Circulating fibrinogen to pre-albumin ratio is a promising biomarker for diagnosis of colorectal cancer
Circulating fibrinogen to pre-albumin ratio is a promising biomarker for diagnosis of colorectal cancer
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DOI：
10.1002/jcla.22635
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发表时间：
2019-01-01
影响因子：
2.7
通讯作者：
Wang, Xiao-Zhong
中科院分区：
文献类型：
--
作者：
Sun, Fan;Tan, Yu-Ao;Wang, Xiao-Zhong
背景炎症和营养与结直肠癌（CRC）的发生和进展密切相关。本研究旨在探讨 FAR（FAR = 100*纤维蛋白原/白蛋白）和 FPR（FPR = 纤维蛋白原/前白蛋白）对 CRC 的诊断价值。方法 计算 455 名新诊断的 CRC 患者、455 名健康个体和 455 名结直肠息肉良性对照患者的中性粒细胞与淋巴细胞比值 (NLR)、FPR 和 FAR。通过受试者工作特征曲线（ROC）评估生物标志物对CRC的诊断价值。采用逻辑回归分析来评估区分结直肠癌与良性疾病的危险因素。此外，组合的生物标志物用于区分结直肠癌和良性疾病。结果结直肠癌患者的中性粒细胞与淋巴细胞比值、FAR和FPR均显着高于良性或健康对照（P < 0.05）。 ROC分析显示FAR和FPR对CRC的诊断效能优于NLR。此外，逻辑回归分析显示，FPR、NLR、癌胚抗原（CEA）和碳水化合物抗原19-9（CA199）与良性疾病和CRC的分化显着相关。 FPR、CEA 和 CA199 组合在区分 CRC 和良性疾病时具有最大的 ROC 曲线下面积 (AUC)（AUC = 0.845，敏感性 = 67.9%，特异性 = 85.3%，阳性预测值 = 83.5%，阴性预测值 = 70.9%）。结论 纤维蛋白原/前白蛋白可能是一种有用的CRC诊断生物标志物，FPR、CEA和CA199联合应用可显着提高区分CRC和良性结直肠疾病的诊断效能。
Background Inflammation and nutrition are closely associated with initiation and progression of colorectal cancer (CRC). This study aimed to investigate the diagnostic value of the FAR (FAR = 100*Fibrinogen/Albumin) and FPR (FPR = Fibrinogen/pre-Albumin) in CRC. Methods Neutrophil-to-lymphocyte ratio (NLR), FPR, and FAR were calculated in 455 newly diagnosed CRC patients, 455 healthy individuals, and 455 benign controls with colorectal polyp. The diagnostic value of biomarker for CRC was evaluated by receiver operating characteristic curve (ROC). Logistic regression analysis was adopted to assess the risk factors for telling CRC apart from benign disease. Moreover, the combined biomarkers were used for discriminating between CRC and benign disease. Results Neutrophil-to-lymphocyte ratio, FAR, and FPR were significantly higher in CRC patients compared with the benign or healthy controls (P < 0.05). ROC analysis showed that the diagnostic efficacy of FAR and FPR were better than NLR for CRC. Besides, FPR, NLR, carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA199) were markedly associated with differentiation of benign disease and CRC in the logistic regression analysis. And the combination of FPR, CEA, and CA199 had the maximum area under the ROC curve (AUC) in separating CRC from benign disease (AUC = 0.845, Sensitivity = 67.9%, Specificity = 85.3%, Positive Predictive Value = 83.5%, Negative Predictive Value = 70.9%). Conclusions Fibrinogen/pre-Albumin could be a useful CRC diagnostic biomarker, and the combination of FPR, CEA, and CA199 could significantly improve the diagnostic efficacy in discriminating CRC from the benign colorectal disease.