Nutritional-C-reactive protein ratio as a prognostic marker in gastric cancer: a multicenter study.

Authors

Yibo Chen, Fuquan Yang, Changyang Chen, Pengyu Chen, Haitao Wen, Nuo Xu, Shuyao Wang, Changhong Xu, Siyu Lin, Hanping Shi, Hailun Xie

Published in

Frontiers in nutrition. Volume 13. Pages 1840225. Epub Aug 03, 2026.

Abstract

This study aimed to investigate the association of baseline Nutritional-C-reactive Protein Ratio (NCR) with overall survival (OS), severe malnutrition, and cachexia in patients with gastric cancer.
Baseline NCR was calculated as BMI (kg/m²) × albumin (g/L) / C-reactive protein (mg/L) using measurements obtained at study enrollment and original continuous CRP values. The ROC-derived cutoff was used to classify patients into low- and high-NCR groups. Kaplan-Meier curves and log-rank tests were used to compare OS. Cox proportional hazards models assessed the association between NCR and OS, while logistic regression evaluated associations with severe malnutrition and cachexia.
A total of 1,058 patients with pathologically confirmed gastric cancer were included. The exploratory ROC-derived cutoff value for NCR was 178. Patients with high NCR had significantly better OS than those with low NCR (65.3% vs. 48.4%, log-rank p < 0.001). In multivariable Cox regression, high NCR was independently associated with better OS (HR = 0.598, 95% CI: 0.478-0.747, p < 0.001), with a significant dose-response relationship across NCR quartiles (p for trend < 0.001). Logistic regression showed that high NCR was associated with lower odds of severe malnutrition (OR = 0.390, 95% CI: 0.300-0.505, p < 0.001) and cachexia (OR = 0.182, 95% CI: 0.137-0.242, p < 0.001).
Baseline NCR is a simple and clinically accessible composite biomarker integrating nutritional and inflammatory status. It may serve as a complementary marker for risk stratification in patients with gastric cancer.

PMID:
42609247
Bibliographic data and abstract were imported from PubMed on 18 Aug 2026.

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