Abstract:

Objective To investigate the efficiency and prognosis role of preoperative albumin/fibrinogen ratio（AFR） and fibrinogen/prealbumin ratio（FPR） in Ⅱ-Ⅲ colorectal cancer patients undergoing adjuvant chemotherapy. Methods A total of 212 colorectal cancer patients were enrolled. Their clinical data and the results of fibrinogen（Fib）,albumin（Alb） and prealbumin（PA） were collected. These patients were followed up for 3 years. The relationship of the parameters with adjuvant chemotherapy efficiency and prognosis was evaluated. Results The optimal cut-off values of Fib,Alb,PA,FPR and AFR were 3.50 mg/L,40.00 g/L,180.00 mg/L,18.00 and 12.50,respectively. Overall survival time of low AFR group was shorter than that of high AFR group（P=0.02）,and overall survival time of low FPR group was longer than that of high FPR group（P<0.01）. The results of Cox regression showed that Alb（>40.00 g/L）,PA（>180.00 mg/L） and FPR（>18.00） were correlated with overall survival of the patients [adjusted hazard ratios（HR） were 0.64,0.52 and 3.40;95% confidence intervals（CI） were 0.34-0.92,0.39-0.83 and 1.36-5.06,respectively）. However,Fib（adjusted HR=1.40,95%CI 0.91-2.18） and AFR（adjusted HR=0.79,95%CI 0.45-1.17） were not correlated with overall survival of the patients. The area under curve of FPR was 0.76 for predicting the survival of the patients,which was higher than those of CEA（0.73）,CA19-9（0.68）,Alb（0.70） and PA（0.72）. The survival of high FPR group without chemotherapy was inferior to that undergoing chemotherapy（adjusted HR=6.41,95%CI 2.97-13.30）. Conclusions Preoperative FPR is associated with clinical efficiency of chemotherapy and prognosis,and it could used as an independent biomarker to predict the overall survival of colorectal cancer patients.

Key words: Fibrinogen/prealbumin ratio, Colorectal cancer, Biomarker