The Value Of Cumulative Scoring System Based On Preoperative Fibrinogen And Prealbumin Levels In Patients With Gastric Cancer In Prognostic Evaluation

Objective: To investigate the prognostic significance of the cumulative score based on preoperative fibrinogen and pre-albumin(FP score)in patients with gastric cancer after radical gastrectomy.Methods: Gastric cancer patients who were initially diagnosed without distant metastasis and underwent radical resection in the First Affiliated Hospital of Anhui Medical University were selected as the study objects.The hematological examination,pathological information and postoperative treatment were collected and followed up.X-tile 3.6.1 software was used to get the best cut-off value of FIB and pre ALB.The FP score was constructed according to the truncation value.Cox proportional risk model was used to evaluate the influence of FIB,pre-ALB,FP score and other clinicopathological parameters on the overall survival(OS)and disease-free survival(DFS).Kaplan Meier method was used to calculate the survival curve and to explore the value of FP score in the prognosis evaluation of different clinicopathological subgroups.Results: The optimal cut-off values for fibrinogen and pre-albumin were defined as 4.0g/L and 230.0 mg/L,respectively.Patients with elevated fibrinogen(? 4.0 g/L)and decreased pre-albumin(< 230.0 mg/L)levels were allocated an FP score of 2,those with only one of these two abnormalities were assigned a score of 1,and those with neither of the two abnormalities were allocated a score of 0.The preoperative FP score was significantly correlated with age,tumor size,fibrinogen level,pre-albumin level and white blood cell count.No significant differences based on sex,tumor location,degree of differentiation,depth of invasion,lymph node status,tumor-node-metastasis(TNM)stage or adjuvant chemotherapy were identified between the groups.Cox regression analysis suggested that a high preoperative FP score was significantly associated with poor disease-free survival(DFS)and overall survival(OS).Compared with the FP = 0 group,the risk of recurrence was significantly increased in the FP = 1and FP = 2 groups [HR were 1.59(95% CI: 1.13-2.22)and 2.18(1.47-3.23),and P values were 0.007 and 0.000,respectively].Compared with the FP = 0 group,the risk of death was significantly increased in the FP = 1 and FP = 2 groups [HR were 1.68(95% CI: 1.17-2.43)and 2.63(1.72-4.02),P values were 0.005 and 0.000,respectively].For patients with T3-4 gastric cancer or gastric cancer with regional lymph node metastasis,DFS and OS were significantly different between different FP score groups before surgery.The prognosis of patients with FP?1 was significantly worse than that of patients with FP = 0.Conclusions: The preoperative FP score is related to the poor clinicopathological characteristics of gastric cancer patients and has certain predictive value for the long-term survival of patients with resectable gastric cancer.