Prognostic Value of C-Reactive Protein to Albumin Ratio in Gastric Cancer: A Meta-Analysis

Objective C-reactive protein to albumin ratio (CRP/Alb) is investigated as a prognostic marker in gastric cancer in previous studies, with presence of inconsistent data. Therefore, this study aimed to explore the prognostic role of CRP/Alb in gastric cancer through meta-analysis. Methods This meta-analysis systemically retrieved PubMed, Embase, Web of Science, the Chinese National Knowledge Infrastructure (CNKI), and Wanfang up to July 4, 2020. Pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were conducted to evaluate the association between CRP/Alb and survival outcomes. Results A total of nine studies with 3346 patients were included in the present meta-analysis. The pooled HR and 95%CI were: HR = 1.89, 95%CI = 1.64-2.19,p < 0.001 for overall survival (OS) and HR = 2.15, 95%CI = 1.72-2.70,p < 0.001 for disease-free survival (DFS). Subgroup analysis demonstrate that an elevated CRP/Alb remain a significant prognostic factor for poor OS and DFS irrespective of sample size, nationality of patients, or cutoff value resource (p < 0.05 in all subgroups). Conclusions The present meta-analysis suggests that high CRP/Alb is predictive of poor OS and DFS in gastric cancer. CRP/Alb is therefore a potential prognostic factor in the management of patients with gastric cancer.