The Prognostic Role and Nomogram Establishment of a Novel Prognostic Score Combining with Fibrinogen and Albumin Levels in Patients with WHO Grade II/III Gliomas

Figures & data

Table 1 Relationships Between Patient Demographics and Clinicopathological Characteristics and FA Score with Characteristics

Characteristics	N	Percent/Mean (SD)	FA Score 0 (n=35)	FA Score 1 (n=42)	FA Score 2 (n=14)	P value
Age, years	91	45.42(14.61)	39.74±12.06	46.83±14.50	55.36±15.3	0.002
Gender						0.648
Male	56	61.5%	20(57.1)	26(61.9)	10(71.4)
Female	35	38.5%	15(42.9)	16(38.1)	4(28.6)
ECOG PS						0.467
0–1	64	70.3%	27(77.1)	27(64.3)	10(71.4)
2–3	27	29.7%	8(22.9)	15(35.7)	4(28.6)
Grade						0.082
II	60	65.9%	28(80.0)	24(57.1)	8(57.1)
III	31	34.1%	7(20.0)	18(42.9)	6(42.9)
Location						0.574
Left brain	38	41.8%	13(37.1)	20(47.6)	5(35.7)
Right brain	53	58.2%	22(62.9)	22(52.4)	9(64.3)
Max tumor	87	4.822(1.90)	4.62±1.75	4.96±2.03	4.93±1.97	0.735
Adjuvant treatment						0.920
None	35		13	16	6
Radiotherpy	9		4	4	1
TMZ	16		8	7	1
Radiotherpy +TMZ	13		3	7	3
Unknown	18		7	8	3
WBC, 10^9/L	91	7.48(3.28)	7.04±2.87	7.62±2.92	8.19±5.00	0.509
HGB, g/L	91	137.01(15.57)	137.7±13.33	136.99±16.94	135.37±15.57	0.896
PLT, 10^9/L	91	212.91(57.32)	205.64±64.52	221.65±47.23	204.86±66.06	0.408
NLR	91	3.41(3.37)	2.79±1.81	3.43±3.16	4.90±5.91	0.140
PLR	91	131.79(54.77)	125.58±61.14	134.16±50.73	140.19±51.74	0.656
TP, g/L	89	67.49(5.58)	68.23±4.66	68.47±5.94	62.82±4.53	0.002
ALB, g/L	91	41.07(4.13)	42.71±2.69	41.52±4.03	35.67±2.95	<0.001
ALT, U/L	86	22.52(20.84)	27.89±28.15	20.05±14.01	14.92±7.29	0.107
AST, U/L	89	17.27(10.29)	19.57±14.64	16.72±6.09	13.07±3.29	0.122
TBIL, umol/L	89	10.11(4.52)	10.96±4.80	10.01±4.38	8.31±3.87	0.176
DBIL, umol/L	89	3.88(2.01)	4.18±1.86	3.65±1.85	3.75±2.78	0.516
Fibrinogen, g/L	91	2.71(0.77)	2.07±0.32	3.06±0.55	3.35±0.96	<0.001
D-dimer, ug/L	87	204.69(298.59)	218.11±409.26	174.59±142.52	258.85±305.62	0.645

Abbreviations: ECOG PS, Eastern Cooperative Oncology Group performance status; WBC, white blood cell count; HGB, hemoglobin; PLT, platelet count; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; TP, total protein; ALB, albumin; ALT, alanine aminotransferase; AST, aspartate aminotransferase; TBIL, total bilirubin; DBIL, direct bilirubin; TMZ, Temozolomide.

Figure 1 Kaplan-Meier survival curves comparing the three FA score groups.

Figure 2 The comparative analyses between FA score and AFR. (A). Kaplan-Meier survival curves comparing the three albumin/fibrinogen ratio (AFR) score groups. (B). Table 1. Relationships between patient demographics and clinicopathological characteristics and FA score with characteristics.

Table 2 The Result of Univariate Cox Hazards Analysis of Overall Survival

Variables	HR	95% CI	P value
Age	2.837	1.555–5.178	0.001
<44
≥44
Gender	0.810	0.446–1.473	0.491
Male
Female
ECOG PS	2.271	1.281–4.024	0.005
0–1
2–3
Grade	2.948	1.668–5.213	<0.001
II
III
Location	0.711	0.403–1.256	0.240
Left brain
Right brain
Max tumor	0.924	0.520–1.639	0.786
< 4.8cm
≥ 4.8cm
Adjuvant treatment	1.103	0.921–1.321	0.288
WBC	2.390	1.275–4.482	0.007
<8.7*10^9/L
≥8.7*10^9/L
HGB	1.764	0.878–3.545	0.111
<132 g/L
≥132 g/L
PLT	0.665	0.376–1.174	0.159
<203*10^9/L
≥203*10^9/L
NLR	2.318	1.219–4.410	0.010
< 4.1
≥ 4.1
PLR	1.345	0.767–2.359	0.302
<117.4
≥117.4
TP	0.613	0.274–1.373	0.234
<61.6 g/L
≥ 61.6 g/L
ALB	0.449	0.242–0.834	0.011
< 38.3 g/L
≥ 38.3 g/L
ALT	1.809	1.004–3.261	0.049
< 20 U/L
≥ 20 U/L
AST	0.782	0.430–1.423	0.421
< 16 U/L
≥ 16 U/L
TBIL	0.686	0.329–1.427	0.313
< 6.8 umol/L
≥ 6.8 umol/L
DBIL	0.648	0.360–1.165	0.147
< 2.9 umol/L
≥ 2.9 umol/L
Fibrinogen	3.155	1.659–6.000	<0.001
<2.5 g/l
≥2.5 g/l
D-dimer	2.264	1.210–4.236	0.011
< 106 ug/L
≥ 106 ug/L
FA	2.441	1.604–3.715	<0.001
0
1
2

Abbreviations: ECOG PS, Eastern Cooperative Oncology Group performance status; WBC, white blood cell count; HGB, hemoglobin; PLT, platelet count; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; TP, total protein; ALB, albumin; ALT, alanine aminotransferase; AST, aspartate aminotransferase; TBIL, total bilirubin; DBIL, direct bilirubin; FA, fibrinogen and albumin.

Table 3 The Result of Multivariate Cox Hazards Analysis of Overall Survival

Variable	HR	95% CI	P value
Age	3.014	1.522–5.969	0.002
WBC	4.243	2.078–8.666	<0.001
FA	1.916	1.205–3.048	0.006

Abbreviations: WBC, white blood cell count; FA, fibrinogen and albumin.

Figure 3 A nomogram predicting 1-year and 3-year overall survival in patients with WHO Grade II/III gliomas.

Figure 4 Validation of the nomogram. (A). The calibration curve of predicting patient survival percentages at 1 year. (B). The calibration curve of predicting patient survival percentages at 3 year. (C). The integrated area under the curve was calculated for the nomogram for every month.