Li Yicheng, Li Zhengli, Deng Kangjian, Liao Minjun, Yuan Shengguang, Huang Zhaoquan
Department of Hepatobiliary and Pancreatic Surgery, The Second Affiliated Hospital of Guilin Medical University, Guilin 541199, Guangxi, People's Republic of China.
Laboratory of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi, People's Republic of China.
Cancer Manag Res. 2020 Oct 1;12:9057-9066. doi: 10.2147/CMAR.S266653. eCollection 2020.
Preoperative fibrinogen levels are associated with the development, recurrence and metastasis of malignant tumors. This study was designed to investigate the clinical value of preoperative fibrinogen/lymphocyte count ratio (FLR) index in hepatocellular carcinoma (HCC).
The clinical data of 479 patients with HCC who underwent radical resection were retrospectively analyzed. The correlation between FLR and clinicopathological features was analyzed by chi-square test or non-parametric test. The overall survival (OS) and progression-free survival (PFS) were analyzed by Kaplan-Meier method.
The optimal cut-off value of FLR was determined as 1.6 according to the receiver operating characteristic curve (ROC) analysis, in order to predict prognosis for HCC patients after radical resection. It was further found that FLR level was correlated with tumor size, TNM stage, microvascular invasion and prognosis. Multivariate Cox regression analyses found that FLR was an independent predictor for postoperative OS (overall survival) ( = 0.002) and PFS (progression-free survival) ( = 0.001) in patients with HCC; and the 1-, 3- and 5-year OS and PFS of HCC patients in the FLR ≤1.6 level group were significantly higher than those in the FLR >1.6 level group.
Preoperative FLR level is a novel and effective predictor of prognosis in patients with HCC, and elevated FLR level is associated with poor prognosis in patients with HCC.
术前纤维蛋白原水平与恶性肿瘤的发生、复发及转移相关。本研究旨在探讨术前纤维蛋白原/淋巴细胞计数比值（FLR）指数在肝细胞癌（HCC）中的临床价值。
回顾性分析479例行根治性切除的HCC患者的临床资料。采用卡方检验或非参数检验分析FLR与临床病理特征的相关性。采用Kaplan-Meier法分析总生存期（OS）和无进展生存期（PFS）。
根据受试者工作特征曲线（ROC）分析，将FLR的最佳截断值确定为1.6，以预测HCC患者根治性切除后的预后。进一步发现FLR水平与肿瘤大小、TNM分期、微血管侵犯及预后相关。多因素Cox回归分析发现，FLR是HCC患者术后OS（总生存期）（ = 0.002）和PFS（无进展生存期）（ = 0.001）的独立预测因素；FLR≤1.6水平组HCC患者的1年、3年和5年OS及PFS均显著高于FLR>1.6水平组。
术前FLR水平是HCC患者预后的一种新型有效预测指标，FLR水平升高与HCC患者预后不良相关。
