Biomarker-Based Models Utilizing the Albumin-Fibrinogen Ratio Effectively Predict Peritoneal Metastasis in Patients with Gastric Cancer: A Retrospective Study.
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引用次数: 0
Abstract
Objective: Peritoneal carcinomatosis (PC) is a common pattern of recurrence in gastric cancer patients and is associated with a poor prognosis. This study aimed to evaluate the predictive value of the albumin-fibrinogen ratio (AFR) for PC in patients with gastric cancer and to develop two preoperative prediction models.
Methods: A total of 745 gastric cancer patients were included in this study. Preoperative AFR, along with other serum markers and clinical tumor characteristics, was assessed. Univariate and multivariate logistic regression analyses were performed to determine the odds ratios (ORs) and 95% confidence intervals (CIs) of the independent variables. Propensity score matching (PSM) was used to control for potential confounders, and one-way ANOVA was conducted to evaluate differences in distribution between groups. Two prediction models incorporating the independent predictive indicators were constructed and validated via receiver operating characteristic (ROC) curves.
Results: Poorly differentiated type (OR 2.679; P = 0.001), nondiffuse morphological type (OR 2.123; P = 0.040), BMI < 23.550 kg/m2 (OR 4.635; P = 0.001), AFR < 11.275 (OR 2.895; P = 0.003) and CA199 ≥ 73.615 U/mL (OR 2.040; P = 0.037) were identified as independent risk factors for PC in patients with gastric cancer. After PSM, the AFR remained the only inflammatory marker that was independently associated with PC (P = 0.003). AFR demonstrated consistent robustness in predicting PC across multiple sample sets. Among all the independent risk factors, the AFR had the highest area under the curve (AUC) for ROC analysis (AUC 0.648; 95% CI 0.580-0.715). Two combination models incorporating the AFR demonstrated enhanced predictive ability: Combination Model 1 (AUC 0.759; 95% CI 0.699-0.820) and Combination Model 2 (AUC 0.801; 95% CI 0.744-0.859).
Conclusions: The preoperative AFR serves as a useful indicator for predicting PC. Two reliable prediction models based on the AFR have been developed.
期刊介绍:
Current Medical Science provides a forum for peer-reviewed papers in the medical sciences, to promote academic exchange between Chinese researchers and doctors and their foreign counterparts. The journal covers the subjects of biomedicine such as physiology, biochemistry, molecular biology, pharmacology, pathology and pathophysiology, etc., and clinical research, such as surgery, internal medicine, obstetrics and gynecology, pediatrics and otorhinolaryngology etc. The articles appearing in Current Medical Science are mainly in English, with a very small number of its papers in German, to pay tribute to its German founder. This journal is the only medical periodical in Western languages sponsored by an educational institution located in the central part of China.