Combined fibrinogen and neutrophil‐lymphocyte ratio as a prognostic marker of advanced esophageal squamous cell carcinoma

Abstract

Patients with advanced esophageal squamous cell carcinoma (ESCC) is received chemoradiotherapy or chemotherapy for clinical management. However, it is difficult to predict tumor response and prognosis using blood markers before starting treatments. The purpose of this study was to investigate the pre‐treatment plasma fibrinogen and neutrophil–lymphocyte ratio (NLR) in patients with advanced ESCC treated with chemoradiotherapy or chemotherapy, and to assess the clinical utility of a combined score using these blood markers, named as the F‐NLR (fibrinogen and NLR) score, as a predictor of tumor response and prognosis. A total of 98 advanced ESCC patients, treated with chemoradiotherapy or chemotherapy, were classified into three groups: F‐NLR score of 2, having both hyperfibrinogenemia (>400 mg/dL) and high NLR (>3.0), score of 1, one of these hematological abnormalities, and score of 0, having neither hyperfibrinogenemia nor high NLR. Fibrinogen and NLR were significantly higher in the progressive disease (PD) group than the non‐PD group (P = 0.0419, and P = 0.0001, respectively). A significantly higher F‐NLR score was found in the PD group than the non‐PD group (P = 0.0140). Overall survival was significantly lower in patients with an F‐NLR score of 2 than in those with an F‐NLR score of 0 or 1 (P < 0.0001). Multivariate analysis showed that the F‐NLR score was one of the independent prognostic factors (P = 0.0081). Our study demonstrates that the F‐NLR score is promising as a predictive marker for therapeutic effects and prognosis in patients with advanced ESCC.

A cumulative score based on preoperative fibrinogen and the neutrophil&ndash;lymphocyte ratio to predict outcomes in resectable gastric cancer

“…Furthermore, higher F-NLR scores were associated with larger tumor size, deeper tumor invasion, and lymph node metastasis. This observation was in line with previous studies that indicated that the F-NLR score was significantly correlated with tumor progression and aggressive biological behavior 14,15. In subgroup analyses, the F-NLR score still exhibited potential prognostic value, as shown in Figures 2 and 3.…”

“…Many investigators have demonstrated the clinical utility of fibrinogen as a prognostic predictor in various types of malignancies 12,13. Recently, a new scoring system combining preoperative fibrinogen and the NLR (F-NLR) has been demonstrated as a promising prognostic marker for esophageal squamous cell carcinoma 14,15. However, the prognostic role of F-NLR in GC remains unclear.…”

The combination of plasma fibrinogen and neutrophil lymphocyte ratio (F‐NLR) is a predictive factor in patients with resectable non small cell lung cancer

“…Recent studies have emphasized that hyperfibrinogenemia is involved in the malignant behaviors of various types of cancer (Kijima et al, ; Lu et al, ; Qiu et al, ). And the elevated preoperative plasma fibrinogen levels are associated with worse outcome in various malignancies.…”

Combined Plasma Fibrinogen and Neutrophil Lymphocyte Ratio in Ovarian Cancer Prognosis May Play a Role?

“…17 Based on NLR values, an additional prognostic score, combining NLR and fibrinogen levels (F-NLR), has been proposed in different tumors, 18 with interesting results. 19 The aim of our study was to investigate the correlation between NLR, fibrinogen, and F-NLR with survival in our OC population.…”