Diagnostic and Prognostic Role of Neutrophil Percentage to Albumin Ratio (NPAR) in Systemic Inflammatory and Neoplastic Disorders: A Pathological Insight

Background: Neutrophil percentage to albumin ratio (NPAR) is a new indicator of inflammation and nutrition, and its diagnostic and prognostic potential has yet to be exploited in the inflammatory and neoplastic conditions. The purpose of the study was to determine the clinical usefulness of NPAR as indicator of disease severity and predictor of short-term outcomes of patients of inflammatory and neoplastic diseases. Methods: In this study, the Pathology department of a tertiary care Akhtar Saeed hospital Lahore admitted 150 patients for the evaluation of possible infections under ethical approval (AST-2312) from October 2024- December 2024. Out of 150, 80 patients had systemic inflammatory diseases (e.g. rheumatoid arthritis) and 70 patients had neoplastic diseases (e.g. colorectal cancer, lymphoma). Complete blood counting and the level of serum albumin were used to calculate NPAR. Its correlation with C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), staging of the disease and 3-month clinical outcomes was determined. Using the SPSS version 26.0, statistical significance was p < 0.05. Results: NPAR was higher in severe inflammatory disease and advanced malignancy with significance p value 0.001 and p 0.0005 respectively. It was correlated with CRP(r = 0.68, p = 0.01) and ESR (r = 0.59, p = 0.02). NPAR had a high diagnostic accuracy in both inflammatory and neoplastic categories with an AUC of 0.801 and 0.842, and sensitivity/specificity of 79.1%/75.0% and 81.4%/76.3 respectively. Conclusion: NPAR is a potential biomarker with low costs to determine disease severity and short term prognosis of inflammatory and neoplastic diseases. Longitudinal studies should be conducted further.