Albumin-to-D-dimer ratios: A novel prognostic factor for evaluating first-line chemotherapy efficacy in advanced lung adenocarcinoma patients.

IF 2 4区 医学 Q3 ONCOLOGY
Liqun Zhang, Xing Li, Zhuo Wang, Zhiyan Zhang, Lei Zhang, Zhaoyang Liu, Lisha Zhang, Shuowen Wang, Tatiana Vitalevna Khorobrykh, Mingze He, Jiawen Xiao
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引用次数: 0

Abstract

The prognosis of advanced lung adenocarcinoma (LUAD) remains unfavorable, with chemotherapy constituting a primary treatment modality. Discerning the efficacy of chemotherapy for advanced LUAD is imperative. Prior investigations have demonstrated the prognostic value of albumin and D-dimer individually for malignancies; however, the predictive capacity of albumin-to-D-dimer ratios (ADR) for advanced LUAD subjected to first-line platinum-based chemotherapy remains unexplored. A cohort of 313 patients with advanced LUAD was retrospectively examined in this study, spanning from January 2017 to January 2021. ADR threshold values were ascertained via receiver operating characteristic analysis, followed by the evaluation of the association between pretreatment ADR and clinicopathological characteristics, disease control rate (DCR), and overall response rate (ORR) pertinent to first-line chemotherapy. Prognostic factors for progression-free survival (PFS) were determined employing Cox univariate and multivariate analyses. Subsequently, survival data were illustrated utilizing the Kaplan-Meier method and scrutinized through the log-rank test across the entire and subgroup populations. ADR demonstrated a superior area under the curve (AUC) value relative to albumin and D-dimer individually and exhibited enhanced prognostic predictive capability compared to albumin-to-fibrinogen ratios (AFR) for advanced LUAD (AUC: 0.805 vs. 0.640, DeLong test: p<0.001). ADR yielded a cut-off value of 16.608. A greater proportion of non-smokers was observed within the high-ADR group (ADR>16.608) compared to the low-ADR group (ADR≤16.608). Patients in the high-ADR group displayed elevated BMI and Na+ levels and reduced neutrophil count, monocyte count, globulin, and alkaline phosphatase (all p<0.05). Notably, the high-ADR group exhibited heightened DCR (96.7% vs. 89.2%, p=0.008) and ORR rates (70.1% vs. 51.0%, p=0.001) relative to the low-ADR group. Multivariate analysis outcomes indicated that high ADR constituted an independent risk factor for PFS (hazard ratio: 0.24, p<0.001). Furthermore, patients in the high-ADR cohort displayed a significantly prolonged median PFS (254 vs. 142 days, p<0.0001) compared to their low-ADR counterparts. In subpopulations exhibiting favorable implications for PFS, as determined by multivariate analysis, high-ADR patients consistently demonstrated extended PFS durations relative to the low-ADR group (all p<0.0001). Collectively, our findings suggest that ADR constitutes a novel and promising prognostic indicator for advanced LUAD patients, surpassing the accuracy of albumin and D-dimer individually and AFR. ADR thus serves as a potent instrument for assessing treatment effects and PFS in advanced LUAD patients undergoing first-line chemotherapy.

白蛋白-D-二聚体比率:评估晚期肺腺癌患者一线化疗疗效的新预后因素。
晚期肺腺癌(LUAD)的预后仍然不佳,化疗是主要的治疗方式。鉴别化疗对晚期肺腺癌的疗效势在必行。之前的研究已经证明了白蛋白和D-二聚体各自对恶性肿瘤的预后价值;然而,白蛋白-D-二聚体比值(ADR)对接受一线铂类化疗的晚期LUAD的预测能力仍有待探索。本研究对313名晚期LUAD患者的队列进行了回顾性研究,时间跨度为2017年1月至2021年1月。通过接收器操作特征分析确定了ADR阈值,随后评估了治疗前ADR与一线化疗相关的临床病理特征、疾病控制率(DCR)和总反应率(ORR)之间的关联。通过 Cox 单变量和多变量分析确定了无进展生存期(PFS)的预后因素。随后,利用 Kaplan-Meier 方法对生存期数据进行了说明,并通过对数秩检验对整个群体和亚群体的生存期数据进行了仔细分析。与低 ADR 组(ADR≤16.608)相比,ADR 的曲线下面积(AUC)值优于白蛋白和 D-二聚体,对晚期 LUAD 的预后预测能力也高于白蛋白与纤维蛋白原比率(AFR)(AUC:0.805 vs. 0.640,DeLong 检验:P16.608)。高 ADR 组患者的 BMI 和 Na+ 水平升高,中性粒细胞计数、单核细胞计数、球蛋白和碱性磷酸酶降低(均 p
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来源期刊
Neoplasma
Neoplasma 医学-肿瘤学
CiteScore
5.40
自引率
0.00%
发文量
238
审稿时长
3 months
期刊介绍: The journal Neoplasma publishes articles on experimental and clinical oncology and cancer epidemiology.
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