Predictive Value Of Preoperative Peripheral Blood Fibrinogen To Albumin Ratio And Blood Coagulation Indicators For The Prognosis Of Patients With Oral Squamous Cell Carcinoma

Research objectives:Oral squamous cell carcinoma(OSCC)is the most common malignant tumor in oral and maxillofacial region.As the further medical research on malignant tumors develops,the survival rate of malignant tumors keeps rising with more refined and diversified treatment.However,the prognosis of OSCC patients is always unsatisfactory,and the 5-year survival rate is not high.OSCC causes great pain and financial burden to patients and their families. From what we presented above,if the prognosis and survival of patients with OSCC are evaluated,personalized and reasonable treatment plan can be put forward earlier according to their own conditions to lighten the pain and burden of the patients,it will be beneficial to the future of OSCC treatments and the living standard of the patients. The preoperative fibrinogen to albumin ratio(FAR)and some coagulation indexes of OSCC patients,including plasma fibrinogen(FIB),prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT),were selected in this study to explore the evaluation value of these indicators for the prognosis of patients.By using the clinical pathological information that is easy to obtain in clinical work,we can search for updated,more accurate and more convenient predictive indicators to improve the quality of life of OSCC patients after surgery and alleviate their pain.Research methods:In this study,medical records of 122 patients admitted to North People’s Hospital of Jiangsu Province from January 2015 to December 2017 who were pathologically diagnosed with oral squamous cell carcinoma and underwent the first radical operation for oral cancer were included.These patients were followed up regularly.Their medical records and follow-up data were retrospectively analyzed.Age,gender,and the values of FAR,Fib,PT,APTT and TT in preoperative peripheral blood of patients were collected.After screening and statistics,the data needed for this study were obtained,and the receiver operating characteristic(ROC)curve was used to calculate the best FAR truncation value.According to this,patients were divided into high FAR group and low FAR group,and the prognosis survival time of patients was statistically analyzed.The correlation between preoperative FAR level and postoperative survival time was analyzed.Measurement data conforming to normal distribution were represented by(?±),and t-test was used for comparison between groups.Counting data were expressed as n and percentage,and comparison between groups was performed by chi-square test.Univariate and multivariate analyses were performed using COX proportional risk model,and K-M survival curve was used to analyze the relationship between FAR and other coagulation indicators and survival time after radical resection of malignant tumors.Results:The preoperative FAR level has significant predictive value for the prognosis and survival of patients.The area under ROC curve was 0.855,the best cut-off was 0.075,and the Youden index was 0.577.There were statistically significant differences in age,preoperative albumin,Fib,APTT,PT and TT among patients with different FAR levels(P<0.05).Preoperative OSCC patients with different FAR levels had statistically significant differences in overall survival(P<0.05).The final data obtained by multivariate Cox regression are as follows: the preoperative FAR level was higher than 0.075(HR=7.816,95% CI: 3.559-17.163,p<0.05),the preoperative fibrinogen level was higher than 4g/L(HR=3.945,95% CI: 1.681-9.256,p<0.05),and the preoperative APTT was shorter than 36s(HR=0.311,95% CI: 0.132-0.730,p<0.05).Therefore,high preoperative FAR,high level of Fib and high level of APTT are independent risk factors for OSCC patients.Conclusion:The preoperative FAR level of OSCC patients is of certain value in evaluating the prognosis of patients with oral cancer after radical surgery.High level of FAR indicated short postoperative survival time,while high Fib and APTT indicated poor prognosis.High FAR level and abnormal coagulation index can be used as supplementary indicators to evaluate the prognosis of postoperative OSCC patients.This study can provide some reference for the prognosis and survival of patients after radical OSCC surgery,and further scientific research and exploration are needed.