Masaaki Yamamoto1,2, Yukinori Kurokawa3, Noboru Kobayashi1, Tsuyoshi Takahashi1, Yasuhiro Miyazaki1, Koji Tanaka1, Tomoki Makino1, Makoto Yamasaki1, Kiyokazu Nakajima1, Masaki Mori4, Yuichiro Doki1. 1. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2-E2, Yamadaoka, Suita, 565-0871, Osaka, Japan. 2. Department of Surgery, JCHO Hoshigaoka Medical Center, Osaka, Japan. 3. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, 2-2-E2, Yamadaoka, Suita, 565-0871, Osaka, Japan. ykurokawa@gesurg.med.osaka-u.ac.jp. 4. Department of Surgery and Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan.
Abstract
BACKGROUND: It has been reported that both fibrinogen and the neutrophil-lymphocyte ratio (NLR) are related to the degree of malignancy in various types of cancer. This study compared the combined index of fibrinogen and NLR (F-NLR) with NLR alone for predicting the prognosis of patients with resectable gastric cancer. METHODS: We collected data on 666 patients with resectable gastric cancer. Patients were divided into three F-NLR score groups based on the following criteria: score 2, both hyperfibrinogenemia (≥350 mg/dl) and high NLR (≥2.5); score 1, either hyperfibrinogenemia or high NLR; and score 0, neither abnormality. The association between prognosis and NLR alone or F-NLR was evaluated using the Kaplan-Meier method and Cox multivariate analysis. RESULTS: The high-NLR group had significantly worse overall survival (OS) than the low-NLR group (hazard ratio 1.62; 95% confidence interval [CI] 1.07-2.45; log-rank P = 0.022), but there was no significant difference between the high- and low-NLR groups after adjusting for the fibrinogen level. F-NLR groups showed significantly different OS (log-rank P < 0.001) and recurrence-free survival (log-rank P < 0.001). The 5-year OS rate for the groups with F-NLR scores of 2, 1, and 0 was 72.6%, 81.4%, and 90.4%, respectively. A Cox multivariate analysis of OS revealed that a high F-NLR score (1 or 2) was an independent prognostic factor (P = 0.007). CONCLUSIONS: F-NLR was an independent prognostic factor in patients with gastric cancer and a more useful prognostic indicator than NLR alone.
BACKGROUND: It has been reported that both fibrinogen and the neutrophil-lymphocyte ratio (NLR) are related to the degree of malignancy in various types of cancer. This study compared the combined index of fibrinogen and NLR (F-NLR) with NLR alone for predicting the prognosis of patients with resectable gastric cancer. METHODS: We collected data on 666 patients with resectable gastric cancer. Patients were divided into three F-NLR score groups based on the following criteria: score 2, both hyperfibrinogenemia (≥350 mg/dl) and high NLR (≥2.5); score 1, either hyperfibrinogenemia or high NLR; and score 0, neither abnormality. The association between prognosis and NLR alone or F-NLR was evaluated using the Kaplan-Meier method and Cox multivariate analysis. RESULTS: The high-NLR group had significantly worse overall survival (OS) than the low-NLR group (hazard ratio 1.62; 95% confidence interval [CI] 1.07-2.45; log-rank P = 0.022), but there was no significant difference between the high- and low-NLR groups after adjusting for the fibrinogen level. F-NLR groups showed significantly different OS (log-rank P < 0.001) and recurrence-free survival (log-rank P < 0.001). The 5-year OS rate for the groups with F-NLR scores of 2, 1, and 0 was 72.6%, 81.4%, and 90.4%, respectively. A Cox multivariate analysis of OS revealed that a high F-NLR score (1 or 2) was an independent prognostic factor (P = 0.007). CONCLUSIONS: F-NLR was an independent prognostic factor in patients with gastric cancer and a more useful prognostic indicator than NLR alone.
Authors: Sabine Schiefer; Naita Maren Wirsik; Eva Kalkum; Svenja Elisabeth Seide; Henrik Nienhüser; Beat Müller; Adrian Billeter; Markus W Büchler; Thomas Schmidt; Pascal Probst Journal: Diagnostics (Basel) Date: 2022-02-25