Prognostic value of a novel FPR biomarker in patients with surgical stage II and III gastric cancer.
Prognostic value of a novel FPR biomarker in patients with surgical stage II and III gastric cancer.
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新型 FPR 生物标志物对手术 II 期和 III 期胃癌患者的预后价值
DOI：
10.18632/oncotarget.20661
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发表时间：
2017-09-26
期刊：
影响因子：
--
通讯作者：
Wang XZ
中科院分区：
文献类型：
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作者：
Zhang J;Li SQ;Liao ZH;Jiang YH;Chen QG;Huang B;Liu J;Xu YM;Lin J;Ying HQ;Wang XZ
背景炎症和营养是导致胃癌（GC）进展的两个主要原因，炎症生物标志物可能作为其有价值的预后因素。因此，本研究旨在探讨术前循环白蛋白/纤维蛋白原比值（AFR）、纤维蛋白原/前白蛋白比值（FPR）、纤维蛋白原（Fib）、白蛋白（Alb）和前白蛋白（pAlb）在手术GC中的预后意义。材料与方法 2011 年 6 月至 2013 年 12 月期间 360 例手术 II 期和 III 期 GC 患者纳入本回顾性研究。采用X-tile软件、Kaplan-Meier曲线和Cox回归模型评估其预后作用。建立预测列线图来预测总生存期（OS）的预后，并通过一致性指数（c-index）评估其准确性。结果 Alb、pAlb、AFR 降低和 FPR 升高与 OS 缩短显着相关。通过时间依赖性 ROC 分析，FPR 被确定为预测 3 年 OS 的最有效的预后因素。低FPR水平的患者生存期较长，接受化疗的III期FPR-low GC患者的预后明显优于未治疗的患者（P=0.002）。然而，在根据接受或不接受化疗治疗的 III 期患者的 FPR 和高 FRP 分层的 II 期亚组中，未检测到生存率差异。包含 FPR 的列线图 (c-index=0.756) 的 C 指数高于不含 FPR 的列线图 (c-index=0.748)。结论 术前FPR可能是手术II期和III期GC的可行预后生物标志物，它可以准确区分似乎从辅助化疗中明显受益的III期患者。同时根据临床参数和FPR建立列线图可以提高其预测效果。
Background Inflammation and nutrition are two main causes contributing to progression of gastric cancer (GC), and inflammatory biomarker may be presented as its valuable prognostic factor. Thus, this study was carried out to investigate the prognostic significance of preoperative circulating albumin/fibrinogen ratio (AFR), fibrinogen/pre-Albumin ratio (FPR), fibrinogen (Fib), albumin (Alb) and pre-Albumin (pAlb) in surgical GC. Materials and Methods Three hundred and sixty surgical stage II and III GC patients from June 2011 to December 2013 were enrolled in this retrospective study. X-tile software, Kaplan–Meier curve and Cox regression model were used to evaluate the prognostic role of them. A predictive nomogram was established to predict prognosis of overall survival (OS), and its accuracy was assessed by concordance index (c-index). Results Decreased Alb, pAlb, AFR and elevated FPR were significantly associated with shorter OS. FPR was identified as the most effective prognostic factor to predict 3-year’s OS by time-dependent ROC analysis. A long survival was observed in patients with low level of FPR and the prognosis of stage III FPR-low GC patients undergoing chemotherapy was significantly superior to the patients without the treatment (P=0.002). However, no difference of survival was examined in stage II subgroups stratified by FPR and high FRP of stage III patients with or not the treatment of chemotherapy. C-index of nomogram containing FPR (c-index=0.756) was high in comparison with the nomogram without FPR (c-index =0.748). Conclusion Preoperative FPR might be a feasible prognostic biomarker in surgical stage II and III GC and it could precisely distinguish stage III patients who appeared to obviously benefit from adjuvant chemotherapy. Meanwhile established nomogram based on clinical parameters and FPR could improve its predictive efficacy.