Abstract
BackgroundChronic inflammation is considered as a hallmark of gastric cancer (GC) and plays a critical role in GC progression and metastasis. This study aimed to explore the prognostic values of preoperative fibrinogen-to-prealbumin ratio (FPR), fibrinogen-to-albumin ratio (FAR), and novel FPR-FAR-CEA (FFC) score in patients with GC undergoing gastrectomy.MethodsA total of 273 patients with resectable GC were included in this retrospective study. We performed Kaplan-Meier and Cox regression analyses to assess the prognostic role of preoperative FPR, FAR, and FFC score in patients with GC and analyze their relationships with clinicopathological features.ResultsReceiver operating characteristic curve (ROC) analysis revealed that the optimal cutoff values for FPR and FAR were 0.0145 and 0.0784, respectively. The FFC score had a higher area under the ROC curve than FAR and CEA. Elevated FPR (≥ 0.0145) and FAR (≥ 0.0784) were significantly associated with old age, large tumor size, tumor invasion depth, lymph nodes metastasis, advanced TNM stage, large Borrmann type, and anemia status. Kaplan-Meier analysis showed that high FPR, FAR, and FFC score were related to poor survival. Multivariate analyses indicated that FPR, FFC score, TNM stage, and tumor size were significant independent factors for survival.ConclusionsPreoperative FPR and FFC score could be used as prospective noninvasive prognostic biomarkers for resectable GC.
Highlights
Chronic inflammation is considered as a hallmark of gastric cancer (GC) and plays a critical role in GC progression and metastasis
TNM classification has been clinically recognized as a strong biomarker for predicting the prognosis of GC, high heterogeneity status leads to different outcomes among patients with GC even with the same TNM stage and treatments
Chronic inflammation plays a key role in GC, and inflammation-associated factors provide a rich resource for biomarkers
Summary
Chronic inflammation is considered as a hallmark of gastric cancer (GC) and plays a critical role in GC progression and metastasis. This study aimed to explore the prognostic values of preoperative fibrinogen-toprealbumin ratio (FPR), fibrinogen-to-albumin ratio (FAR), and novel FPR-FAR-CEA (FFC) score in patients with GC undergoing gastrectomy. Gastric cancer (GC) is an important healthcare challenge worldwide, especially in eastern Asia. Recent estimates have indicated that GC is the fifth most common cancer and third leading cause of cancer-related mortality worldwide, with 1,000,000 newly diagnosed cases and 783,000 deaths annually [1]. In China, GC is the second leading cause of cancer mortality [2]. TNM classification has been clinically recognized as a strong biomarker for predicting the prognosis of GC, high heterogeneity status leads to different outcomes among patients with GC even with the same TNM stage and treatments. Novel effective and noninvasive prognostic biomarkers should be identified to provide information for personalized treatment and improve patient’s outcomes
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