JOURNAL OF CLINICAL MEDICINE, vol.13, no.J. Clin. Med. 2024, 13, 2984, pp.1-12, 2024 (SCI-Expanded)
Abstract: Background: The purposes of neoadjuvant chemotherapy are to tumor size to improve
the tumor removal rate, extend survival, and prevent metastasis. In this study, the importance of
CRP/albumin ratio and CEA/albumin ratio in the prediction of neoadjuvant treatment response
in gastric cancer patients was evaluated. Methods: This study retrospectively included 135 gastric
cancer patients who received neoadjuvant chemotherapy at Çukurova University Balcalı Hospital
between January 2018 and December 2023. Preoperative CRP/albumin and CEA/albumin ratios
were compared according to treatment response and multivariate logistic regression analysis was
performed to determine the potential importance of these ratios in predicting pathological response.
Results: The mean age of the 135 patients was 58.79 ± 10.83 (min = 26–max = 78). The CRP/albumin
and CEA/albumin ratios were found to be significantly lower in patients who did not respond to
neoadjuvant therapy. Each 1-unit increase in the CRP/albumin ratio was associated with a 1.16-fold
decrease in the odds of pathological complete response to neoadjuvant therapy. Both CRP/albumin
and CEA/albumin ratios were found to be significant in distinguishing neoadjuvant therapy response.
The optimal cut-off value was 2.74 for the CRP/albumin ratio (sensitivity = 60%, specificity = 78.4%)
and 1.40 for the CEA/albumin ratio (sensitivity = 74.2%, specificity = 67.6%). Values below these
cut-off points favored neoadjuvant therapy response. Pathological complete response to neoadjuvant
therapy was 4.75 times higher in patients with a CRP/albumin ratio below 2.74 and 5.14 times
higher in patients with a CEA/albumin ratio below 1.40. Conclusions: Findings demonstrate that in
patients with locally advanced gastric cancer receiving neoadjuvant treatment, CRP/Albumin and
CEA/Albumin ratios are significant markers of pathological response.