Oda Y. Gastrointestinal stromal tumor: recent advances in pathology and genetics. Pathol Int, 2015, 65(1): 9-18.
10. Joensuu H, Eriksson M, Sundby Hall K, et al. One vs three years of adjuvant imatinib for operable gastrointestinal stromal tumor: a randomized trial. JAMA, 2012, 307(12): 1265-1272.
11. Joensuu H, Eriksson M, Sundby Hall K, et al. Adjuvant imatinib for high-risk GI stromal tumor: analysis of a randomized trial. J Clin Oncol, 2016, 34(3): 244-250.
12. Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol, 2008, 39(10): 1411-1419.
13. 尹晓南, 汤苏敏, 尹源, 等. 胃肠间质瘤患者术前PLR、d-NLR值与预后的关系. 四川大学学报: 医学版, 2017, 48(2): 239-243, 275.
14. 胡根, 李威, 邵国益, 等. 术前血小板和淋巴细胞比值对胃间质瘤患者预后的预测价值. 肿瘤防治研究, 2018, 45(7): 479-482.
15. 金鑫, 冯利, 李福广, 等. 血清中性粒细胞/淋巴细胞比值与胃肠间质瘤患者预后的关系及其临床意义. 中国普外基础与临床杂志, 2013, 20(8): 910-914.
16. 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.
17. Liu X, Sun X, Liu J, et al. Preoperative C-reactive protein/albumin ratio predicts prognosis of patients after curative resection for gastric cancer. Transl Oncol, 2015, 8(4): 339-345.
18. Ni XF, Wu J, Ji M, et al. Effect of C-reactive protein/albumin ratio on prognosis in advanced non-small-cell lung cancer. Asia Pac J Clin Oncol, 2018, 14(6): 402-409.
19. Toiyama Y, Shimura T, Yasuda H, et al. Clinical burden of C-reactive protein/albumin ratio before curative surgery for patients with gastric cancer. Anticancer Res, 2016, 36(12): 6491-6498.
20. 刘恒昌, 陈羽佳, 许永飞, 等. 术前C反应蛋白与白蛋白比值对胃癌患者预后的影响. 中国实验诊断学, 2018, 22(1): 27-29.
21. 乔乐乐, 王公平, 周博, 等. 胃癌患者术前CRP/Alb比与淋巴结转移相关性的研究. 中国肿瘤临床, 2017, 44(5): 210-213.
22. Morris-Stiff G, Gomez D, Prasad KR. C-reactive protein in liver cancer surgery. Eur J Surg Oncol, 2008, 34(7): 727-729.
23. Du J, Hu W, Yang C, et al. C-reactive protein is associated with the development of tongue squamous cell carcinoma. Acta Biochim Biophys Sin (Shanghai), 2018, 50(3): 238-245.
24. Fiala O, Hosek P, Pesek M, et al. Prognostic role of serum C-reactive protein in patients with advanced-stage NSCLC treated with pemetrexed. Neoplasma, 2017, 64(4): 605-610.
25. Frydenberg H, Thune I, Lofterød T, et al. Pre-diagnostic high-sensitive C-reactive protein and breast cancer risk, recurrence, and survival. Breast Cancer Res Treat, 2016, 155(2): 345-354.
26. Kim ES, Kim SY, Koh M, et al. C-reactive protein binds to integrin α2 and Fcγ receptor Ⅰ, leading to breast cell adhesion and breast cancer progression. Oncogene, 2018, 37(1): 28-38.
27. Heneghan HM, Zaborowski A, Fanning M, et al. Prospective study of malabsorption and malnutrition after esophageal and gastric cancer surgery. Ann Surg, 2015, 262(5): 803-807.
28. Ryan AM, Power DG, Daly L, et al. Cancer-associated mal- nutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later. Proc Nutr Soc, 2016, 75(2): 199-211.
29. Fairclough E, Cairns E, Hamilton J, et al. Evaluation of a modified early warning system for acute medical admissions and comparison with C-reactive protein/albumin ratio as a predictor of patient outcome. Clin Med (Lond), 2009, 9(1): 30-33.

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Correlation between preoperative C-reactive protein/albumin ratio and NIH risk classification in patients with gastric stromal tumor

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