Predictive value of preoperative plasma fibrinogen combined with lymphocyte-to-monocyte ratio in the prognosis of patients with esophageal squamous cell carcinoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

HE Xianneng ¹ , XIANG Yishun ^1,2 , LI Yunfeng ³ , LIN Chengbin ¹ ,  SHEN Weiyu ^1,2

1. Department of Thoracic Surgery, The Affiliated Lihuili Hospital, Ningbo University, Ningbo, 315000, Zhejiang, P. R. China;
2. Health Science Center, Ningbo University, Ningbo, 315211, Zhejiang, P. R. China;
3. Department of Cardiothoracic Surgery, Ningbo Yinzhou No. 2 Hospital, Ningbo, 315199, Zhejiang, P. R. China;

Corresponding?author：

SHEN Weiyu, Email: shenweiyu@nbu.edu.cn

Keywords：

Fibrinogen; inflammatory respose; lymphocyte-to-monocyte ratio; esophageal squamous cell carcinoma; prognosis; F-LMR score

DOI：

10.7507/1007-4848.202403059

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Objective To investigate the prognostic value of preoperative plasma fibrinogen (FIB) combined with lymphocyte-to-monocyte ratio (LMR) in predicting the prognosis of patients with esophageal squamous cell carcinoma (ESCC). Methods A retrospective analysis was conducted on ESCC patients who underwent esophagectomy in the Affiliated Lihuili Hospital of Ningbo University from 2015 to 2018. Based on the cut-off values of preoperative FIB and LMR, the F-LMR scoring system was constructed, and patients were divided into three groups according to the F-LMR score. Kaplan-Meier analysis was used to assess 5-year overall survival (OS) and 5-year progression free survival (PFS), and univariate and multivariate Cox regression analyses were performed to identify prognostic factors. Results Finally 260 patients were collected, including 237 males and 23 females, with a median age of 64 years (IQR: 59-70). The 5-year OS rates for patients with F-LMR score of 0, 1, and 2 were 24.44%, 51.69%, and 67.31%, respectively, and the 5-year PFS rates were 15.56%, 42.37%, and 57.62%, respectively. Lower preoperative F-LMR scores were associated with worse prognosis. Multivariate analysis showed that deeper tumor invasion, presence of lymph node metastasis, larger tumor maximum diameter, and lower preoperative F-LMR score were independent risk factors for OS. Conclusion The F-LMR scoring system based on the preoperative FIB and LMR may serve as an effective tool for predicting the prognosis of patients with ESCC.

Citation： HE Xianneng, XIANG Yishun, LI Yunfeng, LIN Chengbin, SHEN Weiyu. Predictive value of preoperative plasma fibrinogen combined with lymphocyte-to-monocyte ratio in the prognosis of patients with esophageal squamous cell carcinoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2026, 33(4): 570-577. doi: 10.7507/1007-4848.202403059 Copy

1.	Lin Y, Totsuka Y, He Y, et al. Epidemiology of esophageal cancer in Japan and China. J Epidemiol, 2013, 23(4): 233-242.
2.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
3.	Lagergren J, Smyth E, Cunningham D, et al. Oesophageal cancer. Lancet, 2017, 390(10110): 2383-2396.
4.	Bedenne L, Michel P, Bouché O, et al. Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD 9102. J Clin Oncol, 2007, 25(10): 1160-1168.
5.	Chen M, Huang J, Zhu Z, et al. Systematic review and meta-analysis of tumor biomarkers in predicting prognosis in esophageal cancer. BMC Cancer, 2013, 13: 539.
6.	Shalapour S, Karin M. Immunity, inflammation, and cancer: an eternal fight between good and evil. J Clin Invest, 2015, 125(9): 3347-3355.
7.	Tong YS, Tan J, Zhou XL, et al. Systemic immune-inflammation index predicting chemoradiation resistance and poor outcome in patients with stage Ⅲ non-small cell lung cancer. J Transl Med, 2017, 15(1): 221.
8.	Lv X, Han S, Xu B, et al. The value of complete blood count for the prognosis analysis of preoperative esophageal squamous cell carcinoma. BMC Cancer, 2021, 21(1): 1072.
9.	Angelidakis E, Chen S, Zhang S, et al. Impact of fibrinogen, fibrin thrombi, and thrombin on cancer cell extravasation using in vitro microvascular networks. Adv Healthc Mater, 2023, 12(19): e2202984.
10.	Li Q, Kong F, Ma J, et al. Nomograms based on fibrinogen, albumin, neutrophil-lymphocyte ratio, and carbohydrate antigen 125 for predicting endometrial cancer prognosis. Cancers (Basel), 2022, 14(22): 5632.
11.	Perisanidis C, Psyrri A, Cohen EE, et al. Prognostic role of pretreatment plasma fibrinogen in patients with solid tumors: a systematic review and meta-analysis. Cancer Treat Rev, 2015, 41(10): 960-970.
12.	Arnold M, Soerjomataram I, Ferlay J, et al. Global incidence of oesophageal cancer by histological subtype in 2012. Gut, 2015, 64(3): 381-387.
13.	Kelly RJ. Emerging multimodality approaches to treat localized esophageal cancer. J Natl Compr Canc Netw, 2019, 17(8): 1009-1014.
14.	Dougan M, Dranoff G. Immune therapy for cancer. Annu Rev Immunol, 2009, 27: 83-117.27-83.
15.	Greten FR, Grivennikov SI. Inflammation and cancer: triggers, mechanisms, and consequences. Immunity, 2019, 51(1): 27-41.
16.	Gutiérrez-Melo N, Baumjohann D. T follicular helper cells in cancer. Trends Cancer, 2023, 9(4): 309-325.
17.	Cui C, Craft J, Joshi NS. T follicular helper cells in cancer, tertiary lymphoid structures, and beyond. Semin Immunol, 2023, 69: 101797.
18.	Mantovani A, Marchesi F, Malesci A, et al. Tumour-associated macrophages as treatment targets in oncology. Nat Rev Clin Oncol, 2017, 14(7): 399-416.
19.	Fernandes CJ, Morinaga LTK, Alves JL, et al. Cancer-associated thrombosis: the when, how and why. Eur Respir Rev, 2019, 28(151): 180119.
20.	Chen S, Zhang J, Qian C, et al. Prognostic value of combined LMR and CEA dynamic monitoring in postoperative colorectal cancer patients. J Inflamm Res, 2023, 16: 4229-4250.
21.	Tang Y, Hu HQ, Tang YL, et al. Preoperative LMR and serum CA125 level as risk factors for advanced stage of ovarian cancer. J Cancer, 2021, 12(19): 5923-5928.
22.	Wolberg AS. Fibrinogen and fibrin: synthesis, structure, and function in health and disease. J Thromb Haemost, 2023, 21(11): 3005-3015.
23.	Levi M. Disseminated intravascular coagulation in cancer: an update. Semin Thromb Hemost, 2019, 45(4): 342-347.
24.	Murray JC. Coagulation and cancer. Br J Cancer, 1991, 64(3): 422-424.
25.	Bauer AT, Gorzelanny C, Gebhardt C, et al. Interplay between coagulation and inflammation in cancer: limitations and therapeutic opportunities. Cancer Treat Rev, 2022, 102: 102322.
26.	Braun A, Anders HJ, Gudermann T, et al. Platelet-cancer interplay: molecular mechanisms and new therapeutic avenues. Front Oncol, 2021, 11: 665534.
27.	Wu M, Pan Y, Jia Z, et al. Preoperative plasma fibrinogen and serum albumin score is an independent prognostic factor for resectable stage Ⅱ-Ⅲ gastric cancer. Dis Markers, 2019, 2019: 9060845.
28.	Palumbo JS, Kombrinck KW, Drew AF, et al. Fibrinogen is an important determinant of the metastatic potential of circulating tumor cells. Blood. 2000, 96(10): 3302-3309.
29.	Kijima T, Arigami T, Uchikado Y, et al. Combined fibrinogen and neutrophil-lymphocyte ratio as a prognostic marker of advanced esophageal squamous cell carcinoma. Cancer Sci, 2017, 108(2): 193-199.
30.	Zhang Y, Xiao G. Prognostic significance of the ratio of fibrinogen and albumin in human malignancies: a meta-analysis. Cancer Manag Res, 2019, 11: 3381-3393.
31.	Gao QF, Qiu JC, Huang XH, et al. The predictive and prognostic role of a novel ADS score in esophageal squamous cell carcinoma patients undergoing esophagectomy. Cancer Cell Int, 2018, 18: 153.
32.	Cao H, Shi H, Zhao M, et al. Prognostic value of the combined preoperative plasma fibrinogen and systemic inflammatory indexes in ESCC patients. Discov Oncol, 2023, 14(1): 143.

1. Lin Y, Totsuka Y, He Y, et al. Epidemiology of esophageal cancer in Japan and China. J Epidemiol, 2013, 23(4): 233-242.
2. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
3. Lagergren J, Smyth E, Cunningham D, et al. Oesophageal cancer. Lancet, 2017, 390(10110): 2383-2396.
4. Bedenne L, Michel P, Bouché O, et al. Chemoradiation followed by surgery compared with chemoradiation alone in squamous cancer of the esophagus: FFCD 9102. J Clin Oncol, 2007, 25(10): 1160-1168.
5. Chen M, Huang J, Zhu Z, et al. Systematic review and meta-analysis of tumor biomarkers in predicting prognosis in esophageal cancer. BMC Cancer, 2013, 13: 539.
6. Shalapour S, Karin M. Immunity, inflammation, and cancer: an eternal fight between good and evil. J Clin Invest, 2015, 125(9): 3347-3355.
7. Tong YS, Tan J, Zhou XL, et al. Systemic immune-inflammation index predicting chemoradiation resistance and poor outcome in patients with stage Ⅲ non-small cell lung cancer. J Transl Med, 2017, 15(1): 221.
8. Lv X, Han S, Xu B, et al. The value of complete blood count for the prognosis analysis of preoperative esophageal squamous cell carcinoma. BMC Cancer, 2021, 21(1): 1072.
9. Angelidakis E, Chen S, Zhang S, et al. Impact of fibrinogen, fibrin thrombi, and thrombin on cancer cell extravasation using in vitro microvascular networks. Adv Healthc Mater, 2023, 12(19): e2202984.
10. Li Q, Kong F, Ma J, et al. Nomograms based on fibrinogen, albumin, neutrophil-lymphocyte ratio, and carbohydrate antigen 125 for predicting endometrial cancer prognosis. Cancers (Basel), 2022, 14(22): 5632.
11. Perisanidis C, Psyrri A, Cohen EE, et al. Prognostic role of pretreatment plasma fibrinogen in patients with solid tumors: a systematic review and meta-analysis. Cancer Treat Rev, 2015, 41(10): 960-970.
12. Arnold M, Soerjomataram I, Ferlay J, et al. Global incidence of oesophageal cancer by histological subtype in 2012. Gut, 2015, 64(3): 381-387.
13. Kelly RJ. Emerging multimodality approaches to treat localized esophageal cancer. J Natl Compr Canc Netw, 2019, 17(8): 1009-1014.
14. Dougan M, Dranoff G. Immune therapy for cancer. Annu Rev Immunol, 2009, 27: 83-117.27-83.
15. Greten FR, Grivennikov SI. Inflammation and cancer: triggers, mechanisms, and consequences. Immunity, 2019, 51(1): 27-41.
16. Gutiérrez-Melo N, Baumjohann D. T follicular helper cells in cancer. Trends Cancer, 2023, 9(4): 309-325.
17. Cui C, Craft J, Joshi NS. T follicular helper cells in cancer, tertiary lymphoid structures, and beyond. Semin Immunol, 2023, 69: 101797.
18. Mantovani A, Marchesi F, Malesci A, et al. Tumour-associated macrophages as treatment targets in oncology. Nat Rev Clin Oncol, 2017, 14(7): 399-416.
19. Fernandes CJ, Morinaga LTK, Alves JL, et al. Cancer-associated thrombosis: the when, how and why. Eur Respir Rev, 2019, 28(151): 180119.
20. Chen S, Zhang J, Qian C, et al. Prognostic value of combined LMR and CEA dynamic monitoring in postoperative colorectal cancer patients. J Inflamm Res, 2023, 16: 4229-4250.
21. Tang Y, Hu HQ, Tang YL, et al. Preoperative LMR and serum CA125 level as risk factors for advanced stage of ovarian cancer. J Cancer, 2021, 12(19): 5923-5928.
22. Wolberg AS. Fibrinogen and fibrin: synthesis, structure, and function in health and disease. J Thromb Haemost, 2023, 21(11): 3005-3015.
23. Levi M. Disseminated intravascular coagulation in cancer: an update. Semin Thromb Hemost, 2019, 45(4): 342-347.
24. Murray JC. Coagulation and cancer. Br J Cancer, 1991, 64(3): 422-424.
25. Bauer AT, Gorzelanny C, Gebhardt C, et al. Interplay between coagulation and inflammation in cancer: limitations and therapeutic opportunities. Cancer Treat Rev, 2022, 102: 102322.
26. Braun A, Anders HJ, Gudermann T, et al. Platelet-cancer interplay: molecular mechanisms and new therapeutic avenues. Front Oncol, 2021, 11: 665534.
27. Wu M, Pan Y, Jia Z, et al. Preoperative plasma fibrinogen and serum albumin score is an independent prognostic factor for resectable stage Ⅱ-Ⅲ gastric cancer. Dis Markers, 2019, 2019: 9060845.
28. Palumbo JS, Kombrinck KW, Drew AF, et al. Fibrinogen is an important determinant of the metastatic potential of circulating tumor cells. Blood. 2000, 96(10): 3302-3309.
29. Kijima T, Arigami T, Uchikado Y, et al. Combined fibrinogen and neutrophil-lymphocyte ratio as a prognostic marker of advanced esophageal squamous cell carcinoma. Cancer Sci, 2017, 108(2): 193-199.
30. Zhang Y, Xiao G. Prognostic significance of the ratio of fibrinogen and albumin in human malignancies: a meta-analysis. Cancer Manag Res, 2019, 11: 3381-3393.
31. Gao QF, Qiu JC, Huang XH, et al. The predictive and prognostic role of a novel ADS score in esophageal squamous cell carcinoma patients undergoing esophagectomy. Cancer Cell Int, 2018, 18: 153.
32. Cao H, Shi H, Zhao M, et al. Prognostic value of the combined preoperative plasma fibrinogen and systemic inflammatory indexes in ESCC patients. Discov Oncol, 2023, 14(1): 143.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Predictive value of preoperative plasma fibrinogen combined with lymphocyte-to-monocyte ratio in the prognosis of patients with esophageal squamous cell carcinoma

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