Zheng Lihua, Zhao Yaheng, Liu Feng, Liu Peng, Li Wei, Yang Yan, Zhang Hongsong, Liu Yunjiang
Department of General Surgery, Hebei Key Laboratory of Colorectal Cancer Precision Diagnosis and Treatment.
Department of Vascular Surgery.
Medicine (Baltimore). 2020 Jun 26;99(26):e20681. doi: 10.1097/MD.0000000000020681.
Plasma albumin to fibrinogen ratio is involved in human cancer, but its prognostic significance in breast cancer is controversy. In the context of breast invasive ductal carcinoma, this research aims to retrospectively evaluate by preoperative plasma albumin to fibrinogen ratio (AFR) and forecast oncological outcome and recurrence.This retrospective study comprised 230 patients with non-metastatic breast invasive ductal carcinoma who underwent surgery between January 2009 and April 2012 in Fourth Hospital of Hebei Medical University. Patients were categorized base on an optimal value of preoperative plasma fibrinogen (Fib) and albumin. Progression-free and cancer-specific survival were assessed using Kaplan-Meier method. The associations between albumin to fibrinogen ratio and clinical outcomes were assessed with univariate and multivariate analysis. A number of risk factors were used to form nomograms to evaluate survival, and Harrell concordance index (C-index) was used to evaluate the predictive accuracy.Plasma AFR was significantly associated with diminished disease-free survival (DFS) and overall survival (OS). Multivariate analysis revealed that plasma AFR was an independent prognostic indicator for DFS (HR = 1.346; 95% CI: 1.107-1.636; P = .03) and overall survival (OS) (HR = 1.485; 95% CI: 1.106-1.993; P = .008). Two prediction model of 3-, 5-years OS and DFS based on the AFR was developed.Elevated preoperative plasma AFR is an independent prognostic factor for oncological outcomes in patients with breast invasive ductal carcinoma. The formulated nomogram showed superior predictive accuracy for DFS and OS.
血浆白蛋白与纤维蛋白原比值与人类癌症有关，但其在乳腺癌中的预后意义存在争议。在乳腺浸润性导管癌的背景下，本研究旨在通过术前血浆白蛋白与纤维蛋白原比值（AFR）进行回顾性评估，并预测肿瘤学结局和复发情况。这项回顾性研究纳入了230例2009年1月至2012年4月在河北医科大学第四医院接受手术的非转移性乳腺浸润性导管癌患者。根据术前血浆纤维蛋白原（Fib）和白蛋白的最佳值对患者进行分类。采用Kaplan-Meier法评估无进展生存期和癌症特异性生存期。通过单因素和多因素分析评估白蛋白与纤维蛋白原比值与临床结局之间的关联。使用多个危险因素构建列线图来评估生存期，并使用Harrell一致性指数（C指数）评估预测准确性。血浆AFR与无病生存期（DFS）和总生存期（OS）的降低显著相关。多因素分析显示，血浆AFR是DFS（HR = 1.346；95%CI：1.107 - 1.636；P = 0.03）和总生存期（OS）（HR = 1.485；95%CI：1.106 - 1.993；P = 0.008）的独立预后指标。基于AFR建立了3年、5年OS和DFS的两种预测模型。术前血浆AFR升高是乳腺浸润性导管癌患者肿瘤学结局的独立预后因素。制定的列线图对DFS和OS显示出卓越的预测准确性。
