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Prognostic Significance of the Combination of Fibrinogen and Tumor Marker Index in Esophageal Squamous Cell Carcinoma Patients

Authors Qiao Y, Ma M, Zhang H, Yu Z, Tang P

Received 26 August 2020

Accepted for publication 10 January 2021

Published 17 February 2021 Volume 2021:14 Pages 1101—1111

DOI https://doi.org/10.2147/OTT.S278831

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Takuya Aoki


Yufeng Qiao, Mingquan Ma, Hongdian Zhang, Zhentao Yu, Peng Tang

Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin’s Clinical Research Center for Cancer, National Clinical Research Center of Cancer, Tianjin, 300060, People’s Republic of China

Correspondence: Peng Tang
Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin’s Clinical Research Center for Cancer, National Clinical Research Center of Cancer, Tianjin, 300060, People’s Republic of China
Tel +86-022-23340123
Fax +86-22-23359984
Email qyf800117@sina.com

Background: The current study was aimed at comparing the prognostic value of the combination of plasma fibrinogen and tumor marker index (TMI) [F-TMI] system with TMI alone in patients with esophageal squamous cell carcinoma (ESCC) after surgical resection.
Methods: A total of 317 patients with ESCC who underwent surgical resection were retrospectively analyzed. The TMI was calculated as the square root of (CYFRA 21– 1 concentration/3.3 μg/L) × (SCC concentration/1.5 μg/L). The patients were divided into F-TMI scores according to the following criteria: score 2, both elevated fibrinogen and high TMI; score 1, either elevated fibrinogen or high TMI; and score 0, neither abnormality. Univariate and multivariate survival analyses were performed to evaluate the prognostic value of F-TMI or TMI alone.
Results: The five-year overall survival rate of patients with high TMI was significantly lower than that of patients with low TMI (30.8% vs 50.4%, p < 0.001). There was a significant correlation between the F-TMI score with age, tumor size, NLR, PLR, pT status, and pN status. The five-year overall survival rates for patients with F-TMI scores of 2, 1, and 0 were 27.6%, 38.7%, and 63.3%. Multivariate analysis revealed that the F-TMI score (HR 1.297; 95% CI 1.046– 1.609, p = 0.018) was an independent prognostic factor. The F-TMI’s prediction ability was larger than that of fibrinogen, TMI, and the conventional TNM stage.
Conclusion: F-TMI was an independent prognostic factor for patients with ESCC and a more useful prognostic indicator than either of the parameters alone.

Keywords: fibrinogen, tumor marker index, esophageal squamous cell carcinoma, prognosis

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