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. 2025 Aug 10:19:11795549251360891.
doi: 10.1177/11795549251360891. eCollection 2025.

The Prognostic Value of B12/CRP Ratio (BCR) in Patients Diagnosed With Solid Cancer

Merve Keskinkilic  1   2 , Elif Cetin Basaran  3 , Tugba Yavuzsen  1
Affiliations

The Prognostic Value of B12/CRP Ratio (BCR) in Patients Diagnosed With Solid Cancer

Merve Keskinkilic et al. Clin Med Insights Oncol. .

Abstract

Background: This study aimed to determine the prognostic effect of the serum vitamin B12 level/CRP ratio (BCR) on patients diagnosed with solid cancer.

Methods: Patients >18 years diagnosed with solid cancer were included in the study, the data of the patients were retrospectively examined, and the cut-off values for BCR were determined using receiver operating characteristic (ROC) analysis. Accordingly, grouping was performed, appropriate statistical analyses were performed, and P < .05 was accepted as the significance limit value.

Results: The median age of the 344 patients included in the study was found to be 60.9 (range: 27-88) years. Around 56.6% (n = 174) of the patients had nondistant metastatic group and 49.4% (n = 170) had metastatic group. The median follow-up period of the patients was found to be 46.8 (range: 4-63) months. In the metastatic group, mortality was statistically significantly 2.1 times higher in those with a BCR cut-off value <3.5 (95% confidence interval [CI]; 1.4-3.2, P < .001). In the nonmetastatic group, mortality was statistically significantly twice higher in those with a BCR cut-off value <3.8 (95% CI; 1.4-3.3, P < .001). In addition, mortality was statistically significantly higher in high-risk patients in the nonmetastatic group (63.8% (n = 188) vs 45.5% (n = 156) (P < .001). The mOS period for patients in the high-risk group was 42.8 ± 1.4 (95% CI: 40.1-45.5) months, the mOS period for patients in the low-risk group was 51.5 ± 1.3 (95% CI: 49.0-54.0) months, and the mOS period for the entire group was 46.8 ± 1.0 (95% CI: 44.8-48.7) months (P < .001).

Conclusıons: In conclusion, our study has shown that BCR, which has not been reported in the literature to date, is one of the cheapest and easily accessible inflammation markers that can determine prognosis in cancer patients.

Keywords: B12/CRP Ratio (BCR); prognostic factors; solid cancer.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

""BCR cut-off value according to ROC analysis for metastastic grade.
Figure 1.
BCR cut-off value according to ROC analysis (nonmetastatic group).
Generate alt text description using this language.
Figure 2.
Median overall survival according to BCR (Kaplan-Meier Analysis-Logrank Test).
## Your explanation### Your explanationThe image depicts a Receiver Operating Characteristic (ROC) curve for B12/CRP in the prediction of advanced stage. The curve is plotted on a Cartesian coordinate system with sensitivity (0.0 to 1.0) on the y-axis and 1-specificity (0.0 to 1.0) on the x-axis. The curve is predominantly gray, with a few dark blue lines that resemble a staircase pattern.The ROC curve has a line of perfect performance, which is the diagonal line from the bottom left corner to the top right corner of the graph. This line represents a 50% sensitivity and 50% specificity. In this case, the curve is below this line, indicating that the sensitivity is less than the specificity, which is not ideal to predict advanced stage.Three important statistical measures are provided in green text on the right side of the image. These measures are the Area Under the Curve (AUC), the precision value (p-value), and the cut-off value.The AUC is 0.640, which falls within the 0.5 to 0.7 range, indicating a moderate level of performance of the B12/CRP test in predicting advanced stage. The p-value is less than 0.001, which suggests that the results are statistically significant and not due to random chance. The cut-off value is 3.5, which is the threshold value used to determine whether a patient's condition is advanced or not.In summary, the image shows a ROC analysis for B12/CRP in the prediction of advanced stage, with a moderate AUC of 0.640, a highly significant p-value, and a cut-off value of 3.5. The curve is below the diagonal line, indicating less sensitivity than specificity in predicting advanced stage.
Figure 3.
BCR cut-off value according to ROC analysis (advanced stage group).
See this image and copyright information in PMC

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