Clinical and prognostic significance of combined plasma fibrinogen concentrations and the monocyte-to-lymphocyte ratio in patients with ovarian cancer

Abstract

Background: Fibrinogen concentrations and the monocyte-to-lymphocyte ratio (FC-MLR) are associated with progression and outcomes of many malignancies. This study aimed to assess the clinical and prognostic significance of the combination of plasma FC-MLR in patients with ovarian cancer. Methods: A total of 155 patients with epithelial ovarian cancer (EOC) and 102 patients with benign gynecological disease were retrospectively reviewed. The clinical and pathological data of all patients with EOC were analyzed. Plasma fibrinogen concentrations and the white blood cell (WBC) count were measured to calculate the MLR and neutrophil-to-lymphocyte ratio (NLR). Furthermore, the association of fibrinogen concentrations, the MLR, and FC-MLR with tumor stage, lymphatic and venous metastasis, and 5-year survival was assessed. Regression analysis was performed to evaluate the risk factors for progression of EOC. Receiver operating characteristic (ROC) curves were constructed to assess the prognostic power of plasma fibrinogen concentrations, the MLR, and FC-MLR, and to determine the optimal cutoff values of fibrinogen and the MLR. On the basis of the cutoff values, patients with EOC were divided into three groups: no abnormality, either increased, and both increased groups, respectively. The effect of FC-MLR on overall survival was calculated by the Kaplan-Meier method and compared by the log-rank test in the three groups. Results: Patients with EOC had higher fibrinogen concentrations and a higher MLR than did controls (both P<0.01), and FC-MLR was closely associated with tumor stage and lymphatic and venous metastasis (all P<0.001). Furthermore, FC-MLR was an independent risk factor for progression of EOC (OR =8.985; 95% CI: 4.912-27.166; P<0.001), and patients with high fibrinogen concentrations and a high MLR showed a lower 5-year survival rate (P<0.001). Conclusions: FC-MLR may be used as a predictor of tumor progression and prognosis for ovarian cancer.

Value of neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio and red blood cell distribution width in distinguishing between reactive lymphadenopathy and lymphoma in children

“…In vivo studies showed that monocytes induce tumorigenesis and angiogenesis and inhibit antitumoral immune response. Therefore, it is thought that increased monocyte and decreased lymphocyte counts may be related to tumor processes and so far, the studies investigating the relationship between tumors and MLR support it (18,19). Other studies have shown that MLR is a more useful marker than WBC, neutrophil count and CRP for differentiating patients with bacteremia from those who do not have bacterial infection (7,20).…”

Oncological impact of inflammatory biomarkers in elderly patients treated with radical cystectomy for urothelial bladder cancer

“…Plasma fibrinogen is another acute reactive protein mainly synthesised by hepatocytes, and with an active role on clot formation, wound healing, and systemic inflammatory response. Hyperfibrinogenaemia has been associated with tumour progression and metastasis in lung [21], hepatic [22] and ovarian [23] cancer. Despite the mechanisms interplaying between cancer cells and fibrinogen remains unknown, it has been observed that interleukin-6, produced by lung cancer cells, induced fibrinogen secretion [24], while in vitro tests showed that cancer cells also synthesise fibrinogen promoting tumour cell growth and angiogenesis due to the interaction with other fibroblast and vascular endothelial growth factors [25].…”

A novel diagnostic nomogram based on serological and ultrasound findings for preoperative prediction of malignancy in patients with ovarian masses

“…Moreover, the quantification of white blood cells (WBCs), lymphocytes, monocytes, neutrophils and platelets from full blood counts were found to be closely correlated with disease status and outcome. In addition, several combinatorial parameters, such as lymphocyte-to-monocyte ratio (LMR), fibrinogen-to-albumin ratio (FAR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) have been identified as prognostic biomarkers in several malignancies, including ovarian cancer [14][15][16]. If these parameters could be integrated into a model to formulate a tool to predict malignancy in ovarian masses, it would be useful to improve the therapeutic plans and surgical options for patients with ovarian cancer.…”