The Relationship Between Preoperative Plasma Fibrinogen And Serum Albumin Levels And The Prognosis Of Gastric Cancer

Objective:Gastric cancer is one of the most common malignant tumors in China.The early symptoms are not typical,and most of them are already in the advanced stage.The treatment of gastric cancer is mainly surgery,supplemented by chemotherapy;however,the 5-year survival rate of patients with gastric cancer is still low.It is of great significance to explore simple and convenient predictors for evaluating prognosis and adjusting treatment plan in time.It was found that the levels of fibrinogen(Fib)and albumin(Alb)may be related to the prognosis of malignant tumors.However,there are few studies on the relationship between the level of serum fibrinogen and albumin and the prognosis of gastric cancer.This study retrospectively analyzed the correlation between preoperative plasma fibrinogen and serum albumin levels and the clinicopathological characteristics and prognosis of stage II-III gastric cancer,providing timely reference for clinical diagnosis and treatment.Methods:A retrospective analysis of clinical data from 1020 cases of gastric cancer treated in the Department of Gastric and Colorectal Surgery of the First Hospital of Jilin University from January 2008 to December 2012.The patient was diagnosed with gastric cancer and underwent gastrectomy with D2 lymphadenectomy.Data collection included age,gender,TNM stage,pathological typing,vascular invasion,nerve infiltration,postoperative chemotherapy and so on.According to the inclusion and exclusion criteria,the statistics of patients who met the criteria were finally determined.The preoperative plasma fibrinogen and serum albumin quantitativevalues were counted,and the correlation between fibrinogen and albumin levels and the prognosis of gastric cancer was analyzed.The R language was used to calculate the cut-off values of fibrinogen and albumin based on the receiver operating characteristic curve(ROC).Values above the optimal cut-off value were considered to be elevated,and those below the optimal cut-off value were considered to be decreased.Fib-Alb scoring was performed as follows: patients with elevated fibrinogen and decreased albumin levels were assigned a Fib-Alb score of 2;those with only one of these abnormalities were assigned a Fib-Alb score of 1;and those with neither of these abnormalities were assigned a Fib-Alb score of 0.Follow-up by telephone was used to understand the current survival of patients,and statistical analysis was performed on the 5-year survival.The COX regression model was used to analyze the factors affecting the prognosis of gastric cancer patients.Result:1.Of the 1,020 patients with gastric cancer treated,178 were excluded,and a total of 842 were included in our study.Patients excluded included 10 patients who received preoperative chemotherapy,10 patients with other types of cancer,55 patients at TNM ? stage,36 patients with positive surgical margins,2 patients with liver cirrhosis,4 patients with chronic renal disease,and 1 patient with coagulation-related diseases,13 patients had no Fib and Alb values,17 died during perioperative period,and 30 had no follow-up information at the first time.1.The cut-off values of Fib and Alb are 3.39g/L and 34.9g/L,respectively.Based on this result,the Fib-Alb score is defined as 2(high Fib,low Alb),1(high Fib,high Alb or low Fib,low Alb),and 0(low Fib,high Alb).2.Patients with high Fib values(> 3.39 g / L)have short survival,patients with low Alb values(<34.9 g / L)have poor prognosis;patients with Fib-Alb scores of 2and 1 have poor prognosis.3.Age(> 60 years),stage II-III tumors,vascular invasion,nerve infiltration,and Fib-Alb score of 2 are independent risk factors that affect the survival of patients with gastric cancer.Conclusion:1.Patients with gastric cancer with high plasma fibrinogen and low albumin before surgery have poor prognosis.2.Preoperative fibrinogen combined with albumin levels can be used as independent indicators to predict the prognosis of gastric cancer patients.