Combination of preoperative fibrinogen and neutrophil to lymphocyte ratio is a predictive prognostic factor in esophageal squamous cell carcinoma systematic review

Objective To explored the clinical value of preoperative fibrinogen and neutrophil to lymphocyte ratio (NLR) in patients with esophageal squamous cell carcinoma (ESCC) in this study. Methods 327 patients undergoing ESCC radical surgery was performed to evaluate prognostic factors for overall survival (OS) by univariate and multivariate COX regression analyses. The optimal cut-off values for fibrinogen and NLR were 3.09 g/L and 1.89, respectively. The fibrinogen and NLR (F-NLR) scoring criteria were defined according to the cut-off criteria. High fibrinogen (≥3.09 g/L) and high NLR (≥1.89) were defined as 2 points, patients with high fibrinogen or high NLR were defined as 1 point, and neither hyperfibrinogen or high NLR scored 0 points. Results The OS of patients with high fibrinogen ESCC was significantly poor than patients with low fibrinogen (31.4% vs. 63.3%, P<0.01), while the OS of patients with elevated NLR was also significantly poor than patients with low NLR (40.4% vs. 50.3%). The F-NLR score was significantly correlated with tumor size (P<0.01) and pathological stage (P<0.01). The 5-year OS rates for F-NLR score groups 0, 1, and 2 were 69.1%, 42.6%, and 31.9%, respectively, there were significant differences between subgroups (P<0.01). Multivariate analysis showed that tumor size (P<0.01), pathological stage (P<0.01), and F-NLR (P<0.01) were independent prognostic factors for OS. Conclusion Preoperative F-NLR score can be used as an independent prognostic indicator for ESCC patients. Key words: Esophageal squamous cell carcinoma; Fibrinogen; Platelet to lymphocyte ratio; Prognostic indicator