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Prognostic Value of the Combination of CEA and Fibrinogen/Albumin Ratio in Resectable Gastric Cancer

Authors Zhang J, Ruan J, Wang W, Lu Y, Wang H, Yu X, Wang H, Teng L

Received 18 January 2020

Accepted for publication 8 April 2020

Published 23 April 2020 Volume 2020:12 Pages 2767—2775

DOI https://doi.org/10.2147/CMAR.S246566

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Eileen O'Reilly


Junbin Zhang, Jiayin Ruan, Weibin Wang, Yimin Lu, Haiyong Wang, Xiongfei Yu, Haohao Wang, Lisong Teng

Department of Surgical Oncology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China

Correspondence: Haohao Wang; Lisong Teng Tel/Fax +86 57187236881
Email coldhot33@126.com; lsteng@zju.edu.cn

Purpose: To investigate the prognostic value of combined serum carcinoembryonic antigen (CEA) levels and fibrinogen/albumin ratio (FAR) in patients with resectable gastric cancer (GC).
Introduction: This retrospective study evaluated the CEA, fibrinogen, and albumin levels and other clinicopathological features of GC patients. The prognostic significance of these factors for overall survival (OS) was assessed using Kaplan–Meier curves and univariate and multivariate Cox proportional models.
Patients and Methods: A total of 267 patients were included. The optimal cutoff values of CEA and FAR were 3.2 ng/mL and 0.086, respectively. Patients were stratified into three groups based on this cutoff value: CEA-FAR=0 (CEA < 3.2 ng/mL and FAR < 0.086), CEA-FAR=1 (CEA ≥ 3.2 ng/mL or FAR ≥ 0.086), and CEA-FAR=2 (CEA ≥ 3.2 ng/mL and FAR ≥ 0.086).
Results: Higher CEA-FAR was strongly associated with age, tumor size, tumor invasion, lymph node status, and TNM stage (all P< 0.05). The OS rates differed significantly between these 3 groups (88.9% vs 65.0% vs 46.9%, P< 0.001). Multivariate analysis showed that CEA-FAR was an independent prognostic factor for OS (P< 0.001). The area under the curve was larger for CEA-FAR than for either CEA or FAR alone (0.683, 0.644, and 0.669, respectively).
Conclusion: Preoperative CEA-FAR could be a potential blood marker for predicting tumor progression and the prognosis of GC patients. Patients with a higher CEA-FAR should undergo extensive follow-up.

Keywords: gastric carcinoma, patients, survival, risk factor

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