The Prognostic Significance of Combined Pretreatment Fibrinogen and Neutrophil-Lymphocyte Ratio in Various Cancers: A Systematic Review and Meta-Analysis

Dis Markers. 2020 Dec 9:2020:4565379. doi: 10.1155/2020/4565379. eCollection 2020.

Abstract

Purpose: The prognostic value of a new scoring system, termed F-NLR, that combines pretreatment fibrinogen level with neutrophil-lymphocyte ratio has been evaluated in various cancers. However, the results are controversial. The purpose of this study was to comprehensively analyze the prognostic value of F-NLR score in patients with cancers.

Methods: An integrated search of relevant studies was conducted by screening the PubMed and Embase databases. Pooled hazard ratios, with 95% confidence intervals (CIs), for overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS) were calculated to estimate the prognostic significance of F-NLR score in patients with various tumors. A random effects model was used for comprehensive analysis, and subgroup and meta-regression analyses were used to explore sources of heterogeneity.

Results: Thirteen articles reporting data from of 4747 patients were included in the study. Pooled analysis revealed that high F-NLR score was significantly associated with poor OS (HR = 1.77; 95% CI, 1.51-2.08) and poor DFS/PFS (HR = 1.63; 95% CI, 1.30-2.05). Subgroup and meta-regression analyses did not alter the prognostic role of F-NLR score in OS and DFS/PFS.

Conclusions: Increased F-NLR score is significantly associated with poor prognosis in patients with cancers and can serve as an effective prognostic indicator.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Disease-Free Survival
  • Fibrinogen / analysis*
  • Humans
  • Leukocyte Count
  • Lymphocytes*
  • Neoplasms / blood*
  • Neoplasms / diagnosis*
  • Neutrophils*
  • Prognosis
  • Progression-Free Survival
  • Proportional Hazards Models

Substances

  • Fibrinogen