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Aim: Systemic inflammatory response is closely related to tumor progression. We retrospectively investigated relationships between systemic inflammatory scores, C‐reactive protein/albumin (CRP/Alb) ratio (CAR) and clinical characteristics in advanced non–small‐cell lung cancer (NSCLC) in 436 patients to find better clinical predictors of NSCLC prognosis. Methods: Blood specimens were collected 1 week before treatment to test for systemic inflammatory scores and albumin. Patients' overall survival (OS) was calculated via Kaplan–Meier method. Single‐factor log‐rank and multivariate Cox regression analyses and receiver operating characteristic curves were used to evaluate the prognostic significance of CAR and other systemic inflammatory indexes in predicting OS. Results: Kaplan–Meier method showed that Glasgow prognosis score (GPS), modified GPS (mGPS), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) were reliable prognostic factors for advanced NSCLC. CAR was positively correlated with GPS, mGPS, NLR, PLR and MLR in these patients. CAR was an independent risk factor for OS in advanced NSCLC, and was more closely associated with prognosis than were GPS, mGPS, NLR, PLR or MLR. Conclusion: In advanced NSCLC patients, CAR may be a better predictor of prognosis compared with other inflammatory markers. A prospective multicenter study is needed to verify these findings. [ABSTRACT FROM AUTHOR]

Aim To assess the prognostic value of mediastinal lymph node metastases ( N2 disease), carcinoembryonic antigen ( CEA) levels and C-reactive protein ( CRP) in non-small cell lung cancer ( NSCLC), according to the 7th edition of the TNM classification. Methods Newly diagnosed stage III-IV NSCLC were enrolled, including 75 patients with malignant pleural effusion. The relationship between serum CRP levels and other relevant variables such as sex, Eastern Cooperative Oncology Group status, smoking status, initial staging, N2 disease, serum albumin, white blood cell count, platelet count, CEA, comorbidity and pathology were analyzed. Univariate and multivariate analyses were performed to find prognostic markers using Cox's proportional hazards model. Results Of the 127 patients enrolled, 55 (43%) had elevated CRP levels. There was a significant correlation between serum CRP level and platelet count ( P = 0.011). Median overall survival ( OS) in the normal CRP group was significantly longer than in the high CRP group (15.7 months vs 9.1 months, P = 0.013). Hypoalbuminemia ( P = 0.047), higher CEA ( P = 0.043) and N2 disease ( P = 0.040) were additional prognostic factors on univariate analysis. On multivariate analysis an elevated CRP serum level ( HR = 1.796; P = 0.005), higher CEA ( HR = 1.563; P = 0.031) and N2 disease ( HR = 1.723; P = 0.012) were independent prognostic factors for poor survival. Conclusion High levels of serum CRP and CEA, and N2 disease are independent prognostic indicators for the survival of patients with stage III- IV NSCLC. [ABSTRACT FROM AUTHOR]