Fibrinogen-to-albumin ratio predicts overall survival of hepatocellular carcinoma

doi:10.4251/wjgo.v15.i9.1662

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World Journal of Gastrointestinal Oncology

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Observational Study

World J Gastrointest Oncol. Sep 15, 2023; 15(9): 1662-1672
Published online Sep 15, 2023. doi: 10.4251/wjgo.v15.i9.1662

Table 1 General characteristics of the 366 hepatocellular carcinoma patients

Characteristics	All patients (n = 366)	The lower group (FAR < 0.081, n = 138)	The higher group (FAR 0.081, n = 228)	P value
Gender
Male	312 (85.24)^c	113 (81.88)^c	199 (87.28)^c	0.16
Female	54 (14.76)^c	25 (18.12)^c	29 (12.72)^c
Age at diagnosis	54.59 (10.60)^a	52.98 (10.83)^a	55.56 (10.36)^a	0.02
Cigarette smoking
No	129 (35.24)^c	54 (39.19)^c	75 (32.89)^c	0.23
Yes	237 (64.76)^c	84 (60.81)^c	153 (67.11)^c
Alcohol drinking
No	161 (43.99)^c	64 (46.38)^c	97 (42.54)^c	0.47
Yes	205 (56.01)^c	74 (53.62)^c	131 (57.46)^c
BMI (kg/m²)	21.55 (2.71)^b	21.93 (2.70)^b	21.32 (2.70)^b	0.04
Stage				< 0.01
I-II	68 (18.58)^c	53 (38.41)^c	15 (6.58)^c
III	166 (45.35)^c	52 (37.68)^c	114 (50.00)^c
IV	132 (36.07)^c	33 (23.91)^c	99 (43.42)^c
Survival length (d)	645.00 (757.25)^b	947.50 (1002.25)^b	530.50 (683.50)^b	< 0.01
AST (U/L)	66.35 (75.22)^b	46.50 (48.08)^b	80.15 (81.30)^b	< 0.01
ALT (U/L)	43.80 (38.68)^b	38.95 (28.10)^b	50.05 (40.93)^b	0.01
AFP (ng/mL)	593.35 (9018.82)^b	315.20 (483.18)^b	743.25 (10910.73)^b	0.53
TBIL (μmol/L)	17.40 (14.00)^b	16.35 (13.55)^b	19.45 (14.13)^b	0.81
NLR (unit free)	2.75 (2.09)^b	1.93 (1.29)^b	3.30 (2.18)^b	< 0.01
CEA (U/L)	2.80 (3.10)^b	2.90 (3.11)^b	2.73 (3.14)^b	0.56
CA125 (U/L)	34.77 (83.51)^b	19.63 (30.11)^b	55.96 (104.58)^b	0.01
CA19-9 (U/L)	29.50 (67.38)^b	21.56 (36.71)^b	36.56 (81.11)^b	0.09
FAR (unit free)	0.09 (0.05)^b		-

^amean ± SD;

^bMedian with interquarti le range (IQR);

^cFrequency with proportion (%).

AFP: Alpha-fetoprotein; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BMI: Body mass index; CA125: Carbohydrate antigen 125; CA19-9: Carbohydrate antigen 19-9; CEA: Carcinoembryonic antigen; FAR: Fibrinogen-to-albumin ratio; NLR: Neutrophil-to-lymphocyte ratio; TBIL: Total bilirubin.

Table 2 Univariate and multivariate Cox proportional hazards model fitting results

Covariates	Univariate Cox model		Multivariate Cox model
Covariates	Crude HR (90%CI)	P value	Adjusted HR (95%CI)	P value
Sex: Male	1.74 (1.30, 2.35)	< 0.01
Age at diagnosis: + 5 yr	1.01 (0.96, 1.06)	0.72
Cigarette smoking: Yes	1.51 (1.23, 1.87)	< 0.01
Alcohol drinking: Yes	1.23 (1.01, 1.50)	0.08
BMI: + 1 kg/m²	0.97 (0.93, 1.00)	0.14
Stage (Ref: I-II)
III	3.49 (2.46, 4.96)	< 0.01	2.14 (1.37, 3.35)	< 0.01
IV	4.86 (3.40, 6.95)	< 0.01	2.33 (1.45, 3.74)	< 0.01
AST: 40 U/L	2.74 (2.12, 3.53)	< 0.01	1.50 (1.01, 2.22)	0.04
ALT: 40 U/L	1.72 (1.41, 2.10)	< 0.01
AFP: 400 ng/mL	1.93 (1.58, 2.36)	< 0.01	1.53 (1.19, 1.96)	< 0.01
TBIL: 17.1 μmo/L	1.81 (1.49, 2.20)	< 0.01
NLR: + 5	1.72 (1.45, 2.05)	< 0.01
CEA: 5 U/L	1.26 (1.01, 1.57)	< 0.01
CA125: 35 U/L	2.89 (2.36, 3.55)	< 0.01	1.72 (1.30, 2.27)	< 0.01
CA19-9: > 37 U/L	1.95 (1.60, 2.37)	< 0.01
FAR: 0.081	2.43 (1.95, 3.02)	< 0.01	1.39 (1.05, 1.83)	< 0.01

90%CI: 90% confidence interval; 95%CI: 95% confidence interval; AFP: Alpha-fetoprotein; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BMI: Body mass index; CA125: Carbohydrate antigen 125; CA19-9: Carbohydrate antigen 19-9; CEA: Carcinoembryonic antigen; FAR: Fibrinogen-to-albumin ratio; HR: Hazard ratio; NLR: Neutrophil-to-lymphocyte ratio; TBIL: Total bilirubin.

Citation: Sun H, Ma J, Lu J, Yao ZH, Ran HL, Zhou H, Yuan ZQ, Huang YC, Xiao YY. Fibrinogen-to-albumin ratio predicts overall survival of hepatocellular carcinoma. World J Gastrointest Oncol 2023; 15(9): 1662-1672
URL: https://www.wjgnet.com/1948-5204/full/v15/i9/1662.htm
DOI: https://dx.doi.org/10.4251/wjgo.v15.i9.1662