Prognostic value of peripheral blood fibrinogen-to-albumin ratio and neutrophil-to-lymphocyte ratio in patients with locally advanced or metastatic pancreatic cancer.

objectiveTo investigate the expression and prognostic value of neutrophil-to-lymphocyte ratio (NLR) and fibrinogen-to-albumin ratio (FAR) in patients with locally advanced or metastatic pancreatic cancer (PC).

methodsThis retrospective study included 118 cases diagnosed with metastatic or locally advanced PC who received systemic chemotherapy at People's Hospital of Deyang City from January 2018 to February 2021. Data and blood indicators were collected from patients, and the platelet-to-lymphocyte ratio (PLR), NLR, and FAR were calculated. Receiver operating characteristic (ROC) curves were used to determine optimal cutoff values. Kaplan-Meier survival curves were plotted, and the Log-rank test was employed for intergroup survival analysis. Prognostic factors affecting the prognosis of PC patients were identified using multiple Cox regression analysis.

resultsThe optimal cutoff values of FAR and NLR were 0.1 and 3.28 respectively, with areas under the curve (AUC) of 0.776 and 0.804, respectively. Significant differences were observed between the low FAR and high FAR groups in terms of tumor invasion into large blood vessels, distant metastasis, and pre-treatment NLR (all P < 0.05). Similarly, significant differences were observed between the low NLR and high NLR groups in terms of distant metastasis, pre-treatment FAR, and pre-treatment PLR (all P < 0.05). At the end of the follow-up, 65 patients died and 53 survived. The 24-month survival rate was 97.62% in the high FAR group, significantly higher than 31.58% in the low FAR group (P < 0.001). The 24-month survival rate for the high NLR group was 91.30%, also significantly higher than 31.94% in the low NLR group (P < 0.001). In the Cox regression model, both high FAR and high NLR were identified as independent risk factors for poor prognosis in PC patients (all P < 0.05). The AUC for FAR combined with NLR in predicting the prognosis of PC patients was 0.946 (95% CI: 0.905-0.986), with a specificity of 92.30% and a sensitivity of 92.40%.

conclusionBoth FAR and NLR are correlated with prognosis in patients suffering from locally advanced or metastatic PC, and their combined detection may precisely predict prognosis in PC patients undergoing systemic chemotherapy.