The prognostic value of C-reactive protein/albumin ratio in nasopharyngeal carcinoma: a meta-analysis

The C-reactive protein/albumin ratio (CRP/Alb ratio) has been reported to have promising prognostic value in several cancers. The current meta-analysis was conducted to better define the prognostic value of CRP/Alb ratio in patients with nasopharyngeal carcinoma (NPC). The Web of Science, Embase, Cochrane Library databases, and PubMed were searched up to 25 February 2018 for the information on CRP/Alb ratio and outcomes of NPC. Pooled hazard ratios (HRs) and corresponding 95% confidence intervals (95% CIs) were used to evaluate the association between CRP/Alb ratio and survival outcomes in NPC. A total of five studies with 5533 patients with NPC were included. Pooled results showed that high CRP/Alb ratio was associated with poor overall survival (OS) (HR = 1.51, 95% CI: 1.30–1.75, P<0.001) and poor distant metastasis-free survival (DMFS) (HR = 1.23, 95% CI: 1.07–1.43, P=0.005). Subgroup analyses showed that patients with higher CRP/Alb ratio have worse OS in NPC. In conclusion, elevated CRP/Alb ratio was associated with worse prognosis in patients with NPC.