The role of albumin-to-fibrinogen and fibrinogen-to-prealbumin ratios in the development of ovarian carcinoma
DOI:
https://doi.org/10.2478/AMB-2025-0006Keywords:
ovarian carcinoma, prealbumin, albumin, fibrinogen, ratios, prognosisAbstract
Ovarian carcinoma (OC) has the highest mortality among gynecological carcinomas in developed countries. Many authors have drawn attention to fibrinogen-to-prealbumin (FPR) and albumin-to-fibrinogen (AFR) ratios and demonstrated that low AFR values and high FPR values correlate with an increased risk of mortality and recurrence of carcinoma and may be promising prognostic markers for malignant diseases. As emerging biomarkers, FPR and AFR have significant advantages due to their availability, cost-effectiveness, and reliability.
References
Miller KD, Siegel RL, Lin CC, et al. Cancer treatment and survivorship statistics. 2016, 66:271-89.
World Cancer Research Fund International. Ovarian cancer statistics [Internet]. 2024 [cited 2024/02/10]. Available from: https://www.wcrf.org/cancer-trends/ovarian-cancer-statistics/.
Stewart C, Ralyea C, Lockwood S. Ovarian cancer: an integrated review. InSeminars in oncology nursing. 2019, 35:151-156.
Fan C, Reader J, Roque DM. Review of immune therapies targeting ovarian cancer. Current treatment options in oncology. 2018, 19:1-21.
Webb PM, Jordan SJ. Epidemiology of epithelial ovarian cancer. Best practice & research Clinical obstetrics & gynaecology. 2017, 41:3-14.
Zhang Y, Luo G, Li M, et al. Global patterns and trends in ovarian cancer incidence: age, period and birth cohort analysis. BMC cancer. 2019, 19:1-4.
Saorin A, Di Gregorio E, Miolo G, et al. Emerging role of metabolomics in ovarian cancer diagnosis. Metabolites. 2019, 10:419.
Kim J, Park EY, Kim O, et al. Cell origins of high-grade serous ovarian cancer. Cancers. 2018, 12:433.
Guo L, Wang J, Li N, et al. Peptides for diagnosis and treatment of ovarian cancer. Frontiers in Oncology. 2023, 5:1135523.
Chen S, Yan H, Du J, et al. Prognostic signifi cance of preresection albumin/fi brinogen ratio in patients with non-small cell lung cancer: A propensity score matching analysis. Clinica chimica acta. 2018, 482:203-8.
Allin KH, Bojesen SE, Nordestgaard BG: Infl ammatory biomarkers and risk of cancer in 84,000 individuals from the general population. Int J Cancer. 2016, 139:1493-1500.
Nazha B, Moussaly E, Zaarour M, et al. Hypoalbuminemia in colorectal cancer prognosis: nutritional marker or inflammatory surrogate?. World J Gastrointest Surg. 2015, 7:370-377.
Zhou J, Hiki N, Mine S, et al. Role of prealbumin as a powerful and simple index for predicting postoperative complications after gastric cancer surgery. Ann Surg Oncol. 2017, 24:510-517.
Cai W, Kong W, Dong B, et al. Pretreatment serum prealbumin as an independent prognostic indicator in patients with metastatic renal cell carcinoma using tyrosine kinase inhibitors as fi rst-line target therapy. Clin Genitourin Cancer. 2017, 15:437-446.
Miura K, Hamanaka K, Koizumi T, et al. Clinical significance of preoperative serum albumin level for prognosis in surgically resected patients with non-small cell lung cancer: comparative study of normal lung, emphysema, and pulmonary fibrosis. Lung Cancer. 2017, 111:88-95.
Huang W, Wang S, Zhang H, et al. Prognostic significance of combined fi brinogen concentration and neutrophil-to-lymphocyte-ratio in patients with resectable non-small cell lung cancer. Cancer Biol Med. 2018, 15:88-96.
Loftus TJ, Brown MP, Slish JH, et al. Serum levels of prealbumin and albumin for preoperative risk stratifi cation. Nutr Clin Pract. 2019, 34:340-348.
Li XF, Wang X, Lu WJ, et al. Relationship between fibrinogen/albumin ratio and coronary collateral circulation in patients with chronic total occlusion. Henan Med Res. 2020, 29:589.
Miao Y, Li S, Yan Q, et al. Prognostic signifi cance of preoperative prognostic nutritional index in epithelial ovarian cancer patients treated with platinum-based chemotherapy. Oncol Res Treat. 2016, 39:712-719.
Deme D, Telekes A. Prognostic importance of albumin in oncology. Orv Hetil. 2018, 159:96-106.
Lu J, Xu BB, Zheng ZF, et al. CRP/prealbumin, a novel inflammatory index for predicting recurrence after radical resection in gastric cancer patients: post hoc analysis of a randomized Phase III trial. Gastric Cancer. 2019, 22:536-545.
Zhang L, Zhang J, Wang Y, et al. Potential prognostic factors for predicting the chemotherapeutic outcomes and prognosis of patients with metastatic colorectal cancer. J Clin Lab Anal. 2019, 33:22958.
Smith SH. Using albumin and prealbumin to assess nutritional status. Nursing. 2017, 47:65-66.
Ma YQ, Zhang YQ, Liu DL, et al. Correlation analysis of postoperative albumin changes and complications in elderly patients with gastric cancer with normal preoperative serum albumin level. Clin Oncol China. 2020, 47:823.
Shafer JA, Higgins DL, Lewis SD. Steady state kinetics for the thrombin catalyzed sequential release of fibrinopeptides A & B from human fibrinogen. InFed. Proc. 1982, 41:654.
Sun YR, Gao XY, Lu ZJ, et al. Predictive effi cacy of preoperative plasma fi brinogen to albumin ratio for adverse cardiovascular events in patients with NSTE-ACS after PCI. Shandong Med. 2020, 60:81.
Kavitha S, Sridhar MG, Satheesh S. Periprocedural plasma fibrinogen levels and coronary stent outcome. Indian Heart J.2015, 67:440-443.
Ahn HJ, Baker SK, Norris EH, et al. Infl aming the Brain. Neuron. 2019, 101:991-993.
Perisanidis C, Psyrri A, Cohen EE, et al. Prognostic role of pretreatment plasma fi brinogen in patients with solid tumors: a systematic review and meta-analysis. Cancer Treat Rev. 2015, 41:960-970.
Ji R, Ren Q, Bai S, et al. Prognostic significance of pretreatment plasma fibrinogen level in patients with digestive system tumors: a meta-analysis. Int J Biol Markers. 2018, 33:254-265.
Marco P, Marco A. Biomolecular markers in cancer-associated thromboembolism. Med Clin Barc. 2015, 144:21-25.
Zhang D, Zhou X, Bao W, et al. Plasma fi brinogen levels are correlated with postoperative distant metastasis and prognosis in esophageal squamous cell carcinoma. Oncotarget. 2015, 6:38410-38420.
Jain A, Zhang Q, Toh HC. Awakening immunity against cancer: a 2017 primer for clinicians. Chin J Cancer. 2017, 36:67.
Zhu L, Zhang JQ. Clinical analysis of coagulation and fi brinolysis indexes in patients with malignant tumor and relevant nursing countermeasures. Thrombosis Hemostasis. 2016, 22:588.
Zhang J, Li SQ, Liao ZH, et al. Prognostic value of a novel FPR biomarker in patients with surgical stage II and III gastric cancer. Oncotarget. 2017, 8:75195-75205.
Virizuela JA, Camblor-álvarez M, Luengo-Pérez LM, et al. Nutritional support and parenteral nutrition in cancer patients: an expert consensus report. Clin Transl Oncol. 2018, 20:619-629.
Daniele A, Divella R, Abbate I, et al. Assessment of nutritional and infl ammatory status to determine the prevalence of malnutrition in patients undergoing surgery for colorectal carcinoma. Anticancer Res. 2017, 37:1281-1287.
Moujaess E, Fakhoury M, Assi T, et al. The Therapeutic use of human albumin in cancer patients’ management. Crit Rev Oncol Hematol. 2017, 120:203-209.
Filip B, Scarpa M, Cavallin F, et al. Postoperative outcome after oesophagectomy for cancer: nutritional status is the missing ring in the current prognostic scores. Eur J Surg Oncol. 2015, 41:787-794.
Xu Q, Yan Y, Gu S, et al. A novel infl ammation-based prognostic score: the fibrinogen/albumin ratio predicts prognosesof patients after curative resection for hepatocellular carcinoma. J Immunol Res. 2018:4925498.
Ingenbleek Y, Young VR: Signifi cance of transthyretin in protein metabolism. Clin Chem Lab Med. 2002, 40:1281-91.
Shenkin A. Serum prealbumin: is it a marker of nutritional status or of risk of malnutrition?. Clinical chemistry. 2006, 52:2177-9.
Sun F, Peng HX, Gao QF, et al. Preoperative circulating FPR and CCF score are promising biomarkers for predicting clinical outcome of stage II-III colorectal cancer patients. Cancer Manag Res. 2018, 10:2151-2161.
Mills JC, Samuelson LC. Past questions and current understanding about gastric cancer. Gastroenterology. 2018, 155:939-944.
Che Y, Wang J, Li Y, et al. Cisplatin-activated PAI-1 secretion in the cancer-associated fi broblasts with paracrine effects promoting esophageal squamous cell carcinoma progression and causing chemoresistance. Cell Death Dis. 2018, 9:759.
Bakker E, Qattan M, Mutti L, et al. The role of microenvironment and immunity in drug response in leukemia. Biochim Biophys Acta. 2016, 1863:414-426.
Isella C, Terrasi A, Bellomo SE, et al. Stromal contribution to the colorectal cancer transcriptome. Nat Genet. 2015, 47:312-319.
Dolan RD, McSorley ST, Park JH, et al. The prognostic value of systemic infl ammation in patients undergoing surgery for colon cancer: comparison of composite ratios and cumulative scores. Br J Cancer. 2018, 119:40-51.
Jagadesham VP, Lagarde SM, Immanuel A, et al. Systemic infl ammatory markers and outcome in patients with locally advanced adenocarcinoma of the oesophagus and gastrooesophageal junction. Br J Surg. 2017, 104:401-407.
Berzigotti A, Reig M, Abraldes JG, et al. Portal hypertension and the outcome of surgery for hepatocellular carcinoma in compensated cirrhosis: a systematic review and meta-analysis. Hepatology. 2015, 61:526-536.
Kozasa K, Mabuchi S, Komura N, et al. Comparison of clinical utilities of the platelet count and platelet-lymphocyte ratio for predicting survival in patients with cervical cancer: a single institutional study and literature review. Oncotarget. 2017, 8:55394-55404.
Wu Y, Zhou D, Zhang G, et al. Preoperative serum plateletlymphocyte ratio as a prognostic factor in cholangiocarcinoma patients after radical resection: a retrospective analysis of 119 patients. Gastroenterol Res Pract. 2019:8506967.
Wu CC, Li SH, Lu HI, et al. Infl ammation-based prognostic scores predict the prognosis of locally advanced cervical esophageal squamous cell carcinoma patients receiving curative concurrent chemoradiotherapy: a propensity scorematched analysis. PeerJ. 2018, 6:5655.
Lv Y, Zhang J, Liu Z, et al. A novel infl ammation-based prognostic index for patients with esophageal squamous cell carcinoma:neutrophil lymphocyte ratio/prealbumin ratio. Medicine :e14562.
Wei XL, Wang FH, Zhang DS, et al. A novel infl ammationbased prognostic score in esophageal squamous cell carcinoma: the C-reactive protein/albumin ratio. BMC Cancer. 2015, 15:350.
Wei SH, Wang Y, Ye ZS, et al. Relationship between preoperative serum albumin level and clinicopathological features and prognosis of patients with gastric stump cancer. Chin J Gen Surg. 2018, 33:828.
Huynh PT, Beswick EJ, Coronado YA, et al. CD90(+) stromal cells are the major source of IL-6, which supports cancer stem-like cells and infl ammation in colorectal cancer. Int J Cancer. 2016, 138:1971-1981.
Li Y, Shi J, Qi S, et al. Correction to: IL-33 facilitates proliferation of colorectal cancer dependent on COX2/PGE2. J Exp Clin Cancer Res. 2020, 39:15.
Graf ME, Sookthai D, Johnson T, et al. Pre-diagnostic plasma concentrations of Fibrinogen, sGPIIb/IIIa, sP-selectin, sThrombomodulin, Thrombopoietin in relation to cancer risk: fi ndings from a large prospective study. Int J Cancer. 2018, 143:2659-2667.
Li SQ, You XH, Sun F, et al. Albumin to fibrinogen ratio and fibrinogen to pre-albumin ratio are economical, simple and promising prognostic factors for solid malignancy. 2019, 11:2036-2036.
Zhang WW, Zhang ZW, He L. Analysis of prognostic factors in 342 patients with ovarian cancer undergoing surgery. Chin J Cancer Prev Treat. 2019, 26:1288-1295. 10.16073/j.cnki.cjcpt.2019.17.11
Tan Z, Zhang M, Han Q, et al. A novel blood tool of cancer prognosis in esophageal squamous cell carcinoma: the fibrinogen/albumin ratio. J Cancer. 2017, 8:1025-1029.
Hwang KT, Chung JK, Roh EY, et al. Prognostic influence of preoperative fi brinogen to albumin ratio for breast cancer. J Breast Cancer. 2017, 20:254-263.
Huang J, Wang Y, Yuan Y, et al. Preoperative serum prealbumin as an independent prognostic indicator in patients with localized upper tract urothelial carcinoma after radical nephroureterectomy. Oncotarget. 2017, 8:36772-36779.
Hu WH, Cajas-Monson LC, Eisenstein S, et al. Preoperative malnutrition assessments as predictors of postoperative mortality and morbidity in colorectal cancer: an analysis of ACSNSQIP. Nutr J. 2015, 14:91.
Suzuki T, Shimada H, Nanami T, et al. Hyperfibrinogenemia is associated with infl ammatory mediators and poor prognosis in patients with gastric cancer. 2016, 46:1394-1401.
Han WX, Chen ZM, Wei ZJ, Xu AM. Preoperative pre-albumin predicts prognosis of patients after gastrectomy for adenocarcinoma of esophagogastric junction. World J Surg Oncol. 2016, 14:279.
Liu BZ, Tao L, Chen YZ, et al. Preoperative Body Mass Index, Blood Albumin and Triglycerides Predict Survival for Patients with Gastric Cancer. PLoS One. 2016, 11:0157401.
Tominaga T, Nonaka T, Sumida Y, et al. The C-reactive protein to albumin ratio as a predictor of severe side effects of adjuvant chemotherapy in stage III colorectal cancer patients. PLoS One. 2016, 11:0167967.
Sun DW, An L, Lv GY. Albumin-fi brinogen ratio and fibrinogen-prealbumin ratio as promising prognostic markers for cancers: an updated meta-analysis. World journal of surgical oncology. 2020, 18:1-5.
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