Prognostic significance of the C-reactive protein-to-lymphocyte ratio in patients with cancers

Abstract

Background The C-reactive protein-to-lymphocyte ratio (CLR), a novel inflammation-based biomarker, has been reported to be associated with prognosis in various cancers. However, the prognostic significance of CLR remains controversial. Therefore, we performed a meta-analysis to comprehensively evaluate the prognostic value of CLR in patients with cancers. Methods Relevant studies were systematically searched in PubMed, Embase, and Web of Science up to March 21, 2026. Pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were calculated to assess the association between CLR and survival outcomes, including overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS). Results A total of 22 studies from 18 articles involving 7220 patients were included. The pooled analysis demonstrated that elevated CLR was significantly associated with poorer OS (HR:1.65, 95% CI: 1.43-1.91), PFS (HR:1.53, 95% CI: 1.15-2.05), and DFS (HR:1.67, 95% CI: 1.41-1.97). Subgroup analysis further confirmed the prognostic value of CLR across country, treatment method, sample size, cancer type and analysis type. Conclusions Elevated CLR was significantly associated with unfavorable survival outcomes in cancers and may serve as a promising prognostic biomarker in clinical practice.