School of Public Health, Nanchang University, Nanchang, PR China.
Jiangxi Provincial Key Laboratory of Preventive Medicine, Nanchang University, Nanchang, PR China.
J Clin Lab Anal. 2021 May;35(5):e23757. doi: 10.1002/jcla.23757. Epub 2021 Mar 18.
Chronic inflammation is a hallmark of colorectal mucinous adenocarcinoma (CMA). Albumin-to-fibrinogen ratio (AFR) and fibrinogen-to-pre-albumin ratio (FPR) were independent prognostic factors for many kinds of solid malignancies. However, the association between the inflammatory scores and progression of metastatic CMA remains unknown.
Peripheral blood neutrophil count and circulating fibrinogen, albumin, and pre-albumin levels were detected, and neutrophil-to-albumin ratio (NAR), neutrophil-to-pre-albumin ratio(NPAR), AFR, and FPR were calculated in 42 metastatic MCA patients. Kaplan-Meier curve, Cox regression, time-dependent receiver operating characteristic curve (tdROC) were selected to investigate the prognostic utility of them in the patients.
Metastatic CMA patients commonly occurred in middle-younger patients (80.95%). NPAR (adjusted hazard ratio (HR)=2.405, 95% confidence interval (CI)=1.195-4.842) and FPR (p =0.007, adjusted HR=2.364, 95% CI=1.203-4.645) were significantly associated with poor progression-free survival in these patients. The prognostic prediction area under tdROC (AUROC) of FPR was significantly higher than that of NPAR(0.703 versus 0.537). Moreover, the patients with a high CA19-9-FPR score showed worse outcomes than those with the low score (p <0.001, adjusted HR=7.273, 95% CI=2.721-19.435 for the score 1 versus 0). The prediction AUROC, sensitivity, and specificity of the score were 0.892 (0.788-0.996), 76.32%, and 100.00%, respectively, and its predicted efficacy was better than that of the single biomarkers.
The combined CA19-9-FPR score is an economical, simple, effective, and independent prognostic factor for metastatic MCA.
慢性炎症是结直肠黏液腺癌（CMA）的一个标志。白蛋白-纤维蛋白原比值（AFR）和纤维蛋白原-前白蛋白比值（FPR）是许多实体恶性肿瘤的独立预后因素。然而，炎症评分与转移性 CMA 进展之间的关系尚不清楚。
检测 42 例转移性 MCA 患者的外周血中性粒细胞计数和循环纤维蛋白原、白蛋白和前白蛋白水平，并计算中性粒细胞-白蛋白比值（NAR）、中性粒细胞-前白蛋白比值（NPAR）、AFR 和 FPR。选择 Kaplan-Meier 曲线、Cox 回归、时间依赖性接收者操作特征曲线（tdROC）来研究它们在患者中的预后价值。
转移性 CMA 患者常见于中青年人（80.95%）。NPAR（调整后的危险比（HR）=2.405，95%置信区间（CI）=1.195-4.842）和 FPR（p=0.007，调整后的 HR=2.364，95%CI=1.203-4.645）与这些患者无进展生存期不良显著相关。FPR 的 tdROC 预测面积（AUROC）明显高于 NPAR（0.703 比 0.537）。此外，CA19-9-FPR 评分高的患者比评分低的患者预后更差（p<0.001，调整后的 HR=7.273，95%CI=2.721-19.435，评分 1 比 0）。该评分的预测 AUROC、敏感性和特异性分别为 0.892（0.788-0.996）、76.32%和 100.00%，其预测效果优于单一生物标志物。
CA19-9-FPR 联合评分是一种经济、简便、有效、独立的转移性 MCA 预后因素。
