Correlation between C-reactive protein to albumin ratio,ferritin and clinicopathological features as well as prognosis in patients with B-cell non-Hodgkin lymphoma

Zhao Tianhua; Li Ya; Li Chao; Liu Jingjing; Li Wenjing; Hou Lanfen

doi:10.3760/j.issn.1673-4777.2026.04.010

Abstract：Objective To investigate the correlation between C-reactive protein to albumin ratio(CAR),ferritin and clinicopathological features as well as prognosis in patients with B-cell non-Hodgkin lymphoma(B-NHL).Methods A total of 175 B-NHL patients diagnosed and treated standardizedly in the 980th Hospital of Joint Logistics Support Force of the Chinese People's Liberation Army from May 2021 to May 2023 were enrolled.Patients with CAR≥the optimal cut-off value were assigned to the high CAR group(82 cases),and those with CAR＜the optimal cut-off value were assigned to the low CAR group(93 cases).Patients with ferritin≥the optimal cut-off value were assigned to the high ferritin group(79 cases),and those with ferritin＜the optimal cut-off value were assigned to the low ferritin group(96 cases).Differences in clinicopathological features such as gender,age,pathological type and Ann Arbor stage were compared among patients in different CAR and ferritin groups.Kaplan-Meier method was used to plot survival curves,and Log-rank test was used to compare differences between groups.Cox proportional hazards regression analysis was used to evaluate whether CAR and ferritin were independent predictors of short-term prognosis in B-NHL patients.Results There were statistically significant differences in age,Ann Arbor stage,international prognostic index(IPI)score,B symptoms and lactate dehydrogenase(LDH)level between the high CAR group and the low CAR group(all P＜0.05).There were statistically significant differences in Ann Arbor stage,IPI score and hemoglobin level between the high ferritin group and the low ferritin group(all P＜0.05).Kaplan-Meier analysis showed that the 2-year cumulative progression-free survival rates of B-NHL patients in the high CAR group and high ferritin group after treatment were 58.5％and 55.7％respectively,which were lower than those in the low CAR group and low ferritin group(77.4％and 79.2％,P=0.007,0.001).Cox proportional hazards regression analysis showed that Ann Arbor stage Ⅲ-Ⅳ,IPI score 3-5,LDH ≥250 U/L,high CAR and high ferritin were all independent predictors of poor short-term prognosis in B-NHL patients(all P＜0.05).Conclusion High CAR and high ferritin are correlated with adverse clinicopathological features such as Ann Arbor stage Ⅲ-Ⅳ and high IPI score in B-NHL patients,and can also independently predict the risk of short-term recurrence in patients.