The Association Between Neutrophil-Percentage-to-Albumin Ratio (NPAR) and Mortality Among Individuals With Cancer: Insights From National Health and Nutrition Examination Survey

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2025-01-20 DOI:10.1002/cam4.70527

Xinyang Li, Meng Wu, Minxin Chen, Rufei Liu, Qingxu Tao, Yun Hu, Jinming Yu, Dawei Chen

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Abstract

Background

Neutrophils interact with tumor cells, potentially exacerbating cancer progression. Additionally, decreased albumin levels are a marker of poor cancer prognosis. The neutrophil-percentage-to-albumin ratio (NPAR) has been used for prognostic assessment in non-cancerous diseases, but its relationship with mortality risk in cancer patients has not been explored. Therefore, we utilized data from the National Health and Nutrition Examination Survey (NHANES) to investigate the correlation between NPAR and the risks of all-cause mortality and cancer-related mortality among cancer patients.

Methods

This study leveraged comprehensive NHANES data spanning 2005–2016. We analyzed the relationship between NPAR and the risks of cancer incidence, all-cause mortality, and cancer-related mortality using weighted Logistic and Cox regression models, as well as trend tests. Restricted cubic spline analysis was employed to investigate NPAR's nonlinear relationship with mortality risk. Furthermore, Kaplan–Meier survival analysis was utilized to assess patient prognoses across varying NPAR levels.

Results

Elevated NPAR was associated with an increased risk of all-cause mortality and cancer-related mortality in cancer patients (p < 0.05), with higher NPAR values correlating with greater risk (p-trend < 0.05). However, no significant association between NPAR and cancer incidence was observed (p > 0.05). Our analysis further identified a non-linear relationship between NPAR and all-cause mortality risk (p-nonlinear < 0.05), while no non-linear relationship was found with cancer-related mortality risk. The relationship is characterized by an optimal NPAR value, correlating with the lowest hazard ratio (HR). Deviations from this optimal NPAR result in increased all-cause mortality risk (p < 0.05). Kaplan–Meier analysis indicated superior survival rates in patients with lower NPAR values compared to those with higher NPAR values (p < 0.05).

Conclusions

According to our study, higher NPAR was associated with an increased risk of all-cause mortality and cancer-related mortality in cancer patients.

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中性粒细胞百分比-白蛋白比率（NPAR）与癌症患者死亡率之间的关系：来自全国健康和营养检查调查的见解

背景：中性粒细胞与肿瘤细胞相互作用，可能加剧癌症进展。此外，白蛋白水平降低是癌症预后不良的标志。中性粒细胞百分比-白蛋白比率（NPAR）已被用于非癌性疾病的预后评估，但其与癌症患者死亡风险的关系尚未探讨。因此，我们利用国家健康和营养调查（NHANES）的数据来调查NPAR与癌症患者全因死亡率和癌症相关死亡率风险之间的相关性。方法：本研究利用了2005-2016年的NHANES综合数据。我们使用加权Logistic和Cox回归模型以及趋势检验分析了NPAR与癌症发病率、全因死亡率和癌症相关死亡率风险之间的关系。采用限制三次样条分析研究NPAR与死亡风险的非线性关系。此外，Kaplan-Meier生存分析用于评估不同NPAR水平的患者预后。结果：NPAR升高与癌症患者全因死亡率和癌症相关死亡率风险增加相关（p < 0.05）。我们的分析进一步确定了NPAR与全因死亡风险之间的非线性关系(p-非线性结论：根据我们的研究，较高的NPAR与癌症患者全因死亡率和癌症相关死亡率的风险增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.