Prognostic value of preoperative fibrinogen to albumin ratio combined with systemic inflammation response index in patients with resectable gastric cancer

doi:10.3877/cma.j.issn.1674-0793.2020.04.007

Abstract

Abstract:

Objective

To investigate the prognostic value of preoperative fibrinogen to albumin ratio (FAR) combined with systemic inflammation resonance index (SIRI) in patients with resectable gastric cancer (rGC).

Methods

From January 2014 to December 2016, 105 patients with rGC underwent radical gastrectomy were included, followed up to December 31, 2019 or patient’s death. The cut-off values for FAR and SIRI were determined by ROC curve. The clinicopathological characteristics of three different groups were compared, and the prognostic factors of rGC patients were analyzed.

Results

According to the cut-off values of FAR and SIRI, patients were divided into three groups: FAR-SIRI 2 score group (FAR≥0.08, and SIRI≥0.74), FAR-SIRI 1 score group (FAR<0.08, and SIRI≥0.74), FAR-SIRI 0 score group (SIRI<0.74). FAR-SIRI was related to sex, age, tumor diameter, TNM stage, carcinoembryonic antigen and tissue differentiation (all P<0.05). Cox regression multivariate analysis showed that age≥60 yearsold (HR=1.957, 95% CI: 1.015-3.773, P=0.045), TNM stage (P=0.047, 0.003), poor degree of tissue differentiation (HR=0.363, 95% CI: 0.172-0.764, P=0.008) and FAR-SIRI 2 score (HR=2.576, 95% CI:1.313-5.051, P=0.006) were independent risk factors that affected the prognosis of rGC patients.

Conclusions

FAR-SIRI can be used as an effective predictor for prognosis in rGC patients, and can guide individualized treatment. High FAR-SIRI indicates that patients have a poor prognosis.

Key words: Stomach neoplasms, Systemic inflammatory response index, Fibrinogen to albumin ratio, Prognosis

Zhengyuan Yan, Heng Zhang, Guangping Yin. Prognostic value of preoperative fibrinogen to albumin ratio combined with systemic inflammation response index in patients with resectable gastric cancer[J]. Chinese Archives of General Surgery(Electronic Edition), 2020, 14(04): 266-270.

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Figures/Tables 5

References 13

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项目	临界值	AUC(95% CI)	敏感度(%)	特异度(%)	约登指数	P值
中性粒细胞(×10⁹/L)	3.28	0.660(0.561~0.750)	75.00	60.00	0.35	0.003
单核细胞(×10⁹/L)	0.34	0.693(0.596~0.780)	70.00	69.23	0.39	<0.001
淋巴细胞(×10⁹/L)	1.56	0.662(0.563~0.751)	72.50	66.15	0.39	0.003
纤维蛋白原(g/L)	3.09	0.644(0.545~0.735)	67.50	61.54	0.29	0.009
白蛋白(g/L)	38.40	0.629(0.529~0.721)	60.00	69.23	0.29	0.020
FAR	0.08	0.734(0.639~0.815)	62.50	90.77	0.53	<0.001
SIRI	0.74	0.785(0.694~0.859)	72.50	93.85	0.66	<0.001
FAR-SIRI	-	0.919(0.849~0.963)	90.00	89.23	0.79	<0.001
CEA(μg/L)	4.30	0.765(0.673~0.843)	80.00	58.46	0.38	<0.001

项目	临界值	AUC(95% CI)	敏感度(%)	特异度(%)	约登指数	P值
中性粒细胞(×10⁹/L)	3.28	0.660(0.561~0.750)	75.00	60.00	0.35	0.003
单核细胞(×10⁹/L)	0.34	0.693(0.596~0.780)	70.00	69.23	0.39	<0.001
淋巴细胞(×10⁹/L)	1.56	0.662(0.563~0.751)	72.50	66.15	0.39	0.003
纤维蛋白原(g/L)	3.09	0.644(0.545~0.735)	67.50	61.54	0.29	0.009
白蛋白(g/L)	38.40	0.629(0.529~0.721)	60.00	69.23	0.29	0.020
FAR	0.08	0.734(0.639~0.815)	62.50	90.77	0.53	<0.001
SIRI	0.74	0.785(0.694~0.859)	72.50	93.85	0.66	<0.001
FAR-SIRI	-	0.919(0.849~0.963)	90.00	89.23	0.79	<0.001
CEA(μg/L)	4.30	0.765(0.673~0.843)	80.00	58.46	0.38	<0.001

项目		FAR-SIRI 0分组	FAR-SIRI 1分组	FAR-SIRI 2分组	χ²值	P值
例数		62	14	29	?	?
性别		?	?	?	6.267	0.044
?	男	33(53.2)	10(71.4)	23(79.3)	?	?
?	女	29(46.8)	4(28.6)	6(20.7)	?	?
年龄(岁)		?	?	?	12.741	0.002
?	<60	35(56.5)	5(35.7)	5(17.2)	?	?
?	≥60	27(43.5)	9(64.3)	24(82.8)	?	?
肿瘤直径(cm)		?	?	?	10.152	0.006
?	<3	37(59.7)	6(42.9)	7(24.1)	?	?
?	≥3	25(40.3)	8(57.1)	22(75.9)	?	?
TNM分期		?	?	?	11.459	0.022
?	Ⅰ	24(38.7)	2(14.3)	5(17.2)	?	?
?	Ⅱ	20(32.3)	6(42.9)	6(20.7)	?	?
?	Ⅲ	18(29.0)	6(42.9)	18(62.1)	?	?
分化程度		?	?	?	8.166	0.017
?	差	32(51.6)	9(64.3)	24(82.8)	?	?
?	中-好	30(48.4)	5(35.7)	5(17.2)	?	?
CEA(μg/L)		?	?	?	6.470	0.039
?	<4.3	34	5	8	?	?
?	≥4.3	28	9	21	?	?

项目		FAR-SIRI 0分组	FAR-SIRI 1分组	FAR-SIRI 2分组	χ²值	P值
例数		62	14	29	?	?
性别		?	?	?	6.267	0.044
?	男	33(53.2)	10(71.4)	23(79.3)	?	?
?	女	29(46.8)	4(28.6)	6(20.7)	?	?
年龄(岁)		?	?	?	12.741	0.002
?	<60	35(56.5)	5(35.7)	5(17.2)	?	?
?	≥60	27(43.5)	9(64.3)	24(82.8)	?	?
肿瘤直径(cm)		?	?	?	10.152	0.006
?	<3	37(59.7)	6(42.9)	7(24.1)	?	?
?	≥3	25(40.3)	8(57.1)	22(75.9)	?	?
TNM分期		?	?	?	11.459	0.022
?	Ⅰ	24(38.7)	2(14.3)	5(17.2)	?	?
?	Ⅱ	20(32.3)	6(42.9)	6(20.7)	?	?
?	Ⅲ	18(29.0)	6(42.9)	18(62.1)	?	?
分化程度		?	?	?	8.166	0.017
?	差	32(51.6)	9(64.3)	24(82.8)	?	?
?	中-好	30(48.4)	5(35.7)	5(17.2)	?	?
CEA(μg/L)		?	?	?	6.470	0.039
?	<4.3	34	5	8	?	?
?	≥4.3	28	9	21	?	?

影响因素	单因素分析				多因素分析
影响因素	β	Wald χ2	HR(95% CI)	P	β	Wald χ2	HR(95% CI)	P
性别(女 vs男)	0.803	5.859	2.233(1.165~4.279)	0.015	0.485	2.323	1.624(0.871~3.030)	0.127
年龄(<60岁 vs ≥60岁)	0.936	6.839	2.551(1.264~5.145)	0.009	0.671	4.020	1.957(1.015~3.773)	0.045
肿瘤直径(<3 cm vs ≥3 cm)	0.334	1.076	1.397(0.743~2.627)	0.300	-	-	?	?
TNM分期(Ⅰ vs Ⅱ)	1.619	6.369	5.048(1.436~17.750)	0.012	0.986	3.944	2.680(1.013~7.091)	0.047
TNM分期(Ⅰvs Ⅲ)	2.256	12.965	9.545(2.796~32.590)	<0.001	1.251	8.944	3.495(1.539~7.935)	0.003
分化程度(差 vs中-好)	-1.622	11.474	0.197(0.077~0.505)	0.001	-1.013	7.116	0.363(0.172~0.764)	0.008
FAR-SIRI (0 vs 1)	0.888	4.112	2.431(1.030~5.738)	0.043	0.628	2.250	1.874(0.825~4.259)	0.134
FAR-SIRI (0 vs 2)	1.270	13.831	3.561(1.823~6.954)	<0.001	0.946	7.581	2.576(1.313~5.051)	0.006
CEA(<4.3 μg/L vs ≥4. 3 μg/L)	0.488	1.992	1.629(0.827~3.210)	0.158	?	?	?	?

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