The Significance of Fibrinogen in Combination with the Neutrophil to Lymphocyte Ratio in Predicting the Prognosis of Patients with Gastric Cancer

Figures & data

Figure 1 Receiver operating curve for predicting the prognosis with neutrophil to lymphocyte ratio.

Table 1 Comparison of Various Indicators Between the High and Low Fib, NLR Levels

Project		Low Fib	High Fib	χ^2/t	P	Low NLR	High NLR	χ^2/t	P
n		210	71			90	191
Group	Survival	182	52	6.868	0.009	87	147	17.051	0.000
	Death	28	19			3	44
Gender	Male	140	46	0.084	0.772	45	141	15.513	0.000
	Female	70	25			45	50
Age	>60	140	61	9.654	0.002	62	139	0.454	0.501
	≤60	70	10			28	52
Preoperative bleeding	Yes	50	28	6.462	0.011	21	57	1.293	0.256
	No	160	43			69	134
Blood transfusion	Yes	24	16	5.361	0.021	8	32	3.100	0.078
	No	186	55			82	159
NLR		2.91±2.08	4.56±5.32	2.539	0.013	1.42±0.29	4.21±3.64	10.489	0.000
Fib(g/L)		2.69±0.46	4.16±0.47	22.531	0.000	2.77±0.63	3.17±0.81	4.380	0.000
Hb(g/L)		126.01±21.95	115.34±18.66	3.669	0.000	122.50±17.85	123.69±23.25	0.472	0.637
WBC(x10^9/L)		5.65±1.79	6.80±2.83	3.227	0.002	4.74±1.34	6.50±2.24	8.196	0.000
NE(x10^9/L)		3.69±1.66	4.88±2.80	3.357	0.001	2.49±0.79	4.69±2.10	12.711	0.000
LY(x10^9/L)		1.47±0.53	1.40±0.51	1.020	0.309	1.79±0.56	1.30±0.43	7.431	0.000
MO(x10^9/L)		0.37±0.17	0.46±0.24	3.767	0.000	0.33±0.15	0.42±0.20	4.315	0.000
PLT(x10^9/L)		212.40±70.05	242.61±94.67	2.470	0.015	212.29±59.51	223.68±85.17	1.295	0.196
CRP(mg/L)		3.52±5.49	15.69±23.92	4.249	0.000	2.93±3.86	8.32±16.40	4.293	0.000
ALB(g/L)		39.42±5.23	36.91±4.85	3.563	0.000	38.51±6.18	38.92±4.75	0.610	0.542
CAR		0.10±0.16	0.46±0.74	4.074	0.000	0.09±0.15	0.23±0.50	3.680	0.000
PA(mg/L)		223.26±66.22	169.57±66.65	5.816	0.000	213.25±64.54	208.05±72.88	0.574	0.567
CPR		0.02±0.07	0.17±0.36	3.272	0.002	0.02±0.04	0.08±0.24	3.172	0.002

Abbreviations: NLR, neutrophil to lymphocyte ratio; Fib, fibrinogen; Hb, hemoglobin; WBC, white blood cells; NE, neutrophils; LY, lymphocytes; MO, monocytes; PLT, platelet; CRP, C-reactive protein; ALB, albumin; CAR, C-reactive protein to albumin ratio; PA, prealbumin; CPR, C-reactive protein to prealbumin ratio.

Table 2 Correlation Between Fib, NLR and Other Indicators

Compare Items	r	P	Compare Items	r	P
Fib/WBC	0.285	0.000	NLR/WBC	0.649	0.000
Fib/NE	0.305	0.000	NLR/NE	0.798	0.000
Fib/LY	−0.092	0.129	NLR/LY	−0.484	0.000
Fib/MO	0.239	0.000	NLR/MO	0.204	0.001
Fib/NLR	0.266	0.000	NLR/Fib	0.266	0.000
Fib/Hb	−0.234	0.000	NLR/Hb	−0.111	0.064
Fib/PLT	0.209	0.001	NLR/PLT	0.205	0.001
Fib/CRP	0.437	0.000	NLR/CRP	0.351	0.000
Fib/ALB	−0.257	0.000	NLR/ALB	−0.216	0.000
Fib/CAR	0.422	0.000	NLR/CAR	0.395	0.000
Fib/PA	−0.341	0.000	NLR/PA	−0.230	0.000
Fib/CPR	0.413	0.000	NLR/CPR	0.658	0.000

Table 3 Comparison of Various Indicators Among the Three Classifications of F-NLR (0, 1, 2)

		Low F-NLR (=0 Score)	Middle F-NLR (=1 Score)	High F-NLR (=2 Score)	χ^2/F	P
n		76	148	57
Group	Survival	73	123	38	20.200
	Death	3	25	19		0.000
Gender	Male	39	107	40	10.385
	Female	37	41	17		0.006
Age	>60	50	102	49	7.557
	≤60	26	46	8		0.023
Preoperative bleeding	Yes	16	39	23	6.358
	No	60	109	34		0.042
Blood transfusion	Yes	6	20	14	7.544
	No	70	128	43		0.023
Fib(g/L)		2.60±0.45	2.84±0.55	4.20±0.49	177.709	0.000
NLR		1.42±0.29	3.55±2.19	5.27±5.66	H=150.883	0.000
WBC(x10^9/L)		4.71±1.39	6.06±1.77	7.27±2.94	H=50.504	0.000
Hb(g/L)		124.08±17.96	125.85±23.51	115.68±19.55	H=9.123	0.010
PLT(x10^9/L)		209.33±57.80	215.49±75.45	246.11±100.31	H=5.087	0.079
CRP(mg/L)		2.71±3.91	3.99±5.96	18.52±25.91	H=49.248	0.000
ALB(g/L)		38.52±6.52	39.80±4.25	36.53±5.00	8.574	0.000
CAR		0.08±0.16	0.10±0.16	0.54±0.80	H=47.170	0.000
PA(mg/L)		217.25±64.53	223.33±67.32	163.90±67.03	16.546	0.000
CPR		0.02±0.04	0.03±0.07	0.20±0.40	H=48.502	0.000

Note: Non-normal distribution data, using rank sum test (H).

Table 4 SNK-q Test Between Classifications

	High/Low q	High/Middle q	Middle/Low q
Fib	25.13**	24.01**	4.68*
NLR	10.34**	5.19**	7.10**
WBC	10.45**	5.55**	6.84**
Hb	3.17	4.32*	0.83
CRP	10.15**	10.48**	1.02
ALB	3.14	5.81**	2.51
CAR	9.59**	10.31**	0.52
PA	6.47**	8.11**	0.92
CPR	7.77**	8.24**	0.54

Notes: *P<0.05, **P<0.01, the rest are P>0.05.

Table 5 Univariate and Multivariate Analyses in Predicting the Prognosis of Patients with Gastric Cancer

Variables	Categories	Univariate Analysis		Multivariate Analysis
		HR(95% CI)	P	HR(95% CI)	P
Gender	Male	1.210(0.654–2.237)	0.544
Age	>60	1.711(0.850–3.444)	0.132
Preoperative bleeding	Yes	1.818(1.008–3.278)	0.047*	1.808(0.968–3.377)	0.063
Blood transfusion	Yes	2.000(1.018–3.932)	0.044*	1.309(0.645–2.657)	0.455
Fib(g/L)	>3.5	2.274(1.269–4.074)	0.006**	1.032(0.514–2.075)	0.929
NLR	>1.82	7.728(2.399–24.898)	0.001**	6.090(1.790–20.716)	0.004**
WBC(x10^9/L)	>5.95	1.985(1.116–3.529)	0.020*	1.301(0.702–2.411)	0.403
Hb(g/L)	>152.5	1.263(0.536–2.980)	0.593
PLT(x10^9/L)	>222.5	2.799(1.553–5.042)	0.001**	2.528(1.368–4.673)	0.003**
CRP(mg/L)	>6.5	3.586(1.964–6.544)	0.000**	2.002(0.686–5.847)	0.204
ALB(g/L)	>17.25	20.271(0.000–1.076E+18)	0.878
CAR	>0.06	1.983(1.112–3.538)	0.020*	0.903(0.342–2.381)	0.836
PA(mg/L)	>65.55	1.681(0.231–12.209)	0.608
CPR	>0.02	2.230(1.256–3.958)	0.006**	1.386(0.411–4.669)	0.598
F-NLR	(0.1.2)	2.751(1.763–4.293)	0.000**

Notes: *P<0.05, **P<0.01. F-NLR is a three-class classification and the result of univariate analysis.

Figure 2 Kaplan–Meier curve for overall survival in gastric cancer patients of F-NLR classifications.