A serum CRP/ALB ratio of ≥ 2 on day 1 of NEC diagnosis has a reasonably good predictive value for surgical intervention with a sensitivity of 43.9% (95% CI 32.6–55.9) and a specificity of 76.1% (95% CI 66.4–83.6). The gene discussed is CRP; the disease is necrotizing enterocolitis.