Background The ratio of C‐reactive protein to albumin (CRP/Alb) is a biochemical marker of systemic inflammatory response and has been associated with poor survival in cancer. This study retrospectively investigated the relationship between the CRP/Alb ratio and prognosis in gastric cancer patients. Methods This study enrolled 453 patients with a histopathological diagnosis of gastric adenocarcinoma who underwent curative surgery. Results A statistically significant weak correlation was observed between CRP/Alb ratio and neutrophil/lymphocyte ratio (NLR) ( r = 0.19; P < 0.0001). There were statistically significant correlations between high CRP/Alb ratio and age ( P = 0.0004), tumor size ( P = 0.02), depth of invasion ( P = 0.012), and lymph node metastasis ( P = 0.022). A high NLR was significantly correlated with age ( P = 0.0027), tumor size ( P = 0.0006), depth of invasion ( P < 0.0001), lymphatic involvement ( P = 0.0031), venous involvement ( P = 0.0022), and stage of disease ( P = 0.0024). Based on results by receiver operating characteristic analysis, patients were divided as follows: CRP/Alb ratio ≥ 0.0232 (CAR High ), CRP/Alb ratio < 0.0232 (CAR Low ), NLR ≥ 2.43 (NLR High ), and NLR < 2.43 (NLR Low ). Five‐year survival rates of patients with both CAR High and NLR High , either CAR High or NLR High , and both CAR Low and NLR Low were 59.6, 75.8, and 87.5%, respectively, with statistically significant differences ( P < 0.0001). Multivariate analysis revealed that the combination of CRP/Alb ratio and NLR was an independent prognostic indicator. Conclusions The combination of CRP/Alb ratio and NLR may be useful in predicting prognosis in gastric cancer patients.
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Saito et al. (2017) studied this question.