背景:纤维蛋白原与白蛋白比值(FAR)越来越被认为是预测各种恶性肿瘤预后的潜在生物标志物,但不在胃印戒细胞癌(GSRC)中。这项研究旨在检查FAR的预后价值,并探索可切除的GSRC患者的新型FAR-CA125评分(FCS)。
方法:对330例接受根治性切除的GSRC患者进行回顾性队列研究。采用Kaplan-Meier(K-M)和Cox回归分析FAR和FCS的预后价值。并建立了预测列线图模型。
结果:CA125和FAR的最佳截止值分别为9.88和0.0697,根据接收器工作特性曲线(ROC)。FCS的ROC曲线下面积高于CA125和FAR。根据FCS将330例患者分为三组。高FCS与男性有关,贫血,肿瘤大小,TNM阶段,淋巴结转移,肿瘤浸润深度,SII,和病理亚型。K-M分析显示,高FCS和FAR与低生存率相关。在多变量分析中,FCS,TNM阶段,和SII是可切除GSRC患者OS差的独立预后因素。包含FCS的临床列线图的预测准确性优于TNM分期。
结论:这项研究表明FCS是一种预后因素,和手术切除GSRC患者的有效生物标志物。这种开发的基于FCS的列线图可以是帮助临床医生确定治疗策略的有效工具。
BACKGROUND: The fibrinogen to albumin ratio (FAR) is increasingly regarded as a potential biomarker for predicting prognosis in variety of malignant tumors, but not in gastric signet ring cell carcinoma (GSRC). This study seeks to examine the prognostic value of the FAR and explore a novel FAR-CA125 score (
FCS) in resectable GSRC patients.
METHODS: A retrospective cohort was conducted including 330 GSRC patients who underwent curative resection. Kaplan-Meier (K-M) and Cox regression were used to analysis the prognostic value of FAR and
FCS. And a predictive nomogram model was developed.
RESULTS: The optimal cut-off values for CA125 and FAR were 9.88 and 0.0697, respectively, according to the receiver operating characteristic curve (ROC). Th area under the ROC curve of FCS is higher than CA125 and FAR. 330 patients were grouped into three groups according to the
FCS. High FCS was related to males, anemia, tumor size, TNM stage, lymph node metastasis, tumor invasion depth, SII, and pathological subtypes. K-M analysis showed that high
FCS and FAR were associated with poor survival. In the multivariate analysis, FCS, TNM stage, and SII were independent prognostic factors for poor OS in resectable GSRC patients. And the predictive accuracy of clinical nomogram contained
FCS was better than TNM stage.
CONCLUSIONS: This study indicated that the FCS is a prognostic, and effective biomarker for patients with surgically resectable GSRC. Such developed FCS-based nomogram could be effective tools to assist the clinicians to determine the treatment strategy.