Prognostic significance of preoperative C-reactive protein to albumin ratio in non-small cell lung cancer patients: A meta-analysis

OBJECTIVE: We aimed to assess whether C-reactive protein to albumin ratio (CAR) is associated with the clinicopathology and prognosis of patients with non-small cell lung cancer (NSCLC) after surgery. METHODS: Several literature databases were searched for eligible studies in English and Chinese published before September 1, 2022, according to the inclusion and exclusion criteria. The pooled odds ratios (ORs) with 95% confidence interval (CI) were calculated to assess the association of CAR in lung cancer with clinicopathological characteristics including age, sex, smoking status, lymph node metastasis, and American Association of Cancer (AJCC) stage. The pooled hazard ratios (HRs) with 95% CI were calculated to assess the association of CAR with prognosis in lung cancer. Publication bias was assessed using Egger's test. RESULTS: Overall, 9 studies involving 3,359 NSCLC patients were included in this meta-analysis. The CAR was observed to be higher in males, smokers, and patients with lymph node metastasis and correlated with advanced AJCC stage but not with age. Moreover, a high CAR correlated with poor survival. No publication bias was observed in this meta-analysis. CONCLUSIONS: CAR was observed to be a significant biomarker for prognosis and associated with clinicopathological characteristics in patients with NSCLC after surgery.