Analysis Of The Relationship Between Preoperative Serum Albumin/Alkaline Phosphatase,Fibrinogen/Prealbumin And The Prognosis Of Laryngeal Carcinoma

Objective:To investigate the ratio of albumin to alkaline phosphatase ratio(AAPR)and fibrinogen to prealbumin ratio(FPR),which provide reference for evaluating the prognosis of patients with laryngeal carcinoma.Methods:The medical records of 193 patients who presented to the Department of Otorhinolaryngology-Head and Neck Surgery of our hospital from January 2014 to January 2018 for surgical treatment and were pathologically confirmed to have laryngeal carcinoma and met the inclusion criteria were reviewed.All patients were followed up for 1-120 months,and peripheral blood albumin(g/L),fibrinogen(mg/L),fibrinogen(g/L)and alkaline phosphatase(U/L)were collected one week before this hospitalization.ROC curve and area under curve were used to determine the optimal cutoff value of preoperative AAPR and FPR,and preoperative AAPR and FPR values were divided into high and low groups according to the cutoff value.Statistical analysis and data collation were performed using SPSS software,and chi-square test and Fisher exact test were used to compare differences between groups.Univariate analysis was performed using the Kaplan-Meier method,and the 5-year cumulative survival probability of different clinical characteristics was analyzed using the Log Rank test,with P < 0.05 considered statistically significant.Results:1.The relationship between preoperative AAPR,FPR and clinical data of patients:According to the ROC curve analysis results,the cutoff values of AAPR and FPR were 0.413 and 0.018,respectively.According to the cutoff value,preoperative AAPR ≥ 0.413 was divided into high group and AAPR < 0.413 into low group;preoperative FPR ≥ 0.018 was divided into high group and FPR < 0.018 into low group.There was no significant difference in sex,age,smoking and drinking between the two groups(all P > 0.05).There was no significant difference in gender,smoking and drinking between the two groups(all P > 0.05),but there was significant difference in age(P < 0.05).2.The relationship between preoperative AAPR,FPR and pathological features:There was no significant difference in preoperative AAPR in tumor location,clinical stage,T stage,N stage and tumor differentiation(all P > 0.05).It was found that FPR had no significant effect on tumor location,tumor differentiation and N stage(all P > 0.05).In T stage and clinical stage,FPR had statistical significance(P<0.05).The results showed that the higher the preoperative FPR value,the higher the T stage and the more advanced the clinical stage.3.Univariate analysis factors of prognosis in patients with laryngeal carcinoma:There was no significant difference in sex,age,smoking,drinking and prognosis between patients with laryngeal carcinoma(P > 0.05).However,tumor differentiation,T stage,N stage and clinical stage were related to the prognosis of patients with laryngeal carcinoma(P < 0.05).There was a statistically significant difference in preoperative AAPR and FPR values and 5-year overall survival between the high and low groups(all P < 0.05).The results showed that the survival rate of patients in low level AAPR group was lower than that of patients in high level AAPR group.Patients in the high FPR group had a worse prognosis than those in the low FPR group for laryngeal carcinoma when compared with those in the low FPR group,and the results showed that the lower the preoperative AAPR value,the worse the 5-year survival rate of laryngeal carcinoma patients,and the higher the preoperative FPR value,the worse the prognosis of laryngeal carcinoma patients.4.COX multivariate regression analysis of factors affecting the prognosis of patients with laryngeal carcinoma:Clinical stage and FPR level are independent risk factors for the prognosis of patients with laryngeal carcinoma.The prognosis of laryngeal carcinoma patients with advanced clinical stage is worse when the value of FPR is higher.Conclusion:1.Preoperative AAPR and FPR levels are prognostic factors in patients with laryngeal carcinoma.2.Preoperative FPR level and clinical stage are independent predictors of the prognosis of laryngeal carcinoma.When preoperative FPR ≥ 0.018,the prognosis of laryngeal carcinoma patients is relatively poor,and the more advanced the clinical stage,the worse the prognosis.