最近的研究报告称，C 反应蛋白 (CRP) 与白蛋白比率 (CAR) 可能是各种类型癌症患者的有用预后生物标志物。然而，这一观察结果背后的机制尚不清楚。本研究旨在阐明为什么CAR可以预测食管癌切除术后的预后、术前和术后CAR之间的关系以及术后CAR是否可以预测食管癌患者的预后。我们对158例食管鳞癌患者进行了调查。术后第1、3、5、7、10、14天进行血液学检查。术前CAR是总生存期（OS）的显着独立预后因素[风险比（HR）=2.247； p=0.0005]，术前CAR与肿瘤深度之间存在很强的相关性。术前高 CAR (pre-high-CAR) 组在术后所有天 (POD) 的 CAR 显着较高。然后，我们将患者进行如下划分：在 POD 5、7 和 10 至少有 2 个低 CAR 天的患者被分配到改良后低 CAR（mPost-low-CAR）组，其他人被分配到改良后低 CAR（mPost-low-CAR）组。改良后高 CAR (mPost-high-CAR) 组。 mPost-low-CAR组的5年OS率显着高于mPost-high-CAR组，预测的预后更准确（p<0.0001，HR=2.769）。术前C​​AR与肿瘤深度相关和直径，并且高 CAR 前组的患者术后仍具有显着较高的 CAR。这些因素被认为反映了疾病的预后。此外，根据 POD 5、7 和 10 进行的 CAR 分组比术前 CAR 更准确地反映了患者的预后。版权所有 © 2023 国际抗癌研究所（George J. Delinasios 博士），保留所有权利。

Recent studies have reported that the C-reactive protein (CRP) to albumin ratio (CAR) may be a useful prognostic biomarker in various types of cancer patients. However, the mechanism underlying this observation is unclear. The present study aimed to clarify why the CAR can predict post-esophagectomy prognosis, the relationship between pre- and postoperative CAR, and whether postoperative CAR can predict the prognosis of esophageal cancer patients.We investigated 158 esophagectomy patients with esophageal squamous cell carcinoma. Hematological examinations were performed on postoperative days (POD) 1, 3, 5, 7, 10, and 14.Preoperative CAR was a significant independent prognostic factor of overall survival (OS) [hazard ratio (HR)=2.247; p=0.0005], and there was a strong correlation between preoperative CAR and tumor depth. The preoperative high-CAR (pre-high-CAR) group had significantly higher CAR on all postoperative days (POD). We then divided the patients as follows: those with at least two low-CAR days on POD 5, 7, and 10 were assigned to the modified post-low-CAR (mPost-low-CAR) group, and others were assigned to the modified post-high-CAR (mPost-high-CAR) group. The 5-year OS rate was significantly higher in the mPost-low-CAR group than in the mPost-high-CAR group, which predicted a more accurate prognosis (p<0.0001, HR=2.769).Preoperative CAR was associated with tumor depth and diameter, and patients in the pre-high-CAR group continued to have significantly higher CAR postoperatively. These factors were presumed to reflect disease prognosis. Furthermore, grouping by CAR on POD 5, 7, and 10 reflected patient prognosis more accurately than preoperative CAR.Copyright © 2023 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.