Role of Chronic Inflammatory Ratios in Predicting Recurrence of Resected Patients with Stage I–III Mucinous Colorectal Adenocarcinoma

Abstract

Background: Cancer-related inflammation is the main cause of the progression of mucinous colorectal adenocarcinoma (MCA). Circulating fibrinogen-to-pre-albumin ratio (FPR) is associated with the clinical outcome in colorectal cancer (CRC). However, the prognostic role of FPR and which is the best inflammatory prognostic biomarker within MCA remain unknown. Methods: We enrolled 157 patients with stage I-III MCA in this study. Kaplan-Meier curve, Cox regression, and time-dependent receiver operation characteristic curve analysis were performed to assess the prognostic value and efficacy of the neutrophil-to-albumin ratio (NAR), neutrophil-to-pre-albumin ratio (NPAR), albumin-to-alkaline phosphatase ratio (AAPR), albumin-to-globulin ratio (AGR), albumin-to-fibrinogen ratio (AFR), and FPR in these patients. Results:: We found that NAR, NPAR, and FPR were significantly associated with unsatisfactory recurrence-free survival (RFS) in patients with stage I-III MCA, and the predicted efficacy of FPR was superior to that of the other two inflammatory biomarkers. Moreover, patients with a high combined TNM-CA199-FPR score had worse outcomes, with a high predicted efficacy of up to 0.779 (0.703-0.856). Using FPR, the patient was monitored for the recurrence up to two months earlier than that achieved using the common imaging techniques (4 vs 6 median months) in stage I-III MCA patients undergoing radical resection. Conclusion: FPR is the preferred inflammatory biomarker and commonly used for predicting and monitoring recurrence in stage I-III MCA patients. The combined TNM-CA199-FPR score is an economical, simple, effective, and independent prognostic factor for localized disease.

The Neutrophil-to-Albumin Ratio as a New Predictor of All-Cause Mortality in Patients with Heart Failure

“…37 Our findings were consistent with studies evaluating the prognostic value of NPAR in other clinical settings including STEMI, acute kidney injury, septic shock, rectal cancer, mucinous colorectal adenocarcinoma, and cardiogenic shock. [14][15][16][17][18][19] Our study found that NPAR was an independent predictor of all-cause mortality in patients with heart failure. Combined with neutrophils and albumin, NPAR was better than neutrophils or albumin alone in evaluating inflammatory process.…”

“…12,13 Recently, several studies had combined these two markers and found that neutrophil-to-albumin ratio (NPAR) could be used as an inflammation based prognostic predictor in patients with STEMI, acute kidney injury, septic shock, rectal cancer, mucinous colorectal adenocarcinoma, or cardiogenic shock. [14][15][16][17][18][19] However, to our knowledge, no previous studies had explored the prognostic value of NPAR in HF patients. The purpose of this study was to investigate the association between admission level of NPAR and mortality in HF patients by using the Medical Information Mart for Intensive Care III database version 1.4 (MIMIC III v1.4) and the data of the Second Affiliated Hospital of Wenzhou Medical University.…”

The Prognostic value of the Fibrinogen to pre-albumin ratio in malignant tumors of the digestive system: a systematic review and meta-analysis

“…1 . A total of 13 relevant articles were included in this study, including 15 cohort studies and 5116 patients [ 12 – 24 ]. Unfortunately, we have not found any studies that meet the inclusion criteria from TCGA and GEO databases.…”

Prognostic Value of Neutrophil Percentage-to-Albumin Ratio in Patients with Oral Cavity Cancer

“…In a retrospective study of 145 individuals with pancreatic adenocarcinoma undergoing palliative treatment, the NPAR was an independent predictor of survival, whereas the platelet-lymphocyte and neutrophil-lymphocyte ratios were not [17]. Similarly, scholars have demonstrated an association between poor survival outcomes and an elevated NPAR in a group of individuals with bladder cancer receiving neoadjuvant chemotherapy and cystectomy [15] as well as in a group of patients receiving surgery for stage I-III colorectal adenocarcinoma [23]. In addition, in a study of 98 patients with rectal cancer receiving neoadjuvant CRT or RT alone, the NPAR independently predicted complete remission [13].…”