Clinical Significance of Fibrinogen and Platelet to Pre-Albumin Ratio in Predicting the Prognosis of Advanced Gastric Cancer

Figures & data

Figure 1 Flow chart for this study.

Table 1 Baseline Clinicopathological Characteristics of the Enrolled Patients

Variable	N=489
Age(years)
<40	37
40–60	251
>60	201
Sex
Male	358
Female	131
Tumor size
<2cm	37
2–5cm	328
>5cm	124
Grade
Well-Moderate	190
Poorly	266
Undifferentiated	33
T-stage
T2	133
T3	75
T4	281
N-stage
N0	201
N1	117
N2	107
N3	64
TNM
I	58
II	220
III	211
Chemotherapy
YES	385
NO	104
Radiotherapy
YES	26
NO	463
SIRI
High	194
Low	295
NLR
High	329
Low	160
PLR
High	310
Low	179
FPAR
High	215
Low	274
Relapse
Yes	180
No	309
Status
Live	356
Death	133

Table 2 Association of FPAR with Clinicopathological Features

Variable	N	FPAR-High (n=215)%	FPAR-Low (n=274)	P value
Age(years)				0.008
<40	37	15(40.54%)	22(59.46%)
40–60	251	95(37.85%)	156(62.15%)
>60	201	105(52.24%)	96(47.76%)
Sex				0.003
Male	358	143(39.94%)	215(60.06%)
Female	131	72(54.96%)	59(45.04%)
Tumor size				<0.001
<2cm	37	6(16.22%)	31(83.78%)
2–5cm	328	132(40.24%)	196(59.76%)
>5cm	124	77(62.10%)	47(37.90%)
Grade				0.031
Well-Moderate	190	70(36.84%)	120(63.16%)
Poorly	266	131(49.25%)	135(50.75%)
Undifferentiated	33	14(42.42%)	19(57.58%)
T-stage				0.037
T2	133	50(37.59%)	83(62.41%)
T3	75	42(56.00%)	33(44.00%)
T4	281	123(43.77%)	158(56.23%)
N-stage				0.294
N0	201	80(39.80%)	121(60.20%)
N1	117	53(45.30%)	64(54.70%)
N2	107	48(44.86%)	59(55.14%)
N3	64	34(53.13%)	30(46.87%)
TNM				0.060
I	58	18(31.03%)	40(68.97%)
II	220	95(43.18%)	125(56.82%)
III	211	102(48.34%)	109(51.66%)

Figure 2 Heat map for correlation analysis between variables.

Table 3 Univariate and Multivariable Cox Analysis of OS in AGC

Variable	N	P value	OR(95CI)	P value
Age(years)		0.014		0.181
<40	37
40–60	251
>60	201
Sex		0.229
Male	358
Female	131
Tumor size		0.006		0.502
<2cm	37
2–5cm	328
>5cm	124
Grade		<0.001		<0.001
Well-Moderate	190		1(reference)
Poorly	266		2.242(1.460–3.442)
Undifferentiated	33		2.809(1.423–5.547)
T-stage		<0.001		0.079
T2	133
T3	75
T4	281
N-stage		<0.001		0.084
N0	201
N1	117
N2	107
N3	64
TNM		<0.001		<0.001
I	58		1(reference)
II	220		6.031(1.858–19.573)
III	211		9.782(3.039–31.484)
Chemotherapy		0.002		<0.001
YES	385		0.422(0.289–0.616)
NO	104		1(reference)
Radiotherapy		0.622
YES	26
NO	463
SIRI		0.035		0.722
High	194
Low	295
NLR		0.002		0.091
High	329
Low	160
PLR		0.009		0.348
High	310
Low	179
FPAR		<0.001		<0.001
High	215		3.054(2.088–4.467)
Low	274		1(reference)

Table 4 Univariate and Multivariable Cox Analysis of RFS in AGC

Variable	N	P value	OR(95CI)	P value
Age(years)		0.371
<40	37
40–60	251
>60	201
Sex		0.721
Male	358
Female	131
Tumor size		0.001		0.369
<2cm	37
2–5cm	328
>5cm	124
Grade		<0.001		0.021
Well-Moderate	190		1(reference)
Poorly	266		1.602(1.142–2.248)
Undifferentiated	33		1.632(0.882–3.020)
T-stage		<0.001		0.296
T2	133
T3	75
T4	281
N-stage		<0.001		0.024
N0	201		1(reference)
N1	117		1.294(0.768–2.181)
N2	107		1.944(1.043–3.624)
N3	64		2.646(1.341–5.222)
TNM		<0.001		0.033
I	58		1(reference)
II	220		3.587(1.278–10.066)
III	211		4.647(1.464–14.751)
Chemotherapy		0.169
YES	385
NO	104
Radiotherapy		0.070
YES	26
NO	463
SIRI		0.080
High	194
Low	295
NLR		0.006		0.164
High	329
Low	160
PLR		0.016		0.618
High	310
Low	179
FPAR		<0.001		<0.001
High	215		2.215(1.634–3.003)
Low	274		1(reference)

Figure 3 Kaplan–Meier curves of OS and RFS in each independent risk factor.(A). K-M curves of OS in FPAR; (B). K-M curves of OS in Grade; (C). K-M curves of OS in N-stage; (D). K-M curves of OS in TNM-stage; (E). K-M curves of OS in chemotherapy; (F). K-M curves of RFS in FPAR; (G). K-M curves of RFS in Grade; (H). K-M curves of RFS in N-stage;(I). K-M curves of RFS in TNM-stage; (J). K-M curves of RFS in chemotherapy).

Figure 4 Kaplan–Meier curve of OS and RFS in each subgroup(A). FPAR for OS in TNM-stage; (B). FPAR for RFS in TNM-stage; (C). OS in stage II and III FPAR patients; (D). RFS in stage II and III FPAR patients).

Table 5 Before and After Evaluation of 100 Cross-Validations of the Model

Model	AUC of OS Model		AUC of RFS Model		C-Index
	2-year	3-year	2-year	3-year	RFS Model	OS Model
Pre-calibration	0.749	0.807	0.751	0.774	0.723	0.756
Post-calibration(Mean)	0.737	0.756	0.738	0.758	0.711	0.746

Figure 5 Prognostic nomograms with FPAR for predicting survival of AGC patient.(A). OS prediction model; (B). RFS prediction model).

Figure 6 Evaluation of predictive models with calibration curves, DCA, ROC(A). Calibration curves for OS prediction models; (B). DCA for OS prediction models; (C). ROC for OS prediction models; (D). Calibration curves for RFS prediction models; (E). DCA for RFS prediction models; (F). ROC for RFS prediction models).

Figure 7 Visualisation of cross-validation results for predictive models,(A). OS predictive model cross-validation visualisation of cloud and rain plots; (B). RFS predictive model cross-validation visualisation of cloud and rain plots; (C). C-index before correction for OS and RFS prediction models; (D). C-index after correction for OS and RFS prediction models).

Figure 8 Evaluation of prognostic nomograms with or without FPAR for predicting survival of AGC patient.(A). Comparing DCA of OS model and model2; (B). Comparing ROC AUC of OS model and model2; (C). Comparing DCA of RFS model and model3; (D). Comparing ROC AUC of RFS model and model3). (model2-OS without FPAR;model3-RFS without FPAR).