Preoperative plasma fibrinogen combined with the platelet-to-lymphocyte ratio (F-PLR) serves as a prognostic indicator in patients with non-small cell lung cancer

Hongzhen Zhao^1,2Xiaopeng Zhang¹Dahu Ren^1,2Shicheng Liu^1,2Yuedong Wang^1,2Wenbo Wu¹Kun Zhang³Yajing Niu^4*Guochen Duan^1*

• ¹Department of Thoracic Surgery, Hebei General Hospital, Shijiazhuang, Hebei Province, China
• ²Hebei Medical University, Shijiazhuang, Hebei Province, China
• ³Department of Cardiovascular Surgery,Hebei General Hospital, Shijiazhuang, China
• ⁴Department of Geriatric Cardiovascular Medicine, Hebei General Hospital, Shijiazhuang,050057, People’s Republic of China, Shijiazhuang, Hebei Province, China

Background: The aim of this study was to explore the prognostic significance of the combined plasma fibrinogen level and platelet-to-lymphocyte ratio (F-PLR) score in patients who had undergone radical surgery for non-small cell lung cancer (NSCLC). Methods: In this study, we retrospectively reviewed the medical records of 214 patients who underwent radical resection for lung cancer. The optimal cut-off values for fibrinogen and the platelet - lymphocyte ratio (PLR) were determined by applying the receiver operating characteristic (ROC) curve and the Youden index. Based on these cut-off values, the patients were categorized into three groups: patients with elevated fibrinogen and PLR were assigned a score of 2; those with either elevated fibrinogen or PLR were assigned a score of 1; and those with neither elevation were assigned a score of 0. The Kaplan-Meier method was utilized to plot the survival curves, and differences among the curves were compared using the log - rank test. Univariate and multivariate analyses were carried out using the Cox proportional hazards model. Results: In this study, the optimal cutoff values were 3.90 for fibrinogen and 213.2 for the PLR. Cox's multifactorial analysis revealed that the implementation of adjuvant therapy after surgery(P<0.001), pathological stage(PStage=IIIA/I=0.041), and F-PLR(PF-PLR=1/0=0.006、PF-PLR=2/0=0.004)were independent prognostic factors influencing patient survival. Additionally, F-PLR was significantly correlated with the overall survival of NSCLC patients after surgery. Conclusions: The F-PLR score exhibits a significant association with the prognosis of NSCLC patients and can serve as a biomarker for predicting the prognosis of patients following NSCLC surgery.