Liu QQ, Li YD, Chen JX, Zhang LL, Guan RC, Zhao W, Meng LY. Prognostic value of preoperative fibrinogen, neutrophil-to-lymphocyte ratio, serum alpha-fetoprotein, and prealbumin for patients with primary liver cancer undergoing transarterial chemoembolization. World J Gastrointest Oncol 2025; 17(6): 103198 [DOI: 10.4251/wjgo.v17.i6.103198]
Corresponding Author of This Article
Ling-Yu Meng, Clinical Laboratory, The Third Affiliated Hospital of Qiqihar Medical University, No. 3 Taishun Street, Tiefeng District, Qiqihar 161000, Heilongjiang Province, China. 18345202361@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Jun 15, 2025; 17(6): 103198 Published online Jun 15, 2025. doi: 10.4251/wjgo.v17.i6.103198
Prognostic value of preoperative fibrinogen, neutrophil-to-lymphocyte ratio, serum alpha-fetoprotein, and prealbumin for patients with primary liver cancer undergoing transarterial chemoembolization
Qi-Qi Liu, Ya-Dong Li, Lin-Lin Zhang, Rong-Chun Guan, Ling-Yu Meng, Clinical Laboratory, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar 161000, Heilongjiang Province, China
Jia-Xin Chen, School of Public Health, Qiqihar Medical University, Qiqihar 161006, Heilongjiang Province, China
Wei Zhao, Clinical Laboratory, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar 161006, Heilongjiang Province, China
Author contributions: Liu QQ, Li YD, Chen JX, and Meng LY designed the experiments, conducted the clinical data collection and collation, and statistical analyses, wrote the original manuscript, and revised the paper; Zhang LL, Guan RC, and Zhao W performed the postoperative follow-up and recorded the data; All authors read and approved the final manuscript.
Supported by Health Commission of Heilongjiang Province, No. 0230404080031.
Institutional review board statement: This study was approved by the Ethics Committee of the Third Affiliated Hospital of Qiqihar Medical University.
Informed consent statement: The Ethics Committee agreed to waive informed consent.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ling-Yu Meng, Clinical Laboratory, The Third Affiliated Hospital of Qiqihar Medical University, No. 3 Taishun Street, Tiefeng District, Qiqihar 161000, Heilongjiang Province, China. 18345202361@163.com
Received: February 18, 2025 Revised: March 21, 2025 Accepted: April 21, 2025 Published online: June 15, 2025 Processing time: 115 Days and 6 Hours
Abstract
BACKGROUND
Primary liver cancer, predominantly hepatocellular carcinoma (HCC), is a major cause of cancer-related mortality. Transarterial chemoembolization (TACE) is a key palliative option for unresectable HCC. However, prognostic outcomes after TACE vary significantly. This study evaluated the prognostic value of the fibrinogen and neutrophil-to-lymphocyte ratio (F-NLR) score, serum alpha-fetoprotein (AFP), and prealbumin (PA) in patients undergoing TACE.
AIM
To investigate the prognostic significance of F-NLR score, AFP, and PA in patients undergoing TACE.
METHODS
Variables such as F-NLR score, AFP, PA, and other clinical indicators were assessed. Follow-ups determined prognosis as good or poor. Statistical assessments, including receiver operating characteristic analyses, were performed to evaluate the prognostic significance and develop an integrated predictive model.
RESULTS
A retrospective analysis of 162 patients with primary liver cancer undergoing TACE was conducted. Low F-NLR scores and AFP levels and high PA were significantly associated with a good prognosis. The combined model, which integrated F-NLR, AFP, and PA, demonstrated a favorable prognostic predictive capability, with an area under the curve of 0.933.
CONCLUSION
Preoperative F-NLR, AFP, and PA are valuable prognostic predictors in patients with HCC undergoing TACE.
Core Tip: This study investigated the prognostic value of combining the fibrinogen and neutrophil-to-lymphocyte ratio (F-NLR) score, alpha-fetoprotein (AFP), and prealbumin (PA) in patients with primary liver cancer undergoing transarterial chemoembolization. Our findings indicate that integrating F-NLR, which reflects systemic inflammation and coagulation status, AFP as a marker of tumor burden, and PA as an indicator of nutritional status and liver function, significantly enhances prognostic accuracy. This combined approach provides a basis for personalized treatment strategies, enabling precise identification of high-risk patients and optimizing therapeutic plans to improve outcomes.
