Inflammation was identified to play a significant effect on progression and prognosis of esophageal cancer (EC). In current study, we investigated the prognostic value of fibrinogen (Fib), albumin (Alb), Alb-Fib ratio (AFR) and circulating blood ratios (NLR, dNLR, PLR and LMR) in patients with EC undergoing esophagectomy.
A total of 153 EC patients were included in present study, and all of them were clinical confirmed and underwent esophagectomy between January 2011 and December 2013. We detected the preoperative circulating Alb, Fib and counts of white blood cells (neutrophil, monocyte, lymphocyte and platelet), and obtained the survival data by 3 years’ following-up in the cases. X-tile software, Kaplan-Meier curve, Cox regression and predicted nomogram were used to evaluate the prognostic role of them in EC patients.
The optimal cut-off points of Fib, Alb, AFR, NLR, dNLR, PLR and LMR were 3.2mg/dl, 38.2g/l, 9.3, 2.1, 4.3, 145.9 and 2.3, respectively. AFR(<9.3), Alb(<38.2g/L), Fib(≥3.2mg/dl), dNLR(≥4.3), PLR(≥145.9) and LMR(<134) were significantly associated with decreased 3 years’ overall survival(OS) in univariate analysis, and AFR ((adjusted HR(95%CI)=2.381(1.152-4.926)), Alb ((adjusted HR(95%CI)=2.398 (1.342-4.273)), Fib ((adjusted HR(95%CI)=2.148(1.229-3.753)), dNLR ((adjusted HR(95%CI)= 2.938(1.626-5.308)) and PLR ((adjusted HR(95%CI) =1.964(1.129-3.415)) remained significant in multivariate analysis. The results of time-dependent receiver operating characteristics curve showed that AFR, dNLR and Alb shared the higher survival predicted efficacy comparing to Fib and PLR. We identified that the prognostic ADS score depending on AFR, Alb and dNLR ((adjusted HR(95%CI) for 1 and 2 score were 3.197(1.813-5.639) and 12.711(2.756-58.614), respectively) and modified ADS score (mADS) ((adjusted HR(95%CI) for 1 and 2 score were 2.725(1.474-5.041) and 9.195(2.048-41.278), respectively) were independent prognostic factors for EC. Moreover, EC patients with higher ADS score could benefit from the adjuvent radio-chemotherapy, however, there was no significant survival difference in EC patient harbored 0, 1 and 2 ADS scores without treatment of radio-chemotherapy. Additionally, we observed a significant difference in c-index values of estimated nomograms including or without ADS score.
Preoperative ADS score including AFR, Alb and dNLR was a prospective biomarker to predict clinical efficacy of adjuvent radio-chemotherapy and 3 year’ OS, and the nomogram including the score obviously improved the predicted survival efficacy for surgically resected EC patients.Preoperative ADS score including AFR, Alb and dNLR was a prospective biomarker to predict clinical efficacy of adjuvent radio-chemotherapy and 3 year’ OS, and the nomogram including the score obviously improved the predicted survival efficacy for surgically resected EC patients.
Medical Ethics Committee of the Second Affiliated Hospital of Nanchang University (Jiangxi, China).
None
All authors have declared no conflicts of interest.