Relationship Between Preoperative FAR And Pathological Features Of Pancreatic Ductal Adenocarcinoma And Prognosis Influencing Factors

Objective: to investigate preoperative fibrinogen to albumin ratio,Significance of FAR as a prognostic indicator for Pancreatic ductal adenocarcinoma and the relationship between FAR and clinicopathologic characteristics of pancreatic duct adenocarcinoma(PDAC).Methods: Clinical data of 92 patients with PDAC who received radical pancreatoduodenectomy admitted to the X Affiliated Hospital of XX Medical University from January 2016 to December 2018 were retrospectively analyzed.Receiver operator characteristic,ROC)to determine the optimal cut-off value of preoperative FAR level,and the patients were divided into high FAR group and low FAR group.The relationship between clinicopathologic features of patients with PDAC at different preoperative FAR levels was analyzed.COX proportional hazard regression model was used to analyze independent risk factors of patients with PDAC.Kaplan-Meier method was used to draw survival curve and Log-rank was used to test.Results: The area under ROC curve was 0.814(95%CI:0.666-0.962,P<0.01),the maximum entry index was 0.642,the optimal critical value of FAR was 0.1059,and the sensitivity and specificity for predicting survival were 0.725 and 0.917,respectively.Analysis of clinicopathologic features of FAR showed that the differences of CA19-9,TB level,N stage and TNM stage between the low level FAR group and the high level FAR group were statistically significant.Univariate analysis showed that high preoperative FAR,high CA19-9,lymph node metastasis,high TNM stage,and tumor length ≥4cm were associated with poor prognosis in PDAC patients.In multivariate analysis,preoperative CA19-9(≥37U/ml,HR=3.007,95%CI: 1.484-6.902,P=0.002),preoperative FAR(≥0.1059,HR=2.427,95%CI: 1.389～4.238,P =0.002),TNM stage(high TNM stage,HR=2.973,95%CI:1.081～8.171,P=0.002),and degree of differentiation(low differentiation,HR=0.418,95%CI:0.260～0.671,P<0.001)were independent risk factors for prognosis in patients with PDAC.Kaplan-Meier survival analysis showed that preoperative overall survival of PDAC patients with different FAR levels was statistically significant.Further analysis showed that the first-year cumulative survival rate of patients with low FAR level was68.3%,and the third-year cumulative survival rate was 37.5%.The 1-year cumulative survival rate in the high level FAR group was 32.4%,and the 3-year cumulative survival rate was 3.1%.The mean survival time of low level FAR group was 24.4months,and the median survival time of 17.0 months was significantly better than the mean survival time of 9.7 months and the median survival time of high level FAR group was 8.0 months(P<0.05).Conclusion:1.Preoperative FAR is an independent prognostic risk factor for PDAC patients.2.Patients with high preoperative FAR have worse prognosis and shorter survival time,which can provide clinical help for the long-term prognosis of PDAC patients.