Fibrinogen-albumin Ratio Research Articles

Predictive Value of Peripheral Blood Markers in Hepatocellular Carcinoma Patients Treated with Anti-PD-1 in Combination with Targeted Therapy

Background: There are currently no recognised biomarkers that identify predictive groups of benefit in patients with hepatocellular carcinoma receiving immune-combined targeted therapy, for which we explored the value of peripheral blood markers as markers of their prognosis. Methods: Patients who underwent anti-PD-1 combination targeted therapy for hepatocellular carcinoma from 1 January 2019 to 31 December 2021 at the First Affiliated Hospital of Chongqing Medical University were retrospectively analysed. The data collected were analysed by R software. Results: A total of 41 cases were included in our study. The optimal threshold values of peripheral blood markers were obtained by plotting ROC curves and grouping patients. Survival analysis of the grouped patients showed statistically significant differences in survival between the different groups for Platelet-lymphocyte ratio (PLR, P = 0.0022), Monocyte-lymphocyte ratio (MLR, P = 0.042), Fibrinogen-Lymphocyte Ratio (FLR, P = 0.0009), Prognostic nutritional index (PIN, P = 0.0005), and Fibrinogen-albumin ratio (FAR, P = 0.0144). An ANOVA was performed on the basic conditions of the patients between the different groups, except for the statistically significant difference in BCLC stage (P = 0.0128) between the high MLR and low MLR groups, there was no statistically significant difference in age, gender, BCLC stage, and hepatitis status between the groups. COX regression analysis showed that BCLC stage, FAR, FLR and PIN were risk factors associated with the prognosis of patients receiving targeted combination immunotherapy for hepatocellular carcinoma, and FLR was an independent risk factor associated with the prognosis of patients receiving targeted combination immunotherapy for hepatocellular carcinoma. Conclusions: We found that peripheral blood markers are promising biomarkers for predicting the prognosis of patients with hepatocellular carcinoma receiving anti-PD-1 combined with targeted therapy, and this study identified FLR as an independent risk factor for the prognosis of patients having advanced hepatocellular carcinoma treated with anti-PD-1 combined with targeted therapy.

Prospective evaluation of hematological parameters in preoperative renal cell cancer patients.

Of all the genitourinary cancers, renal cell carcinoma (RCC) is still the most common malignancy with high mortality rates. There are still insufficient biomarkers to predict disease prognosis. Systemic inflammation markers play an important role in tumor development and growth. There are studies which show the relationship of fibrinogen and albumin individually with cancer prognosis in many cancers. Fibrinogen/albumin ratio(FAR), on the other hand, has prognostic importance like other inflammation indicators in cancer. Therefore, we investigated whether FAR had a potential value in evaluating the prognosis of patients with nonmetastatic kidney cancer or not. A total of 72 patients who had nephrectomy operation at 19 Mayıs University, Faculty of Medicine between January 2019 and January 2021 and who did not have distant metastasis were included in the study. FAR was calculated from the blood taken from the patients before the nephrectomy operation. The cut-off value was found for this FAR by receiver operating characteristic(ROC) curve analysis. The patients were divided into 2 groups as high- and low-FAR according to this cut-off value. Kaplan Meier test was used to evaluate the predictive value of clinicopathological parameters for overall survival (OS). The Log-rank test was used to determine whether there was a relationship between the preoperative FAR and the clinico-pathological data of the patients. The best cutoff value for the FAR was 0.114. A FAR > 0.114 was associated with higher Fuhrman Grade (FG) (P < 0.0001) and later pathological T stage (P < 0.0001). Patients with a high FAR (> 0.114) had worse OS [Std. Error 2.932, 95% confidence interval (CI): 73.659-85.154, P < 0.0001]. In addition, a positive significant correlation was found between high grade and platelet lymphocyte ratio (p < 0,020). Furthermore, a significant correlation was found between the pathology t stage of the patients and the platelet lymphocyte ratio (p: 0.020). The preoperative FAR is an independent prognostic factor of OS in renal cancer patients. A FAR > 0.114 was significantly related to decreased survival in renal cancer patients. In addition, the platelet-lymphocyte ratio seems to be related to OS, as well as FAR. Further studies are required on this subject.

A novel prediction model for pathological complete response based on clinical and blood parameters in locally advanced rectal cancer.

The aim of this study was to investigate whether clinical and blood parameters can be used for predicting pathological complete response (pCR) to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC). We retrospectively enrolled 226 patients with LARC [allocated in a 7:3 ratio to a training (n = 158) or validation (n = 68) cohort] who received nCRT before radical surgery. Backward stepwise logistic regression was performed to identify clinical and blood parameters associated with achieving pCR. Models based on clinical parameters (CP), blood parameters (BP), and clinical-blood parameters (CBP) were constructed for comparison with previously reported Tan's model. The performance of the four models was evaluated by receiver operating characteristic (ROC) curve analysis, calibration, and decision curve analysis (DCA) in both cohorts. A dynamic nomogram was constructed for the presentation of the best model. The CP and BP models based on multivariate logistic regression analysis showed that interval, Grade, CEA and fibrinogen-albumin ratio index (FARI), sodium-to-globulin ratio (SGR) were the independent clinical and blood predictors for achieving pCR, respectively. The area under the ROC curve of the CBP model achieved a score of 0.818 and 0.752 in both cohorts, better than CP (0.762 and 0.589), BP (0.695 and 0.718), Tan (0.738 and 0.552). CBP also showed better calibration and DCA than other models in both cohorts. Moreover, CBP revealed significant improvement compared with other models in training cohort (P < 0.05), and CBP showed significant improvement compared with CP and Tan's model in validation cohort (P < 0.05). We demonstrated that CBP predicting model have potential in predicting pCR to nCRT in patient with LARC.

Impact of CPAP Therapy on New Inflammation Biomarkers.

Obstructive sleep apnea (OSA) is a common sleep disorder leading to increased risk of developing cardiovascular diseases (CVDs) by supporting a low-grade chronic inflammation as one of the pathological mechanisms. The continuous positive airway pressure (CPAP) device is used as an effective treatment for moderate and severe OSA. Neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), white blood cell–mean platelet volume ratio (WMR), C-reactive protein–albumin ratio (CAR) and fibrinogen–albumin ratio (FAR) are new potential inflammatory biomarkers that are widely available and were shown to be possibly favorable screening or follow-up tools for moderate- or severe-grade OSA, as well as indirect indicators for cardiovascular risk. Our study evaluated the impact of CPAP therapy in patients with severe OSA and acceptable therapy adherence on NLR, PLR, WMR, FAR and CAR. Of 57 patients who were initially enrolled and had no exclusion criteria, 37 had a satisfactory CPAP adherence (usage of ≥4 h per night) after a minimum of 6 months of therapy. There was a statistically significant difference in NLR (2.122 ± 0.745 before therapy vs. 1.888 ± 0.735 after therapy) and FAR (86.445 ± 18.763 before therapy vs. 77.321 ± 19.133 after therapy) suggesting a positive effect of the CPAP therapy on chronic inflammatory states, thereby possibly reducing cardiovascular risk.

The Value of Fibrinogen/Albumin Ratio on Prognosis of COVID-19 Patients

Aim: Fibrinogen and albumin are proteins that play a role in inflammation. In this study, it was aimed to investigate the role of fibrinogen, albumin, and fibrinogen/albumin ratio (FAR) levels as markers of disease severity and prognosis in coronavirus disease 2019 (COVID-19) patients. Material and Methods: Seventy-one patients aged between 19 and 84 years diagnosed with COVID-19 who were hospitalized in Sakarya University Training and Research Hospital, Neurology Department between March and May 2020 were analyzed retrospectively. Fibrinogen, albumin, FAR, D-dimer, platelet, and C-reactive protein (CRP) levels of the patients were compared according to the length of hospitalization duration, survival, and clinical severity of COVID-19. Results: Twenty-eight (%39.4) of the patients were male and 43 (%60.6) were female, and the mean age was 55.7±20.7 years. There was a significant difference between the groups of COVID-19 clinical severity in terms of age, fibrinogen, albumin, FAR, D-dimer, and CRP values (all p values were &amp;lt;0.001). Also, significantly higher fibrinogen, FAR, D-dimer, and CRP values were found in patients hospitalized longer, while the albumin level was lower in these patients (all p values were &amp;lt;0.001). FAR values were higher and albumin values were lower in non-surviving patients compared to surviving patients (p=0.025 and p&amp;lt;0.001, respectively). Conclusion: FAR levels may be useful in predicting mortality risk in COVID-19 patients. In addition, it may be helpful and useful in determining the prognosis since it has higher levels as the severity of the disease and the length of hospital stay increase.

A Retrospective Study from a Single Center to Identify Hematological Factors that Distinguish Between Patients with Colorectal Carcinoma and Colorectal Adenoma.

BackgroundThis retrospective study from a single center in China was conducted using data from medical records between 2012 and 2020, to identify hematological factors that distinguish between patients with colorectal carcinoma (CRC) and colorectal adenoma.Material/MethodsIn this case-control study, 856 eligible patients were randomly divided into a training set (n=600) and a testing set (n=256). Routine blood parameters, blood coagulation, and liver and kidney function parameters were collected. Univariate and multivariate Cox regression analyses were used to explore diagnostic indicators. The values of the area under the curve and calibration curves were used to evaluate the model.ResultsThe study included 325 colorectal adenoma and 531 CRC patients. The prediction model for diagnosing CRC using hemoglobin-to-platelet ratio, fibrinogen-albumin ratio (FAR), albumin-globulin ratio (A/G), platelet-lymphocyte ratio, carcinoembryonic antigen (CEA), and thrombin time (TT) was developed on the basis of the patients grouped into the CRC and colorectal adenoma groups. The prediction model for diagnosing CRC stage was developed using prothrombin time (PT), TT, CEA, A/G, FAR, and HPR. The prediction model for diagnosing CRC grade was developed using PT, TT, A/G, plateletcrit, FAR, and HPR. The AUCs of the 3 prediction models were [0.848, 95% CI: (0.800–0.896)], [0.806, 95% CI: (0.775–0.836)], and [0.829, 95% CI: (0.797–0.860)] in the testing set.ConclusionsThree diagnostic prediction models for early screening of CRC, stage of CRC, and grade of CRC were established through a panel of readily available hematological parameters, which could provide auxiliary tools for early screening of CRC.

The Value of the C-Reactive Protein/Albumin and Fibrinogen/Albumin Ratios in Predicting Disease Severity and Mortality in Elderly COVID-19 Patients

Objective: Due to the high mortality levels associated with the novel coronavirus, reliable predictors for determining disease mortality and severity are needed to permit the careful allocation of health services and for earlier clinical intervention and follow-up. The purpose of this study was to determine the predictive value of the C-reactive protein (CRP)/albumin ratio (CAR) and the fibrinogen/albumin ratio (FAR) in determining mortality and evaluate correlations between these values and thoracic computed tomography (CT) findings. Material and Methods: COVID-19 patients aged over 65 presenting to the emergency department of a tertiary training and research hospital between Oct 15, 2021, and Jan 15, 2022, were examined in this single-center, retrospective study. The study population was established based on inclusion and exclusion criteria. The patients’ mortality status and pulmonary involvement percentages were compared with their laboratory parameters. Results: The relationships between patients’ CAR and FAR values and mortality and disease severity were investigated. Cut-off points of 3.0 for CAR (AUC 0.767, sensitivity 76.5% and specificity 70.1%) and 14.4 for FAR (AUC 0.731, sensitivity 75.0% and specificity 69.0%) were determined for the prediction of mortality. In terms of prediction of disease severity, cut-off points were 4.2 for CAR (AUC 0.786, sensitivity 73.7%, and specificity 75.2%) and 15.2 for FAR (AUC 0.789, sensitivity 84.2%, and specificity 69.6%). Conclusion: Based on our study findings, CAR and FAR values may be useful in the early differentiation of mortality and pulmonary parenchymal involvement in elderly COVID-19 patients.

The Fibrinogen/Albumin Ratio Index as an Independent Prognostic Biomarker for Patients with Combined Hepatocellular Cholangiocarcinoma After Surgery.

PurposeThe fibrinogen/albumin ratio (FAR) is increasingly considered as a potential biomarker for predicting prognosis in various malignant tumors, whereas the value of the FAR in predicting the recurrence-free survival (RFS) in patients with combined hepatocellular cholangiocarcinoma (cHCC-CCA) after surgery has not been studied.Patients and MethodsA total of 104 patients with surgical-pathologically proved cHCC-CCA were retrospectively analyzed. The best cut-off value of the FAR was calculated via receiver operating characteristic (ROC) curve analysis, and the cohort was then divided into two groups as high-FAR (H-FAR) group and low-FAR (L-FAR) group. The correlation between the preoperative FAR and clinicopathological characteristics was analyzed. Uni- and multi-variable analyses for RFS were evaluated using a Cox proportional hazards model to verify the predictive value of FAR on the RFS of cHCC-CCA. Additionally, a novel clinical nomogram based on FAR was developed to preoperatively predict the RFS of HCC-CCA. The C-index and calibration were conducted to evaluate the performance of the developed nomogram.ResultsAccording to the cut-off value of the FAR, the patients were grouped into the H-FARI (>0.075) and L-FARI (≤0.075) groups. FAR was significantly correlated with several clinical-pathological features, including age, cirrhosis, AFP, CA19-9, BCLC staging, NLR, and PLR. In the multi-variate analysis, FAR, cirrhosis and tumor size were independent prognostic predictors for poor RFS in cHCC-CCA patients after surgery. Moreover, the clinical nomogram based on FAR was constructed, showing well-predictive accuracy.ConclusionThe preoperative FAR is a convenient and feasible serum biomarker for predicting the RFS of cHCC-CCA after surgery. Such developed FAR-based nomogram integrating tumor size and cirrhosis could be served as a feasible and convenient tool to assist the decision-making of clinical strategy.

Fibrinogen-Albumin Ratio Index Exhibits Predictive Value of Neoadjuvant Chemotherapy in Osteosarcoma.

PurposeInflammatory response and nutritional status are associated with cancer development and progression. The present study aimed to evaluate the predictive ability of the fibrinogen–albumin ratio index (FARI) to the efficacy of neoadjuvant chemotherapy (NAC) for osteosarcoma.Patients and methodsA retrospective analysis involving 752 consecutive osteosarcoma patients between 2012 and 2020 was performed. Data on serum fibrinogen, albumin levels, white blood cell count, platelet count, and alkaline phosphatase (ALP) before and after NAC were collected. The predictive value of the NAC efficacy in osteosarcoma was assessed by constructing a receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC). Prognosis and its predictive factors were analyzed by Kaplan–Meier method and COX regression analysis. Nomogram was established according to selected variables. The predictive performance of the nomogram model was assessed using C-statistics.ResultsA total of 203 patients were included. ROC analysis showed that both FARI before NAC (preFARI; AUC = 0.594, p = 0.032) and the change in FARI before and after NAC (dfFARI = preFARI-postFARI; AUC = 0.652, p = 0.001) exhibited more favorable predictive ability than ALP and other inflammation markers. The preFARI was divided into the high group (>6.1%) and the low group (≤6.1%) based on the optimal cut-off value of 6.1%. Patients with a high preFARI showed significantly decreased metastasis-free survival (MFS) and disease-free survival (DFS) (all p<0.01). In multivariable analysis, preFARI was an independent prognostic marker for patients with osteosarcoma. Predictive nomograms exhibited good ability to predict MFS (C-index = 0.748, se = 0.028) and DFS (C-index=0.727, se = 0.030).ConclusionOur findings indicated that FARI exhibits the favorable predictive ability for the efficacy of NAC for osteosarcoma, which could support clinicians and patients in clinical decision-making and treatment optimization.

High fibrinogen-albumin ratio index (FARI) predicts poor survival in head and neck squamous cell carcinoma patients treated with surgical resection.

The aim of the present study was to investigate the predictive value of the fibrinogen/albumin ratio index(FARI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) on the prognosis of patients with operable head and neck squamous cell carcinoma (HNSCC). A cohort of 155 operable HNSCC patients were enrolled. Laboratory and clinical data were extracted from the patients' electronic medical record. The optimal cut-off values were determined by receiver operating characteristic (ROC) curves analysis. Clinicopathological characteristics of patients were compared via Chi-square test. Survival curves were analyzed by Kaplan-Meier method. The prognostic factors were evaluated by univariate and multivariate analyses via the Cox hazards regression analysis. The median follow-up time was 31.7months. An increased level of NLR was associated with later T stages, later N stages, and more advanced clinical stages(all P < 0.05). On univariate analyses, FARI, NLR, PLR, and N stage were correlated with progression-free survival (PFS) (all P < 0.05) as well as overall survival (OS) (all P < 0.05). And the clinical stage was only relevant to OS (P = 0.007). Multivariate Cox regression analysis revealed that FARI (HR 3.486, 95% CI 2.086-5.825, P < 0.001; HR 4.474, 95% CI 2.442-8.199, P < 0.001), NLR (HR 3.163, 95% CI 1.810-5.528, P < 0.001; HR 3.690, 95% CI 1.955-6.963, P < 0.001), and N stage (HR 1.718, 95% CI 1.058-2.789, P = 0.029; HR 1.777, 95% CI 1.024-3.084, P = 0.041) were independent prognostic factors for PFS and OS. Our findings indicate that FARI and NLR are effective and convenient markers for predicting prognosis in operable HNSCC patients.

Availability of Fibrinogen/Albumin ratio in MS attack

Background/AimMultiple sclerosis (MS) is a chronic central nervous system inflammatory disease. Fibrinogen/Albumin ratio (FAR) has been studied as an inflammatory marker in the past, and its significant relationship with inflammation has been shown. In our study, we examined serum levels of albumin, fibrinogen and FAR in patients presenting with MS attack. We investigated its usability in the diagnosis and management of MS attacks. Materials and methodsThis retrospective study included 40 patients admitted to hospital with MS attack and 40 control patients. All patients’ demographics, medical history, the mean Expanded Disability Status Scale (EDSS), imaging findings and laboratory tests were extracted from medical records. Patients’ fibrinogen, albumin levels were recorded in the blood tests performed before steroid administration, and FAR values were calculated. The patients’ and controls’ results were compared. ResultsFibrinogen and FAR values were significantly higher in the patient group (p<0.001 in both). There was no difference between the patient and control groups in terms of albumin (p = 0,16). No significant relationship was found between parameters such as EDSS, disease duration, smoking status and FAR value (p>0.05 in all). ConclusionSerum fibrinogen and FAR levels in the patients presenting with an attack were significantly higher than the control group. FAR value did not vary with disease duration and EDSS score. Based on this information, FAR may be a useful indicator for MS attack regardless of EDSS and disease duration.

Fibrinogen/albumin ratio as a promising predictor of platinum response and survival in ovarian clear cell carcinoma

BackgroundThis study aims to evaluate the role of the fibrinogen/albumin ratio (FAR) in predicting platinum resistance and survival outcomes of patients with ovarian clear cell carcinoma (OCCC).MethodsCoagulation function and D-dimer, serum albumin, CA125 and HE4 levels were measured before surgery in OCCC patients undergoing initial surgery in our institution. FAR was calculated as fibrinogen/albumin level. The correlation between these indicators and clinicopathological features, platinum response, and survival outcomes was further analyzed. The Kaplan-Meier method and multivariable Cox regression model were used to assess the effects of FAR on progression-free survival (PFS) and overall survival (OS).ResultsAdvanced stage patients accounted for 42.1% of the 114 participants. Optimal cytoreductive surgery was achieved in 105 patients, and the complete resection rate was 78.1%. FAR was associated with tumor stage, residual tumor and platinum response. A receiver operating characteristic curve for predicting platinum response showed that the optimal cutoff point of the FAR was 12%. The sensitivity was 73.3% and the specificity was 68.2%. In multivariate analysis, FAR ≥12% (HR = 4.963, P = 0.002) was an independent risk factor for platinum resistance. In addition, FAR and D-dimer proved to be independent negative factors for outcomes including both PFS and OS. The median follow-up time was 52 months. A high FAR (≥ 12%) showed a stronger correlation with poor OS and PFS in the subgroup analysis of advanced and completely resected patients.ConclusionsThe FAR might be a potential preoperative biochemical marker for predicting treatment response and oncological outcomes in OCCC patients.

Pretreatment Fibrinogen-Albumin Ratio (FAR) Associated with Treatment Response and Survival in Advanced Non-Small Cell Lung Cancer Patients Treated with First-Line Anti-PD-1 Therapy Plus Platinum-Based Combination Chemotherapy.

PurposePD-1 inhibitors have been routinely used to treat advanced non-small cell lung cancer (NSCLC) and have significantly improved clinical outcomes. In this study, we aimed to explore the influence of pretreatment fibrinogen-albumin ratio (FAR) on treatment response and survival in advanced NSCLC patients treated with first-line anti-PD-1 therapy plus platinum-based combination chemotherapy.Patients and MethodsA total of 91 patients with advanced NSCLC were included in the study. All patients received at least two cycles of systemic first-line anti-PD-1 therapy plus platinum-based combination chemotherapy. Receiver operating characteristics analysis was performed to determine the optimal cutoff values of FAR. Univariate and multivariate analyses were used to identify independent prognostic factors, and the Kaplan–Meier method was used to estimate survival curves.ResultsMultivariate logistic regression analysis showed that N stage (N2-3) and high FAR (≥0.175, optimal cutoff value) were independent predictors for objective response rate (P = 0.0002, P = 0.0005, respectively). Multivariate Cox regression analysis of progression-free survival and overall survival showed that high FAR (≥0.145) was independent prognostic factors (P = 0.0061, P = 0.0024, respectively). Progression-free survival and overall survival were significantly shorter in the high FAR (≥0.145) group than those in the low FAR (<0.145) group (P = 0.0024, P = 0.0024, respectively).ConclusionPretreatment FAR was an independent predictor for treatment response and independent prognostic factors in advanced NSCLC patients treated with first-line anti-PD-1 therapy plus platinum-based combination chemotherapy.

Potentials of Varied Inflammatory Indices in the Prediction of COVID-19 Severity Among Nigerians

<i>Background: </i>The coronavirus disease of 2019 (COVID-19) is theorized to be associated with significant inflammatory episodes. This tends to define the severity and culminates in adverse consequences of the disease. Therefore, the current study evaluated the potentials of varied inflammatory markers/indices that define the COVID-19 severity. <i>Methods: </i>This was a retrospective analysis of pre-treatment data obtained from patients with positive real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 disease in one of the treatment centers in Port Harcourt, South-south Nigeria. Data were obtained from case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants in the treatment center using pretested data acquisition templates. Abstracted data were compared between the severe positive and severe negative subgroups and the potentials of varied inflammatory indices were evaluated among the severe positive subgroup using standard protocols. <i>Results: </i>A total of 600 eligible cases were studied. Among the eligible cases, 543 (90.5%) had severe negative disease, while 57 (9.5%) had severe positive disease. The severe positive COVID-19 patients had higher mean blood levels of urea, creatinine, pro-calcitonin, C-reactive protein (CRP), ferritin, higher Glasgow prognostic scores (GPS), fibrinogen, D-dimer, fibrinogen-albumin ratio, total white cell count, neutrophil counts, composite neutrophil/lymphocyte ratio (NLR), composite platelet to lymphocyte ratio but lower potassium, albumin, hemoglobin levels, and isolated lymphocyte and platelet counts compared to the severe positive COVID-19 subjects (p<0.05). The C-reactive protein, GPS, D-dimer, and the composite NLR ratio indices significantly predicted COVID-19 severity on the crude regression model which was maintained in the adjusted model. However, serum CRP concentrations (AUC: 0.95; 95% CI: 0.82-1.00; p<0.001) maintained a more robust predictive potential compared to the GPS (AUC: 0.94; 95% CI: 0.84-1.00; p<0.001), D-dimer levels (AUC: 0.89; 95% CI: 0.79-0.94; p=0.004), and the composite NLR (AUC: 0.87; 95% CI: 0.77-0.92). <i>Conclusion: </i>The current study corroborates the role of inflammation in the COVID-19 disease severity. The clinical utility of these inflammation-induced markers/indices especially the CRP, GPS, D-dimer, and the NLR should be prioritized among Nigerians during the management of the disease.

Assessment of Surrogate Markers/Indices of Systemic Inflammation Among COVID-19 Patients with and Without Comorbid Conditions

Background: As widely reported, comorbid conditions are a significant risk for severe COVID-19 infection which is characterized by heightened adverse consequences. Since cytokine-induced inflammatory processes define COVID-19 severity, this study was aimed to evaluate the burden of COVID-19-induced inflammatory episodes, assessed using surrogate markers/indices of inflammation, among COVID-19 patients with and without comorbid conditions in Nigeria. Methods: This was a retrospective analysis of data obtained from treatment-naive real-time polymerase chain reaction (RT-PCR) confirmed COVID-19 patients at the Eleme COVID-19 treatment center in Port Harcourt within the southern region of Nigeria. All relevant data was acquired from case notes, medical review charts, nurses’ charts, and laboratory records by trained research assistants using data acquisition templates. All the data acquired were analyzed and compared between the COVID-19 patients with and without comorbid conditions using standard descriptive and comparative statistical tools. Results: Among those studied (n=604), 31.8% (n=192) had at least one pre-existing comorbid condition while 68.2% (n=412) had no comorbid conditions before COVID-19 diagnosis/subsequent presentation. The comorbid positive subgroup were mostly males and had higher mean age, BMI, body temperature, SBP, DBP, and higher proportions of elderly patients, high-risk occupational status (health workers) and social behavior (cigarette smoking), obesity, severe disease, and worse disease outcome, but lower oxygen saturation compared to the comorbid negative subjects at presentation. Additionally, the comorbid positive subjects also had higher mean levels of blood urea, creatinine, pro-calcitonin, CRP, ferritin, Glasgow prognostic scores, fibrinogen, D-Dimer, and the fibrinogen-albumin ratio, total white cell counts, isolated neutrophil counts, neutrophil-lymphocyte count ratio, and the platelet-lymphocyte count ratio but lower levels of potassium, albumin, isolated lymphocyte count and isolated platelet count compared to the comorbid negative subjects (p<0.05). The inflammatory markers/indices were significantly associated with obesity, age ≥65 years, hypertension, past/current cigarette smoking, diabetes, and cardiovascular disease. Conclusion: Comorbidities are significantly associated with amplified systemic inflammatory markers and indices among COVID-19 subjects. This may indicate the pathophysiologic link between various comorbidities and the COVID-19 severity among Nigerians. However, further studies are recommended to substantiate the findings of the current study.

Preoperative Fibrinogen Albumin Ratio is an Ideal Biomarker for Prognostic Evaluation of Gallbladder Carcinoma after Radical Resection: A 10-Year Retrospective Study at a Single Center

Preoperative Fibrinogen Albumin Ratio is an Ideal Biomarker for Prognostic Evaluation of Gallbladder Carcinoma after Radical Resection: A 10-Year Retrospective Study at a Single Center

Fibrinogen/Albumin Ratio (FAR) in Patients with Triple Negative Breast Cancer and Its Relationship with Epidermal Growth Factor Receptor Expression.

ObjectiveTo investigate the potential prognostic significance of fibrinogen/albumin ratio (FAR) in triple negative breast cancer (TNBC) patients and its relationship with epidermal growth factor receptor (EGFR) expression.MethodsThere were 164 patients with TNBC enrolled in this study in our hospital from January 2010 to December 2015. The optimal cutoff value of FAR was evaluated by the receiver operating characteristic curve (ROC). The associations between TNBC and clinicopathological variables by FAR were performed by Chi-square test. Kaplan–Meier method and Log rank test were used for survival analysis. The independent prognostic factors were determined by univariate and multivariate Cox’s proportional hazards regression model. The EGFR expression was analyzed by the immunohistochemistry assay.ResultsOne hundred and sixty-four TNBC patients were divided into: low FAR group (FAR < 0.08) and high FAR group (FAR ≥ 0.08) by ROC. The preoperative FAR was associated to BMI, menopause, red blood cell, albumin, fibrinogen (P < 0.05). FAR was an independent prognostic factor for TNBC. In low FAR group, the mean disease-free survival (DFS) and overall survival (OS) were 33.62 months and 52.99 months; in high FAR group, the mean DFS and OS were 30.18 months and 48.27 months, respectively. The DFS and OS survival curve were performed by Log rank assay and were statistically significant (P < 0.05). The mean DFS and OS after operation in patients with EGFR negative expression were longer than that in patients with EGFR positive expression. In EGFR positive group, the mean DFS and OS of low FAR group were higher than that of high FAR group, and the difference was statistically significant (P < 0.05).ConclusionPretreatment FAR is the independent prognostic factor in TNBC, and with low cost, strong repeatability, and high safety. It can be acted as an effective indicator to predict the prognosis of TNBC.

Fibrinogen to Albumin Ratio Predicts Burden of Coronary Artery Disease in Patients with NSTEMI

Objective: Fibrinogen plasma level rises in the event of inflammatory cases. It is known that there is a powerful intercourse between fibrinogen level and plasma viscosity. Albumin plasma level dropes during the inflammatory cases. The aim of this work determine significance of fibrinogen albumin ratio (FAR) as a indicator emphases the burden of atherosclerosis.&#x0D; Method: The study included 83 patients diagnosed with non-ST-segment elevation myocardial infarction (NSTEMI) between January and September 2015. The definition of NSTEMI was made according to “Definition of Third Universal Myocardial Infarction” guidelines published on 2013 by European Society of Cardiology. Burden of atherosclerosis was evaluated by Syntax score (SS) and Gensini Score. Patients were seperated two groups as medium-high SS (n=23) and low SS (n=60). FAR levels were compared.&#x0D; Results: FAR was 80.71 ± 30.3 in low SS group and 120 ± 49.72 in the mid-high SS group respectively (p

Predictive Value of Preoperative Controlling Nutritional Status Score Combined with Fibrinogen-Albumin Ratio in Postoperative Local Recurrence-Free Survival of Patients with Retroperitoneal Liposarcoma.

BackgroundPrevious studies have shown that nutrition and systemic inflammation plays an essential role in the development of soft tissue sarcoma. However, few studies have explored the association of clinicopathologic features and local recurrence with nutritional and inflammatory markers in retroperitoneal liposarcoma (RPLS). This study sought to evaluate the prognostic value of the preoperative nutritional and inflammatory markers for local recurrence-free survival (LRFS) among surgical RPLS patients.MethodsThe study included 111 RPLS patients who underwent surgery between May 2010 and June 2019 at the Peking University Cancer Hospital Sarcoma Center. Time-dependent receiver operating characteristic (time-ROC) curve analysis was conducted to evaluate the ability of markers to predict LRFS. The associations of the CONUT-FAR score with clinicopathological variables and LRFS were evaluated.ResultsIn the time-ROC curve analysis, the CONUT-FAR score was superior to other nutritional and inflammatory markers in predicting LRFS. The CONUT-FAR score was the only nutritional and inflammatory marker that independently predicted LRFS in the multivariate analysis, and patients with a high CONUT-FAR score (> 11) showed significantly decreased LRFS. Although the CONUT-FAR score failed to discriminate patients with low grade (G1) (p = 0.327) or undergoing incomplete (R2) resection (p = 0.072), it stratified patients with high grade (G2 and G3) or undergoing complete resection (R0/R1) into subgroups with significantly distinct LRFS (p < 0.001). The CONUT-FAR score also showed good clinical utility among patients with different clinical characteristics.ConclusionThe preoperative CONUT-FAR score reflects both nutritional and inflammatory factors and is an effective predictor of LRFS for surgical RPLS patients.

The prognostic value of sarcopenia combined with preoperative fibrinogen-albumin ratio in patients with intrahepatic cholangiocarcinoma after surgery: A multicenter, prospective study.

BackgroundTo explore the prognostic value of the fibrinogen–albumin ratio (FAR) combined with sarcopenia in intrahepatic cholangiocarcinoma (ICC) patients after surgery and to develop a nomogram for predicting the survival of ICC patients.Materials and MethodsIn this prospective cohort study, 116 ICC patients who underwent radical surgery were enrolled as the discovery cohort and another independent cohort of 68 ICC patients was used as the validation cohort. Kaplan–Meier method was used to analyze prognosis. The independent predictor of overall survival (OS) and recurrence‐free survival (RFS) was evaluated by univariable and multivariable Cox regression analyses, then developing nomograms. The performance of nomograms was evaluated by concordance index (C‐index), calibration curve, receiver operating characteristic curve analysis (ROC), and decision curve analysis (DCA).ResultsPatients with high FAR had lower OS and RFS. FAR and sarcopenia were effective predictors of OS and RFS. Patients with high FAR and sarcopenia had a poorer prognosis than other patients. OS nomogram was constructed based on age, FAR, and sarcopenia. RFS nomogram was constructed based on FAR and sarcopenia. C‐index for the nomograms of OS and RFS was 0.713 and 0.686. Calibration curves revealed great consistency between actual survival and nomogram prediction. The area under ROC curve (AUC) for the nomograms of OS and RFS was 0.796 and 0.791 in the discovery cohort, 0.823 and 0.726 in the validation cohort. The clinical value of nomograms was confirmed by the DCA.ConclusionsICC patients with high FAR and sarcopenia had a poor prognosis, the nomograms developed based on these two factors were accurate and clinically useful in ICC patients who underwent radical resection.