Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center(Group), Linhai 317000, Zhejiang Province, China.
Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, Linhai, 317000, Zhejiang, Province, China.
Clin Chim Acta. 2018 Jul;482:203-208. doi: 10.1016/j.cca.2018.04.012. Epub 2018 Apr 10.
Nutrition and coagulation play important roles in cancer progression. This study was aimed to investigate the value of the albumin/fibrinogen ratio (AFR) in non-small cell lung cancer (NSCLC) patients, through a propensity score matching (PSM) method.
We retrospectively analyzed 529 NSCLC patients underwent surgical resection from 2010 to 2015. PSM was used to eliminate possible biases. A Cox proportional hazards regression model was performed to evaluate the prognostic value of AFR in NSCLC.
The optimal value was 9.67 for the AFR by ROC (receiver operating characteristic) curve. The AFR was statistically significantly associated with age, sex, smoking history, histological subtype, tumor size, pathological stage and adjuvant therapy (p < 0.05). Multivariate analysis indicated that the pathological stage and pre-resection AFR were independent prognostic factors for patients with NSCLC. Additionally, elevated AFR indicated a better outcome, and patients with higher AFR had lower risk for overall death (OS) (HR 0.512, 95% CI 0.316-0.829, p = 0.006) as well as disease-free death (DFS) (HR 0.561, 95% CI 0.399-0.787, p = 0.001). The propensity score model identified 120 patients from each group that were balanced for age, sex, smoking history, histological subtype, tumor size, stage distribution and adjuvant therapy. In multivariable regression analysis of PSM groups, the result indicated that the AFR was predictive for OS (HR 0.392, 95% CI 0.225-0.683, p < 0.001) and DFS (HR 0.526, 95% CI 0.344-0.805, p = 0.003).
Pre-resection AFR can be considered as an independent prognostic factor in NSCLC patients, and higher AFR may enhance OS and DFS of NSCLC patients.
营养和凝血在癌症进展中起着重要作用。本研究旨在通过倾向评分匹配（PSM）方法探讨白蛋白/纤维蛋白原比值（AFR）在非小细胞肺癌（NSCLC）患者中的价值。
我们回顾性分析了 2010 年至 2015 年间接受手术切除的 529 例 NSCLC 患者。采用 PSM 消除可能的偏倚。采用 Cox 比例风险回归模型评估 AFR 对 NSCLC 的预后价值。
通过 ROC 曲线，AFR 的最佳值为 9.67。AFR 与年龄、性别、吸烟史、组织学亚型、肿瘤大小、病理分期和辅助治疗显著相关（p<0.05）。多因素分析表明，病理分期和术前 AFR 是 NSCLC 患者独立的预后因素。此外，升高的 AFR 表明预后更好，AFR 较高的患者总死亡（OS）（HR 0.512，95%CI 0.316-0.829，p=0.006）和无病死亡（DFS）（HR 0.561，95%CI 0.399-0.787，p=0.001）风险较低。倾向评分模型从每组中各选择 120 名年龄、性别、吸烟史、组织学亚型、肿瘤大小、分期分布和辅助治疗均衡的患者。在 PSM 组的多变量回归分析中，结果表明 AFR 可预测 OS（HR 0.392，95%CI 0.225-0.683，p<0.001）和 DFS（HR 0.526，95%CI 0.344-0.805，p=0.003）。
术前 AFR 可作为 NSCLC 患者的独立预后因素，较高的 AFR 可能提高 NSCLC 患者的 OS 和 DFS。
