Predictive value of preoperative plasma fibrinogen combined with lymphocyte-to-monocyte ratio in the prognosis of patients with esophageal squamous cell carcinoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HE Xianneng ¹ , XIANG Yishun ¹ , LI Yunfeng ³ , LIN Chengbin ² ,  SHEN Weiyu ^1,2

1. Department of Thoracic Surgery, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315000, Zhejiang, P. R. China;
2. Health Science Center, Ningbo University, Ningbo, 315211, Zhejiang, P. R. China;
3. Department of Cardiothoracic Surgery, Ningbo Yinzhou No;
2. Hospital, Ningbo, 315199, Zhejiang, P. R. China;

Corresponding author：

SHEN Weiyu, Email: shenweiyu@nbu.edu.cn

Keywords：

Fibrinogen; lymphocyte-to-monocyte ratio; esophageal squamous cell carcinoma; prognosis

DOI：

10.7507/1007-4848.202403059

Video：

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Objective To investigate the prognostic value of preoperative plasma fibrinogen (FIB) combined with lymphocyte-to-monocyte ratio (LMR) in predicting the prognosis of patients with esophageal squamous cell carcinoma. Methods A retrospective analysis was conducted on patients who underwent esophagectomy in our hospital from January 2015 to December 2018. Based on the cut-off values of preoperative FIB and LMR, The F-LMR scoring system was constructed, and patients were divided into three groups. Kaplan-Meier analysis was used to assess 5-year overall survival and 5-year progression free survival, and univariate and multivariate Cox regression analyses were performed to identify prognostic factors. Results Finally 260 patients were collected, including 237 males and 23 females, with a median age of 64 years (ranging from 59 to 70 years). The 5-year OS rates for patients with F-LMR score of 0, 1, and 2 were 24.44%, 51.69%, and 67.31%, respectively, and the 5-year PFS rates were 15.56%, 42.37%, and 57.62%, respectively. Lower preoperative F-LMR scores were associated with worse prognosis. Multivariate analysis showed that deeper tumor invasion, presence of lymph node metastasis, larger tumor maximum diameter, and lower preoperative F-LMR score were independent prognostic factors for OS. Conclusion The F-LMR score system based on the preoperative FIB and LMR can serve as an effective tool for predicting the prognosis of patients with esophageal squamous cell carcinoma.

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15.	Cui C, Craft J, Joshi NS. T follicular helper cells in cancer, tertiary lymphoid structures, and beyond. Semin Immunol, 2023 Sep: 69: 101797.
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18.	Wolberg AS. Fibrinogen and fibrin: Synthesis, structure, and function in health and disease. J Thromb Haemost, 2023, 21(11): 3005-3015.
19.	Levi M. Disseminated intravascular coagulation in cancer: An update. Semin Thromb Hemost, 2019, 45(4): 342-347.
20.	Wu M, Pan Y, Jia Z, et al. Preoperative plasma fibrinogen and serum albumin score is an independent prognostic factor for resectable stage Ⅱ-Ⅲ Gastric Cancer. Dis Markers, 2019, 2019: 9060845.
21.	Palumbo JS, Kombrinck KW, Drew AF, et al. Fibrinogen is an important determinant of the metastatic potential of circulating tumor cells. Blood. 2000, 96(10): 3302-3309.
22.	Kijima T, Arigami T, Uchikado Y, et al. Combined fibrinogen and neutrophil-lymphocyte ratio as a prognostic marker of advanced esophageal squamous cell carcinoma. Cancer Sci, 2017, 108(2): 193-199.
23.	Zhang Y, Xiao G. Prognostic significance of the ratio of fibrinogen and albumin in human malignancies: A meta-analysis. Cancer Manag Res, 2019, 11: 3381-3393.

1. Lin Y, Totsuka Y, He Y, et al. Epidemiology of esophageal cancer in Japan and China. J Epidemiol, 2013, 23(4): 233-242.
2. Bedenne L, Michel P, Bouché O, et al. Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD 9102. J Clin Oncol, 2007, 25(10): 1160-1168.
3. Chen M, Huang J, Zhu Z, et al. Systematic review and meta-analysis of tumor biomarkers in predicting prognosis in esophageal cancer. BMC Cancer, 2013, 13: 539.
4. Shalapour S, Karin M. Immunity, inflammation, and cancer: An eternal fight between good and evil. J Clin Invest, 2015, 125(9): 3347-3355.
5. Tong YS, Tan J, Zhou XL, et al. Systemic immune-inflammation index predicting chemoradiation resistance and poor outcome in patients with stage Ⅲ non-small cell lung cancer. J Transl Med, 2017, 15(1): 221.
6. Lv X, Han S, Xu B, et al. The value of complete blood count for the prognosis analysis of preoperative esophageal squamous cell carcinoma. BMC Cancer, 2021, 21(1): 1072.
7. Angelidakis E, Chen S, Zhang S, et al. Impact of fibrinogen, fibrin thrombi, and thrombin on cancer cell extravasation using in vitro microvascular networks. Adv Healthc Mater, 2023, 12(19): e2202984.
8. Li Q, Kong F, Ma J, et al. Nomograms based on fibrinogen, albumin, neutrophil-lymphocyte ratio, and carbohydrate antigen 125 for predicting endometrial cancer prognosis. Cancers (Basel), 2022, 14(22): 5632.
9. Perisanidis C, Psyrri A, Cohen EE, et al. Prognostic role of pretreatment plasma fibrinogen in patients with solid tumors: A systematic review and meta-analysis. Cancer Treat Rev, 2015, 41(10): 960-970.
10. Arnold M, Soerjomataram I, Ferlay J, et al. Global incidence of oesophageal cancer by histological subtype in 2012. Gut, 2015, 64(3): 381-387.
11. Kelly RJ. Emerging multimodality approaches to treat localized esophageal cancer. J Natl Compr Canc Netw, 2019, 17(8): 1009-1014.
12. Dougan M, Dranoff G. Immune therapy for cancer. Annu Rev Immunol, 2009, 27: 83-117.27-83.
13. Greten FR, Grivennikov SI. Inflammation and cancer: Triggers, mechanisms, and consequences. Immunity, 2019, 51(1): 27-41.
14. Gutiérrez-Melo N, Baumjohann D. T follicular helper cells in cancer. Trends Cancer, 2023, 9(4): 309-325.
15. Cui C, Craft J, Joshi NS. T follicular helper cells in cancer, tertiary lymphoid structures, and beyond. Semin Immunol, 2023 Sep: 69: 101797.
16. Mantovani A, Marchesi F, Malesci A, et al. Tumour-associated macrophages as treatment targets in oncology. Nat Rev Clin Oncol, 2017, 14(7): 399-416.
17. Fernandes CJ, Morinaga LTK, Alves JL, et al. Cancer-associated thrombosis: The when, how and why. Eur Respir Rev, 2019, 28(151): 180119.
18. Wolberg AS. Fibrinogen and fibrin: Synthesis, structure, and function in health and disease. J Thromb Haemost, 2023, 21(11): 3005-3015.
19. Levi M. Disseminated intravascular coagulation in cancer: An update. Semin Thromb Hemost, 2019, 45(4): 342-347.
20. Wu M, Pan Y, Jia Z, et al. Preoperative plasma fibrinogen and serum albumin score is an independent prognostic factor for resectable stage Ⅱ-Ⅲ Gastric Cancer. Dis Markers, 2019, 2019: 9060845.
21. Palumbo JS, Kombrinck KW, Drew AF, et al. Fibrinogen is an important determinant of the metastatic potential of circulating tumor cells. Blood. 2000, 96(10): 3302-3309.
22. Kijima T, Arigami T, Uchikado Y, et al. Combined fibrinogen and neutrophil-lymphocyte ratio as a prognostic marker of advanced esophageal squamous cell carcinoma. Cancer Sci, 2017, 108(2): 193-199.
23. Zhang Y, Xiao G. Prognostic significance of the ratio of fibrinogen and albumin in human malignancies: A meta-analysis. Cancer Manag Res, 2019, 11: 3381-3393.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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