Cancer Medicine (Jan 2025)

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

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

DOI
https://doi.org/10.1002/cam4.70527
Journal volume & issue
Vol. 14, no. 2
pp. n/a – n/a

Abstract

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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). 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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