Prognostic Value of Combined Detection of Preoperative Albumin-to-Fibrinogen Ratio and Neutrophil-to-Lymphocyte Ratio in Operable Esophageal Squamous Cell Carcinoma Patients without Neoadjuvant Therapy

Zhiyuan Zheng,1,2,* Donghong Lin,2,* Qiaoqian Chen,2,* Bin Zheng,1 Mingqiang Liang,1 Chun Chen,1 Wei Zheng1 1Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, People’s Republic of China; 2Medical Technology and Engineering College of Fujian M...

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Main Authors: Zheng Z, Lin D, Chen Q, Zheng B, Liang M, Chen C, Zheng W
Format: Article
Language:English
Published: Dove Medical Press 2021-03-01
Series:Cancer Management and Research
Subjects:
Online Access:https://www.dovepress.com/prognostic-value-of-combined-detection-of-preoperative-albumin-to-fibr-peer-reviewed-article-CMAR
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spelling doaj-89ecb493be9345e5ae3c69c7b19a38eb2021-03-14T19:15:20ZengDove Medical PressCancer Management and Research1179-13222021-03-01Volume 132359237063031Prognostic Value of Combined Detection of Preoperative Albumin-to-Fibrinogen Ratio and Neutrophil-to-Lymphocyte Ratio in Operable Esophageal Squamous Cell Carcinoma Patients without Neoadjuvant TherapyZheng ZLin DChen QZheng BLiang MChen CZheng WZhiyuan Zheng,1,2,* Donghong Lin,2,* Qiaoqian Chen,2,* Bin Zheng,1 Mingqiang Liang,1 Chun Chen,1 Wei Zheng1 1Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, People’s Republic of China; 2Medical Technology and Engineering College of Fujian Medical University, Fuzhou, Fujian, 350004, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wei Zheng; Chun ChenDepartment of Thoracic Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, People’s Republic of ChinaTel +86 591-83357896Fax +86 591-87113828Email zwfjxh@fjmu.edu.cn; ccfjxh@fjmu.edu.cnBackground: We retrospectively analyzed the prognostic value of the albumin-to-fibrinogen ratio (AFR)–neutrophil-to-lymphocyte ratio (NLR) score, comprising preoperative AFR and NLR, in esophageal squamous cell carcinoma (ESCC) patients after radical resection.Patients and Methods: Overall, 215 patients were included. The optimal cutoff value was determined using the receiver operating characteristic (ROC) curve. Based on a low AFR (< 12.06) and high NLR (≥ 1.78), the AFR–NLR score was classified as 2 (both hematological abnormalities present), 1 (one abnormality present), or 0 (both abnormalities absent). Kaplan–Meier curves, Cox regression, and predicted nomogram were used to evaluate the prognostic value of the score.Results: The prognostic value of the AFR–NLR score was better than that of AFR or NLR alone (P < 0.05). Multivariate analysis showed that a high AFR–NLR score was an independent predictor of poor prognosis for overall survival (P < 0.001). Additionally, in the nomogram including the AFR–NLR score, the net reclassification improvement index increased by 35.5% (P < 0.001), and the integrated discrimination improvement index increased by 9.0% (P < 0.001). The predictive accuracy of the established nomogram model was proved using Harrell’s concordance index (0.811, 95% confidence interval: 0.765– 0.856) and calibration curve. Notably, the decision analysis curve showed that the nomogram had a higher net benefit within most of the threshold probability range, indicating better clinical applicability.Conclusion: The AFR–NLR score is a useful predictor of the prognosis of ESCC patients after radical resection, and the nomogram established on the basis of this score has a good prognostic value.Keywords: esophageal squamous cell cancer, AFR–NLR score, prognosis, nomogramhttps://www.dovepress.com/prognostic-value-of-combined-detection-of-preoperative-albumin-to-fibr-peer-reviewed-article-CMAResophageal squamous cell cancerafr–nlr scoreprognosisnomogram
collection DOAJ
language English
format Article
sources DOAJ
author Zheng Z
Lin D
Chen Q
Zheng B
Liang M
Chen C
Zheng W
spellingShingle Zheng Z
Lin D
Chen Q
Zheng B
Liang M
Chen C
Zheng W
Prognostic Value of Combined Detection of Preoperative Albumin-to-Fibrinogen Ratio and Neutrophil-to-Lymphocyte Ratio in Operable Esophageal Squamous Cell Carcinoma Patients without Neoadjuvant Therapy
Cancer Management and Research
esophageal squamous cell cancer
afr–nlr score
prognosis
nomogram
author_facet Zheng Z
Lin D
Chen Q
Zheng B
Liang M
Chen C
Zheng W
author_sort Zheng Z
title Prognostic Value of Combined Detection of Preoperative Albumin-to-Fibrinogen Ratio and Neutrophil-to-Lymphocyte Ratio in Operable Esophageal Squamous Cell Carcinoma Patients without Neoadjuvant Therapy
title_short Prognostic Value of Combined Detection of Preoperative Albumin-to-Fibrinogen Ratio and Neutrophil-to-Lymphocyte Ratio in Operable Esophageal Squamous Cell Carcinoma Patients without Neoadjuvant Therapy
title_full Prognostic Value of Combined Detection of Preoperative Albumin-to-Fibrinogen Ratio and Neutrophil-to-Lymphocyte Ratio in Operable Esophageal Squamous Cell Carcinoma Patients without Neoadjuvant Therapy
title_fullStr Prognostic Value of Combined Detection of Preoperative Albumin-to-Fibrinogen Ratio and Neutrophil-to-Lymphocyte Ratio in Operable Esophageal Squamous Cell Carcinoma Patients without Neoadjuvant Therapy
title_full_unstemmed Prognostic Value of Combined Detection of Preoperative Albumin-to-Fibrinogen Ratio and Neutrophil-to-Lymphocyte Ratio in Operable Esophageal Squamous Cell Carcinoma Patients without Neoadjuvant Therapy
title_sort prognostic value of combined detection of preoperative albumin-to-fibrinogen ratio and neutrophil-to-lymphocyte ratio in operable esophageal squamous cell carcinoma patients without neoadjuvant therapy
publisher Dove Medical Press
series Cancer Management and Research
issn 1179-1322
publishDate 2021-03-01
description Zhiyuan Zheng,1,2,* Donghong Lin,2,* Qiaoqian Chen,2,* Bin Zheng,1 Mingqiang Liang,1 Chun Chen,1 Wei Zheng1 1Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, 350001, People’s Republic of China; 2Medical Technology and Engineering College of Fujian Medical University, Fuzhou, Fujian, 350004, People’s Republic of China*These authors contributed equally to this workCorrespondence: Wei Zheng; Chun ChenDepartment of Thoracic Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, People’s Republic of ChinaTel +86 591-83357896Fax +86 591-87113828Email zwfjxh@fjmu.edu.cn; ccfjxh@fjmu.edu.cnBackground: We retrospectively analyzed the prognostic value of the albumin-to-fibrinogen ratio (AFR)–neutrophil-to-lymphocyte ratio (NLR) score, comprising preoperative AFR and NLR, in esophageal squamous cell carcinoma (ESCC) patients after radical resection.Patients and Methods: Overall, 215 patients were included. The optimal cutoff value was determined using the receiver operating characteristic (ROC) curve. Based on a low AFR (< 12.06) and high NLR (≥ 1.78), the AFR–NLR score was classified as 2 (both hematological abnormalities present), 1 (one abnormality present), or 0 (both abnormalities absent). Kaplan–Meier curves, Cox regression, and predicted nomogram were used to evaluate the prognostic value of the score.Results: The prognostic value of the AFR–NLR score was better than that of AFR or NLR alone (P < 0.05). Multivariate analysis showed that a high AFR–NLR score was an independent predictor of poor prognosis for overall survival (P < 0.001). Additionally, in the nomogram including the AFR–NLR score, the net reclassification improvement index increased by 35.5% (P < 0.001), and the integrated discrimination improvement index increased by 9.0% (P < 0.001). The predictive accuracy of the established nomogram model was proved using Harrell’s concordance index (0.811, 95% confidence interval: 0.765– 0.856) and calibration curve. Notably, the decision analysis curve showed that the nomogram had a higher net benefit within most of the threshold probability range, indicating better clinical applicability.Conclusion: The AFR–NLR score is a useful predictor of the prognosis of ESCC patients after radical resection, and the nomogram established on the basis of this score has a good prognostic value.Keywords: esophageal squamous cell cancer, AFR–NLR score, prognosis, nomogram
topic esophageal squamous cell cancer
afr–nlr score
prognosis
nomogram
url https://www.dovepress.com/prognostic-value-of-combined-detection-of-preoperative-albumin-to-fibr-peer-reviewed-article-CMAR
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