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Prognostic significance of the combination of preoperative fibrinogen and the neutrophil‑lymphocyte ratio in patients with non‑small cell lung cancer following surgical resection

  • Authors:
    • Hua‑Gang Liang
    • Kun Gao
    • Rui Jia
    • Jian Li
    • Chao Wang
  • View Affiliations / Copyright

    Affiliations: Department of Thoracic Surgery, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei 066000, P.R. China
    Copyright: © Liang et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 1435-1444
    |
    Published online on: November 26, 2018
       https://doi.org/10.3892/ol.2018.9760
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Abstract

The purpose of the present study was to evaluate the prognostic value of preoperative coagulation factor levels (including fibrinogen and D‑dimer) and inflammatory indicators in patients with non‑small cell lung cancer (NSCLC). The medical records of 456 patients with NSCLC who had undergone curative resection were retrospectively analysed. The recommended cut‑off values for preoperative fibrinogen, neutrophil‑lymphocyte ratio (NLR), platelet‑lymphocyte ratio and lymphocyte‑monocyte ratio were determined using receiver operating characteristic curve analyses. The associations between preoperative fibrinogen or D‑dimer levels and clinicopathological variables were analysed using the χ2 test. Univariate Kaplan‑Meier analysis and a multivariate Cox proportional hazards model were applied to identify which prognostic variables were significantly associated with overall survival (OS) rates. Multivariate analyses revealed that lymph node metastasis (P<0.001), preoperative fibrinogen (P=0.024) and NLR (P=0.028) were effective independent prognostic variables associated with OS. Based on this result, a novel, single inflammation‑based combination of fibrinogen and NLR (COF‑NLR) score was proposed for the determination of prognosis. Patients with elevated fibrinogen and NLR levels were allocated a score of 2 (n=136), and those that demonstrated elevated levels of one or neither were allocated a score of 1 (n=152) or 0 (n=168), respectively. The 5‑year OS rates were significantly poorer for patients with COF‑NLR=2 compared with those with COF‑NLR=1 or 0 (23.5% vs. 34.2% vs. 50.0%, P<0.001). A subgroup analysis demonstrated that the prognostic significance of COF‑NLR was independent of histological subtype, lymph node metastasis and pathological stage. Therefore, COF‑NLR has potential as a novel and useful blood marker for predicting tumour progression and the postoperative survival of patients with NSCLC. It may assist clinicians in risk stratification, prognosis predictions and facilitating individualised treatment.
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Copy and paste a formatted citation
Spandidos Publications style
Liang HG, Gao K, Jia R, Li J and Wang C: Prognostic significance of the combination of preoperative fibrinogen and the neutrophil‑lymphocyte ratio in patients with non‑small cell lung cancer following surgical resection. Oncol Lett 17: 1435-1444, 2019.
APA
Liang, H., Gao, K., Jia, R., Li, J., & Wang, C. (2019). Prognostic significance of the combination of preoperative fibrinogen and the neutrophil‑lymphocyte ratio in patients with non‑small cell lung cancer following surgical resection. Oncology Letters, 17, 1435-1444. https://doi.org/10.3892/ol.2018.9760
MLA
Liang, H., Gao, K., Jia, R., Li, J., Wang, C."Prognostic significance of the combination of preoperative fibrinogen and the neutrophil‑lymphocyte ratio in patients with non‑small cell lung cancer following surgical resection". Oncology Letters 17.2 (2019): 1435-1444.
Chicago
Liang, H., Gao, K., Jia, R., Li, J., Wang, C."Prognostic significance of the combination of preoperative fibrinogen and the neutrophil‑lymphocyte ratio in patients with non‑small cell lung cancer following surgical resection". Oncology Letters 17, no. 2 (2019): 1435-1444. https://doi.org/10.3892/ol.2018.9760
Copy and paste a formatted citation
x
Spandidos Publications style
Liang HG, Gao K, Jia R, Li J and Wang C: Prognostic significance of the combination of preoperative fibrinogen and the neutrophil‑lymphocyte ratio in patients with non‑small cell lung cancer following surgical resection. Oncol Lett 17: 1435-1444, 2019.
APA
Liang, H., Gao, K., Jia, R., Li, J., & Wang, C. (2019). Prognostic significance of the combination of preoperative fibrinogen and the neutrophil‑lymphocyte ratio in patients with non‑small cell lung cancer following surgical resection. Oncology Letters, 17, 1435-1444. https://doi.org/10.3892/ol.2018.9760
MLA
Liang, H., Gao, K., Jia, R., Li, J., Wang, C."Prognostic significance of the combination of preoperative fibrinogen and the neutrophil‑lymphocyte ratio in patients with non‑small cell lung cancer following surgical resection". Oncology Letters 17.2 (2019): 1435-1444.
Chicago
Liang, H., Gao, K., Jia, R., Li, J., Wang, C."Prognostic significance of the combination of preoperative fibrinogen and the neutrophil‑lymphocyte ratio in patients with non‑small cell lung cancer following surgical resection". Oncology Letters 17, no. 2 (2019): 1435-1444. https://doi.org/10.3892/ol.2018.9760
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