| BackgroundGastric cancer,as one of the most common digestive system tumors,has atypical early symptoms and is often found in the advanced stage.Its morbidity and mortality are not low in China.Although the treatment of gastric cancer is diversified,it is still based on chemotherapy after radical gastrectomy.The overall prognosis of patients with gastric cancer after treatment is poor,and the disease-free survival rate is low.The main cause of postoperative death is local,even distant recurrence and metastasis.The relationship between the levels of fib,CRP,Alb and gastric cancer has been extensively studied.Fib,CRP are related to the pathological characteristics of gastric cancer and can predict the survival prognosis.Alb is related to the survival prognosis of gastric cancer patients,but it is deficient and one-sided.Therefore,the exploration and discovery of simple,convenient biomarkers with positive clinical application value plays an important role and is of great significance in the early diagnosis,prognosis evaluation,timely adjustment of treatment plan to make it more personalized,and ultimately improve the prognosis and survival rate of gastric cancer patients.ObjectiveThis study analyzed the relationship between the preoperative peripheral blood Fib/Alb(Fibrinogen to albumin ratio,FAR)and CRP/Alb(C-reactive protein to albumin ratio,CAR)ratios and their clinicopathological characteristics,prognosis and survival in patients with gastric cancer,in order to provide experimental reference for clinical preoperative prediction of gastric cancer progression and selection of highly personalized and targeted treatment programs.MethodTo retrospectively investigate and analyze the clinical and pathological data of patients with gastric cancer who underwent radical gastrectomy in the first People’s Hospital of Xinxiang from January 2016 to June 2016 and were 2021 pathologically,according to the inclusion criteria and exclusion criteria,63 patients were selected as study group according to the last blood routine,CRP,FIB and ALB data.The data of blood routine,CRP,FIB and Alb were collected and recorded from 80 healthy persons who were examined in the physical examination center of our hospital.SPSS software was used to carry out data processing and statistical analysis.Independent sample t test was used to analyze the significant difference between the study group and the healthy control group.The best cut-off values of FAR and CAR were obtained by X-tile software.According to the best cut-off values of FAR and CAR,the patients with gastric cancer were divided into groups and compared between groups by chi-square test or Fisher’s exact test.Pearson correlation analysis was used to explore the correlation between FAR,CAR and blood routine indexes,and Spearman rank correlation analysis was used to explore the correlation between FAR,CAR and pathological stage.Kaplan-meier survival curves were drawn for different levels of FAR and CAR.Log-rank test was used to analyze the difference of survival curves for FAR and CAR.Cox regression model was used to explore the factors influencing DFS in patients with gastric cancer.Result1 By comparing the basic data of the study group and the control group,i.e.age and sex,the statistical results showed that there was no significant difference(P>0.05).2 Compare the differences between the study group and the control group in Fib,Alb,CRP,FAR,CAR,Neutrophils to lymphocytes ratio(NLR),Platelet to lymphocytes ratio(PLR).The statistical results show that,except Alb,which is lower than the control group,other indicators in the study group are higher than the control group,with statistically significant differences(P<0.05).3 According to the cut-off value of FAR,the two groups were divided into high FAR group(FAR≥10.3,n=21)and low FAR group(FAR<10.3,n=42).There were significant differences between the two groups in tumor size,tumor site,vascular and neural invasion,differentiation,T stage,N stage and TNM stage(P<0.05).More than 5cm in diameter,pyloric tumors,vascular and nerve invasion accounted for a higher proportion in the high FAR group.Compared with low FAR group,high FAR group had deeper infiltration,later N stage,later TNM stage,higher NLR and PLR.There was no significant difference between the two groups in terms of age and gender(P>0.05).4 The patients were divided into high CAR group(CAR≥0.1,n=38)and low CAR group(CAR<0.1,n=25)according to the cut-off value of CAR.The difference between the two groups was statistically significant(P<0.05)in age,tumor size,tumor site,vascular and neural invasion,differentiation degree,T stage,N stage and TNM stage.The elderly,with a diameter of more than 5 cm,pyloric tumors,vascular and nerve invasion accounted for a higher proportion in the high CAR group.Compared with the low CAR group,the high CAR group had deeper infiltration,later N stage,later TNM stage,higher NLR and PLR.There was no significant difference between the two groups in terms of gender(P>0.05).5 Correlation analysis showed that FAR was positively correlated with CAR,NLR and PLR,and CAR was positively correlated with NLR and PLR.The correlation between FAR,CAR and clinicopathological features showed that FAR,CAR were positively correlated with T stage,N stage and TNM stage of gastric cancer.6 Kaplan Merier survival analysis showed that DFS in the high FAR group was significantly lower than that in the low FAR group(log rank test: P=0.003),and DFS in the high CAR group was significantly lower than that in the low CAR group(log rank test:P<0.001).7 Single factor COX proportional hazard regression model showed that age in basic data,tumor size,vascular and neural invasion,T stage,N stage,TNM stage in pathological data,and FAR,CAR,NLR,and PLR were related to DFS.Multivariate analysis showed that FAR≥10.3(P=0.007,HR=2.713,95%CI:1.315-5.524),CAR≥0.1(P=0.008,HR=2.562,95%CI:1.163-5.218),tumor≥5cm(P=0.038,HR=2.720,95%CI:1.043-6.814),positive vascular invasion(P=0.015,HR=2.261,95%CI:1.187-4.425)and pathological stage III(P=0.012,HR=2.112,95%CI:1.232-4.113)were independent risk factors for postoperative recurrence and metastasis,affecting DFS of patients.Conclusion1 The proportion of tumors located in pylorus,with a diameter of more than 5 cm,positive vascular and nerve invasion was higher in high FAR(Fib/Alb)group and high CAR(CRP/Alb)group;The patients in the high FAR group and the high CAR group had a deeper degree of tumor invasion and invasion,and had a later N stage and TNM stage.2 Preoperative FAR and CAR are independent risk factors for DFS in patients with gastric cancer,which can be used as evaluation indicators for recurrence,metastasis and survival prognosis. |
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