Combined fibrinogen concentration and neutrophil-to-lymphocyte ratio, an integrative model of the inflammatory response and coagulation cascades, for predicting prognosis in patients with upper tract urothelial carcinoma

• Published in: Biomolecules & biomedicine
• Main Authors: Zheng, Yangqing, Chen, Chen, Lu, Chaoyue, Bao, Yongxing, Zhang, Weishi, Liang, Haote, Ye, Tingyu, Yu, Zhixian, Li, Yeping, Zhou, Lina, Yu, Deguan, Lin, Binwei
• Format: Journal Article
• Language: English
• Published: Association of Basic Medical Sciences of Federation of Bosnia and Herzegovina 08-11-2024
• Subjects: biomarker; fibrinogen; neutrophil-to-lymphocyte ratio; prognosis; Upper tract urothelial carcinoma
• ISSN: 2831-0896; 2831-090X; 2831-090X
• DOI: 10.17305/bb.2024.11039

Inflammation and coagulation cascades are closely correlated with cancer occurrence and progression. This study investigated the prognostic value of the combination of plasma fibrinogen level and neutrophil-to-lymphocyte ratio (F-NLR) in patients with upper tract urothelial carcinoma (UTUC). The predictive ability of the F-NLR for overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) was initially established and then further validated in patients who underwent radical nephroureterectomy for UTUC. As a result, patients were divided into three groups following the establishment of cut-off values for the NLR (≥2.53 vs. <2.53) and fibrinogen (≥4.55 vs. <4.55) through receiver operating characteristic (ROC) curve analysis: F-NLR score 0 (low fibrinogen and low NLR), 2 (high fibrinogen and high NLR), or 1 (remaining patients). The F-NLR score was then identified as an independent risk factor for OS, CSS, and PFS (all P-value <0.05) by multivariate regression analysis in both the training and validation cohorts. In addition, F-NLR-based nomograms for OS, CSS, and PFS were developed and evaluated using the concordance index (C-index) and calibration curves. The integration of the F-NLR into existing nomograms improved predictive accuracy compared to the use of nomograms without the F-NLR score. This suggests that the addition of F-NLR is beneficial for enhancing the accuracy of prognosis prediction in patients with UTUC. The F-NLR score may serve as a powerful predictor for patients with UTUC.