Investigating The Value Of AFR And FPR In Patients With Advanced Lung Cancer

Objective: At present,some studies have shown that hematological indicators such as fibrin,fibrinogen and prealbumin,which reflect the body’s inflammatory state,nutritional status and hypercoagulable state,are related to the prognosis of patients with malignant tumor.However,there are few studies on the relationship between the composite indexes of albumin,fibrinogen and prealbumin,such as AFR(ratio of albumin to fibrinogen),FPR(ratio of fibrinogen to prealbumin)and the prognosis of lung cancer at home and abroad.The purpose of this study was to investigate the prognostic value of AFR and FPR in patients with advanced lung cancer.Method: This study collected the clinical,pathological and laboratory data of 113 patients with advanced lung cancer treated in the Department of respiratory and critical care medicine and Department of oncology of yijishan Hospital of Wannan Medical College from June 2019 to September 2020.The best cut-off values of AFR and FPR were determined by X-tile software,and the patients with advanced lung cancer were divided into two groups.Spss24.0 was used to analyze the correlation between clinical features and the high and low levels of AFR and FPR before chemotherapy;Kaplan Meier survival curve was used to analyze the correlation between PFS and the high and low levels of AFR and FPR before and after chemotherapy;Cox regression was used to analyze the correlation between PFS and the changes of AFR and FPR before and after chemotherapy Risk regression model was used to analyze the influencing factors of PFS in patients with advanced lung cancer.This study found that P ≤ 0.05 had statistical significance.Results: 1.113 patients with advanced lung cancer were included in this study.The median PFS was 179 days.According to X-tile software,the optimal cut-off values of AFR and FPR were 9.6 and 18.2,respectively.According to the cut-off value,lung cancer patients were divided into high level AFR group(AFR > 9.6),low level AFR group(AFR ≤ 9.6),high level FPR group(FPR > 18.2),low level FPR group(FPR ≤18.2).2.There was significant difference in clinical stage(P = 0.032)between high-level AFR group and low-level AFR group,but there was no significant difference in gender(P =0.670),age(P = 0.788),smoking history(P = 0.796)and the number of distant metastasis(P = 0.246);There was significant difference in clinical stage(P = 0.026)between high-level FPR group and low-leve FPR group,but no significant difference in gender(P = 0.850),age(P = 0.689),smoking history(P = 0.562)and number of distant metastasis(P = 0.215);3.Before chemotherapy,the PFS of high level AFR group compared with low level AFR group and high level FPR group compared with low level FPR group in patients with advanced lung cancer was statistically significant(P < 0.001).Further analysis showed that PFS in NSCLC patients and SCLC cancer patients were significantly different in high-level AFR group compared with low-level AFR group and high-level FPR group compared with low-level FPR group before chemotherapy(P < 0.001).4.There was significant difference in progression free survival(PFS)between AFR elevated group and non AFR elevated group before and after 2 cycles of chemotherapy.(P = 0.037)there was no significant difference in progression free survival between patients with elevated FPR and those without elevated FPR before and after chemotherapy.(P=0.427)5.The results of univariate analysis showed that clinical stage(P = 0.008),pleural metastasis(P = 0.002),brain metastasis(P = 0.029),AFR(P < 0.001),FPR(P < 0.001),ΔAFR(P = 0.039)may be the risk factors of PFS in patients with advanced lung cancer.The results of multivariate analysis showed that AFR,FPR and tumor stage were independent risk factors for PFS in patients with advanced lung cancer.Conclusion: 1.The prognosis of low-level AFR group and high-level AFR group before chemotherapy is poor;the level of AFR before chemotherapy may be an independent risk factor for predicting the prognosis of patients with advanced lung cancer receiving first-line platinum containing dual drug chemotherapy.2.The prognosis of high-level FPR group before chemotherapy is worse than that of low-level FPR group;the level of FPR before chemotherapy can be used as an independent risk factor to predict the prognosis of patients with advanced lung cancer receiving first-line platinum double drug chemotherapy.3.The non elevated level of AFR before and after 2 cycles of chemotherapy is closely related to the poor prognosis of patients with advanced lung cancer receiving first-line platinum containing double drugs.