Albumin-to-fibrinogen ratio as a promising biomarker to predict clinical outcome of non-small cell lung cancer individuals.
Albumin-to-fibrinogen ratio as a promising biomarker to predict clinical outcome of non-small cell lung cancer individuals.
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DOI：
10.1002/cam4.1428
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发表时间：
2018-04
期刊：
影响因子：
4
通讯作者：
Ying HQ
中科院分区：
文献类型：
--
作者：
Li SQ;Jiang YH;Lin J;Zhang J;Sun F;Gao QF;Zhang L;Chen QG;Wang XZ;Ying HQ
慢性炎症是促进包括肺癌在内的实体恶性肿瘤发生和转移的重要原因之一。在此，我们旨在探讨白蛋白(Alb)/纤维蛋白原(Fib)比值(AFR)、纤维蛋白原(Fib)和白蛋白(Alb)在LC预后中的作用，并建立一种结合AFR的新的有效的正常参考图。这项前瞻性研究纳入了2005年2月至2014年12月间确诊的412例LC患者。应用X-TILE软件、Kaplan-Meier曲线、Cox回归模型和时间依赖ROC分析AFR、Fib、Alb、中性粒细胞/淋巴细胞比(NLR)、血小板/淋巴细胞比(PLR)和单核细胞/淋巴细胞比(MLR)对预后的影响。治疗前高循环Fib、低AFR和Alb显著增加LC患者的死亡风险，尤其是所有阶段的非小细胞肺癌(NSCLC)患者。AFR、Fib和NLR的曲线下面积(AUC)大于Alb和PLR内的曲线下面积(AUC)，可预测NSCLC患者的生存。高AFR化放疗患者的临床预后优于低AFR患者，低AFRII-III期非小细胞肺癌放化疗患者的总体生存率明显低于手术患者(P<0.001)。反之，在高AFR亚组中，接受放化疗的患者与手术患者和辅助放化疗患者的临床结果相同(P=0.405)。此外，接受放化疗的非小细胞肺癌患者包括AFR在内的预测诺模图的C指数(0.717)高于未接受AFR的患者(0.707)。我们的研究结果表明，循环预处理AFR可能是预测手术切除和辅助放化疗的临床疗效的潜在生物标志物，并可作为非小细胞肺癌患者预后的生物标志物。
Chronic inflammation is one of the critical causes to promote the initiation and metastasis of solid malignancies including lung cancer (LC). Here, we aimed to investigate the prognostic roles of albumin (Alb)‐to‐fibrinogen (Fib) ratio (AFR), Fib and Alb in LC and to establish a novel effective nomogram combined with AFR. Four hundred twelve LC patients diagnosed between February 2005 and December 2014 were recruited in this prospective study. The prognostic roles of AFR, Fib, Alb, neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR) and monocyte‐to‐lymphocyte ratio (MLR) were identified by X‐tile software, Kaplan–Meier curve, Cox regression model, and time‐dependent ROC. Pretreatment high circulating Fib, low AFR, and Alb were significantly associated with increased risk of death for LC patients, especially for non‐small cell lung cancer (NSCLC) patients in all stages. The area under curves (AUCs) of AFR, Fib, and NLR were higher than them within Alb and PLR for predicting the survival of NSCLC patients. Moreover, we found that clinical outcome of high AFR patient with chemo‐radiotherapy was superior to low AFR patient; overall survival rate of stage II‐III NSCLC patients undergoing chemo‐radiotherapy was significantly lower than the surgical patients with treatment of adjuvant chemo‐radiotherapy(P = 0.001) in low AFR subgroup. On the contrary, clinical outcome of the patients receiving chemo‐radiotherapy was the same to the patients undergoing surgery and adjuvant chemo‐radiotherapy (P = 0.405) in high AFR subgroup. In addition, c‐index of predicted nomogram including AFR (0.717) for NSCLC patients with treatment of chemo‐radiotherapy was higher than that without AFR (0.707). Our findings demonstrated that circulating pretreatment AFR might be a potential biomarker to predict clinical efficacy of surgical resection and adjuvant chemo‐radiotherapy and be a prognostic biomarker for NSCLC individuals.
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