Prognostic value of preoperative fibrinogen, neutrophil-to-lymphocyte ratio, serum alpha-fetoprotein, and prealbumin for patients with primary liver cancer undergoing transarterial chemoembolization

Table 1 Demographics of participants, n (%)

Parameters	Good prognosis group (n = 88)	Poor prognosis group (n = 74)	t/χ2	P value
Sex (male)	72 (81.82)	58 (78.38)	0.300	0.584
Age (years)	61.64 ± 8.25	61.78 ± 9.99	0.103	0.918
Body mass index (kg/m²)	24.46 ± 2.40	24.44 ± 2.41	0.036	0.971
Diabetes	13 (14.77)	10 (13.51)	0.052	0.819
Hypertension	23 (26.14)	20 (27.03)	0.016	0.898
Smoking history	24 (27.27)	25 (33.78)	0.808	0.369
Drinking history	26 (29.55)	22 (29.73)	0.001	0.980
Family history of liver cancer	14 (15.91)	9 (12.16)	0.463	0.496
Hepatitis B	67 (76.14)	49 (66.22)	1.946	0.163
Hepatitis C	8 (9.09)	18 (24.32)	6.923	0.009
Cirrhosis	66 (75)	48 (64.86)	1.980	0.159

Table 2 Baseline disease-related features of participants, n (%)

Parameters	Good prognosis group (n = 88)	Poor prognosis group (n = 74)	W/χ2	P value
Tumor diameter (cm)	4.2 (3, 7)	5.2 (3.12, 10)	2629.500	0.035
Number of tumors	19 (21.59)	27 (36.49)	4.387	0.036
Tumor thrombus	58 (65.91)	44 (59.46)	0.717	0.397
Vascular invasion	49 (55.68)	47 (63.51)	1.021	0.312
Child-Pugh grade (A/BC)	60 (68.18)/28 (31.82)	52 (70.27)/22 (29.73)	0.082	0.774
BCLC grade (A/≥ B)	42 (47.73)/46 (52.27)	37 (50)/37 (50)	0.083	0.773
Ascites	41 (46.59)	42 (56.76)	1.663	0.197
Portal hypertension	52 (59.09)	46 (62.16)	0.159	0.690
Portal vein thrombosis	45 (51.14)	52 (70.27)	6.126	0.013
Length of hospital stay (days)	7 (5, 14)	7.5 (2, 15)	3779.500	0.078
Duration of surgery (minutes)	85 (80, 110)	80 (70, 88)	3948.000	0.019

BCLC: Barcelona Clinic Liver Cancer.

Table 3 Comparison of coagulation index between the two groups

Parameters	Good prognosis group (n = 88)	Poor prognosis group (n = 74)	W/t	P value
PT (second)	12 (11.07, 13.12)	12.2 (11.43, 12.9)	3047.000	0.483
TT	17.20 ± 1.56	17.02 ± 1.77	0.709	0.479
APTT	28.4 (27.2, 29.95)	28.6 (26.88, 30.2)	3185.000	0.813
INR	1.04 (0.95, 1.15)	1.06 (0.99, 1.14)	3005.000	0.399

APTT: Activated partial thromboplastin time; INR: International normalized ratio; PT: Prothrombin time; TT: Thrombin time.

Table 4 Comparison of fibrinogen and neutrophil-to-lymphocyte ratio score between the two groups, n (%)

Parameters	Good prognosis group (n = 88)	Poor prognosis group (n = 74)	W/t/χ2	P value
FIB (g/L)	2.66 (2.13, 3.2)	2.67 (2.12, 3.71)	3058.500	0.508
NLR	3.18 ± 0.97	3.87 ± 1.86	2.872	0.005
F-NLR (0/1/2)	39 (44.32)/32 (36.36)/17 (19.32)	15 (20.27)/32 (43.24)/27 (36.49)	11.818	0.003

FIB: Fibrinogen; F-NLR: Fibrinogen and neutrophil-to-lymphocyte ratio; NLR: Neutrophil-lymphocyte ratio.

Table 5 Correlation analysis

Parameters	r	P value
Hepatitis C (no/yes: 0/1)	0.207	0.008
Tumor diameter (cm)	0.166	0.035
Number of tumors (no/yes: 0/1)	0.165	0.036
Portal vein thrombosis (no/yes: 0/1)	0.194	0.013
Duration of surgery (minutes)	-0.185	0.018
AFP (ng/mL)	0.842	p < 0.001
AST (U/L)	0.181	0.021
PA (mg/L)	-0.216	0.006
FIB (g/L)	0.201	0.010
NLR	0.191	0.015
F-NLR (0/1/2)	0.266	p < 0.001

AFP: Alpha-fetoprotein; AST: Aspartate aminotransferase; FIB: Fibrinogen; F-NLR: Fibrinogen and neutrophil-to-lymphocyte ratio; NLR: Neutrophil-lymphocyte ratio; PA: Prealbumin.

Table 6 Predictive value of factors in primary liver cancer patients undergoing transarterial chemoembolization

Parameters	Best_threshold	Sensitivities	Specificities	AUC	Youden_index	F1_score
Hepatitis C (no/yes: 0/1)	0.500	0.243	0.909	0.576	0.152	0.360
Tumor diameter (cm)	9.100	0.324	0.886	0.596	0.210	0.444
Number of tumors (no/yes: 0/1)	0.500	0.365	0.784	0.574	0.149	0.450
Portal vein thrombosis (no/yes: 0/1)	0.500	0.703	0.489	0.596	0.192	0.608
Duration of surgery (minutes)	97.500	0.932	0.352	0.606	0.284	0.091
AFP (ng/mL)	74.000	0.986	1.000	0.986	0.986	0.993
AST (U/L)	45.500	0.581	0.705	0.605	0.286	0.601
PA (mg/L)	168.25	0.662	0.602	0.625	0.264	0.329
FIB (g/L)	3.215	0.473	0.795	0.617	0.268	0.551
NLR	4.495	0.351	0.920	0.610	0.271	0.486
F-NLR (0/1/2)	0.500	0.797	0.443	0.645	0.240	0.648

AUC: Area under the curve; AFP: Alpha-fetoprotein; AST: Aspartate aminotransferase; FIB: Fibrinogen; F-NLR: Fibrinogen and neutrophil-to-lymphocyte ratio; NLR: Neutrophil-lymphocyte ratio; PA: Prealbumin.