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Authors Zhang Y, Xiao G
Received 16 December 2018
Accepted for publication 10 March 2019
Published 23 April 2019 Volume 2019:11 Pages 3381—3393
DOI https://doi.org/10.2147/CMAR.S198419
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Cristina Weinberg
Peer reviewer comments 3
Editor who approved publication: Dr Alexandra Fernandes
Background and aim: Serum
fibrinogen and albumin are two important factors in systemic inflammation and
these two factors are related to tumor progression. This study aimed to
comprehensively reveal the prognostic value of the ratio of fibrinogen and
albumin in malignant tumors.
Methods: We
systematically searched relevant studies in PubMed, Web of Science and Embase
up to November 21, 2018. Hazard ratios (HRs) or odds ratio (ORs) for overall
survival (OS)/disease-free survival (DFS), as well as relevant clinical data,
were collected for analysis; all data analyses were performed by using STATA/SE
14.
Results: Twelve
cohort studies were included in this meta-analysis, with a total of 5,088 cases
including 9 different kinds of tumors recruited. The pooled results showed that
high albumin/fibrinogen ratio (FAR) and low fibrinogen/albumin ratio (AFR) were
significantly associated with poor OS (HR=1.50, 95% CI: 1.30–1.70). Subgroup
analyses for OS were also performed based on the disease type, detection
method, follow-up time and treatment. Similarly, high FAR or low AFR indicated
a worse DFS in cancer patients (HR=1.86; 95% CI: 1.41–2.31). In addition, high
FAR or low AFR was statistically significant in relation to deeper tumor
infiltration (OR=2.81, 95%CI: 1.67–4.72), positive lymph node metastasis
(OR=1.57, 95%CI: 1.23–2.02) and distant metastasis (OR=2.30, 95% CI: 1.36–3.89)
as well as advanced clinical stage (OR=2.02, 95% CI: 1.17–3.47).
Conclusions: The ratio
of fibrinogen and albumin could act as a promising prognostic marker in human
malignant tumors. It might assist physicians to select optimal treatments by
identifying the current status of the patient. Future multicenter clinical
trials are needed to validate its applications.
Keywords: albumin/fibrinogen
ratio, fibrinogen/albumin ratio, malignant tumor, prognosis