The prognostic value of fibrinogen to albumin ratio and a novel FAR-CA125 score in patients with resectable gastric signet ring cell carcinoma

Abstract

Abstract Purpose The fibrinogen to albumin ratio(FAR) is increasingly considered a potential biomarker for predicting prognosis in various malignant tumors, but not in gastric signet ring cell carcinoma(GSRC). This study aims to investigate the prognostic value of the FAR and explore a novel FAR-CA125 score(FCS) in patients with GSRC. Methods The study was a retrospective analysis of 330 patients with GSRC who underwent curative resection. We used Kaplan-Meier and Cox regression analyses to assess the prognostic role of FAR and FCS in patients with GSRC and analyze the association with clinicopathological features. Results The optimal cut-off values for CA125 and FAR were 9.88 and 0.0697, respectively, according to the receiver operating characteristic curve(ROC). The FCS had a higher area under the ROC curve than FAR and CA125. The patients were grouped into three groups according to the FCS. High FCS was related to males, anemia, large tumor size, tumor invasion depth, lymph node metastasis, advanced TNM stage, SII, and pathological subtypes. Kaplan-Meier analysis showed that high FAR and FCS were related to poor survival. In the multivariate analysis, FCS, TNM stage, and SII were independent prognostic predictors for poor OS in GSRC patients after surgery. Moreover, the clinical nomogram based on FCS was constructed, showing well-predictive accuracy. Conclusion This study indicated that the FCS is a prognostic, and effective biomarker for patients with surgically resectable GSRC. Such developed FCS-based nomogram could be feasible and convenient tools to assist the decision-making of clinical strategy.