Prognostic significance of the fibrinogen-to-albumin ratio in gallbladder cancer patients

Table 1 Baseline characteristics of 154 gallbladder cancer patients who underwent potential curative cholecystectomy n (%)

Characteristic	Patients (n = 154)
Age (yr)	64 (29-85)
≤ 60	56 (36.4)
> 60	98 (63.6)
Sex
Male	63 (40.9)
Female	91 (59.1)
Cholecystolithiasis
Absent	79 (51.3)
Present	75 (48.7)
Diabetes
Absent	116 (75.3)
Present	38 (24.7)
Jaundice
Absent	129 (83.8)
Present	25 (8.9)
Blood groups
A	43 (27.9)
B	56 (36.4)
AB	9 (5.8)
O	46 (29.9)
Pathological types
Adenosquamous carcinoma	3 (1.9)
Adenocarcinoma	150 (97.4)
Papillocarcinoma	1 (0.6)
Degree of differentiation
Poor	60 (39.0)
Moderate-well	94 (61.0)
Resection margin status
Negative	96 (62.3)
Positive	58 (37.7)
Maximum tumor diameter (cm)	3 (0.2-13)
≤ 2.45	68 (44.2)
> 2.45	86 (55.8)
T stage
Tis-T1a	10 (6.5)
T1b-T2b	29 (18.8)
T3	103 (66.9)
T4	12 (7.8)
N stage
0	98 (63.6)
1	47 (30.5)
2	9 (5.8)
Distant metastasis
Absent	142 (92.2)
Present	12 (7.8)
TNM stage
0-Istage	16 (10.4)
IIA-IIB stage	16 (10.4)
IIIA-IIIB stage	92 (59.7)
IVA-IVB stage	30 (19.5)
CA199 (U/mL)	69.3 (0.6-10524)
≤ 39	66 (42.9)
> 39	88 (57.1)
Fibrinogen concentration (g/L)	3.54 (1.71-7.47)
≤ 3.47	75 (48.7)
> 3.47	79 (51.3)
Albumin levels (g/L)	41.0 (20.0-50.0)
≤ 40.5	78 (50.6)
> 40.5	76 (49.4)
FAR	0.09 (0.04-0.25)
≤ 0.08	71 (46.1)
> 0.08	83 (53.9)

FAR: Fibrinogen to albumin ratio.

Table 2 Correlation between fibrinogen concentration and clinicopathological characteristics in gallbladder cancer patients n (%)

Characteristics	Fibrinogen concentration		P value
	≤ 3.47 g/L (n = 75)	> 3.47 g/L (n = 79)
Age (yr)
≤ 60	31 (20.1)	25 (16.2)	0.243
> 60	44 (28.6)	54 (35.1)
Sex
Male	33 (21.4)	30 (19.5)	0.513
Female	42 (27.3)	49 (31.8)
Cholecystolithiasis
Absent	38 (24.7)	41 (26.6)	0.878
Present	37 (24.0)	38 (24.7)
Diabetes
Absent	57 (37.0)	59 (38.3)	0.850
Present	18 (11.7)	20 (13.0)
Jaundice
Absent	68 (44.2)	61 (39.6)	0.029
Present	7 (4.5)	18 (11.7)
Blood groups
A	19 (12.3)	24 (15.6)	0.145
B	33 (21.4)	23 (14.9)
AB	2 (1.3)	7 (4.5)
O	21 (13.6)	25 (16.2)
Pathological types
Adenosquamous carcinoma	0 (0)	3 (1.9)	0.142
Adenocarcinoma	75 (48.7)	75 (48.7)
Papillocarcinoma	0 (0)	1 (0.6)
Degree of differentiation
Poor	23 (14.9)	37 (24.0)	0.048
Moderate-well	52 (33.8)	42 (27.3)
Resection margin status
Negative	56 (36.4)	40 (26.4)	0.003
Positive	19 (12.3)	39 (25.3)
Maximum tumor diameter (cm)
≤ 2.45	34 (22.1)	34 (22.1)	0.871
> 2.45	41 (26.6)	45 (29.2)
T stage
Tis-T1a	8 (5.2)	2 (1.3)	< 0.001
T1b-T2b	22 (14.3)	7 (4.5)
T3	43 (27.9)	60 (39.0)
T4	2 (1.3)	10 (6.5)
N stage
N0	50 (32.5)	48 (31.2)	0.748
N1	21 (13.6)	26 (16.9)
N2	4 (2.6)	5 (3.2)
Distant metastasis
Absent	69 (44.8)	73 (47.4)	0.925
Present	6 (3.9)	6 (3.9)
TNM stage
0-Istage	12 (7.8)	4 (2.6)	0.011
IIA-IIB stage	12 (7.8)	4 (2.6)
IIIA-IIIB stage	39 (25.3)	53 (34.4)
IVA-IVB stage	12 (7.8)	18 (11.7)
CA199 (U/mL)
≤ 39	41 (26.6)	25 (16.2)	0.005
> 39	34 (22.1)	54 (35.1)
Albumin levels (g/L)
≤ 40.5	32 (20.8)	44 (28.6)	0.111
> 40.5	43 (27.9)	35 (22.7)
FAR
≤ 0.08	59 (38.3)	12 (7.8)	< 0.001
> 0.08	16 (10.4)	67 (43.5)

FAR: Fibrinogen to albumin ratio.

Table 3 Correlation between albumin levels and clinicopathological characteristics in gallbladder cancer patients n (%)

Characteristics	Albumin levels		P value
	≤ 40.5g/L(n = 76)	> 40.5 g/L(n = 78)
Age (yr)
≤ 60	22 (14.3)	34 (22.1)	0.067
> 60	54 (35.1)	44 (28.6)
Sex
Male	28 (18.2)	35 (22.7)	0.330
Female	48 (31.2)	43 (27.9)
Cholecystolithiasis
Absent	34 (22.1)	45 (29.2)	0.147
Present	42 (27.3)	33 (21.4)
Diabetes
Absent	53 (34.4)	63 (40.9)	0.136
Present	23 (14.9)	15 (9.7)
Jaundice
Absent	54 (35.1)	75 (48.7)	< 0.001
Present	22 (14.3)	3 (1.9)
Blood groups
A	20 (13.0)	23 (14.9)	0.046
B	34 (22.1)	22 (14.3)
AB	6 (7.9)	3 (3.8)
O	16 (21.1)	30 (19.5)
Pathological types
Adenosquamous carcinoma	0 (0)	3 (1.9)	0.137
Adenocarcinoma	75 (48.7)	75 (48.7)
Papillocarcinoma	1 (0.6)	0 (0.0)
Degree of differentiation
Poor	36 (23.4)	24 (15.6)	0.047
Moderate-well	40 (26.0)	54 (35.1)
Resection margin status
Negative	39 (25.3)	57 (37.0)	0.008
Positive	37 (24.0)	21 (13.6)
Maximum tumor diameter (cm)
≤ 2.45	36 (23.4)	32 (20.8)	0.516
> 2.45	40 (26.0)	46 (29.9)
T stage
Tis-T1a	2 (1.3)	8 (5.2)	0.021
T1b-T2b	9 (5.8)	20 (13.0)
T3	58 (37.7)	45 (29.2)
T4	7 (4.5)	5 (3.2)
N stage
N0	45 (29.2)	53 (34.4)	0.403
N1	25 (16.2)	22 (14.3)
N2	6 (3.9)	3 (1.9)
Distant metastasis
Absent	67 (43.5)	75 (48.7)	0.077
Present	9 (5.8)	3 (1.9)
TNM stage
0-Istage	3 (1.9)	13 (8.4)	0.007
IIA-IIB stage	6 (3.9)	10 (6.5)
IIIA-IIIB stage	46 (29.9)	46 (29.9)
IVA-IVB stage	21 (13.6)	9 (5.8)
CA199 (U/mL)
≤ 39	24 (15.6)	42 (27.3)	0.006
> 39	52 (33.8)	36 (23.4)
Fibrinogen concentration (g/L)			0.111
≤ 3.47g/L	32 (20.8)	43 (27.9)
> 3.47 g/L	44 (28.6)	35 (22.7)
FAR
≤ 0.08	21 (13.6)	50 (32.5)	< 0.001
> 0.08	55 (35.7)	28 (18.2)

FAR: Fibrinogen to albumin ratio.

Table 4 Correlation between FAR and clinicopathological characteristics in gallbladder cancer patients n (%)

Characteristics	FAR		P value
	≤ 0.08(n = 71)	> 0.08(n = 83)
Age (yr)
≤ 60	32 (20.8)	24 (15.6)	0.045
> 60	39 (25.3)	59 (38.3)
Sex
Male	30 (19.5)	33 (21.4)	0.870
Female	41 (26.6)	50 (32.5)
Cholecystolithiasis
Absent	37 (24.0)	42 (27.3)	0.873
Present	34 (22.1)	41 (26.6)
Diabetes
Absent	56 (36.4)	60 (39.0)	0.357
Present	15 (9.7)	23 (14.9)
Jaundice
Absent	67 (43.5)	62 (40.3)	< 0.001
Present	4 (2.6)	21 (13.6)
Blood groups
A	22 (14.3)	21 (13.6)	0.148
B	28 (18.2)	28 (18.2)
AB	1 (0.6)	8 (5.2)
O	20 (13.0)	26 (16.9)
Pathological types
Adenosquamous carcinoma	0 (0)	3 (1.9)	0.173
Adenocarcinoma	71 (46.1)	79 (51.3)
Papillocarcinoma	0 (0)	1 (0.6)
Degree of differentiation
Poor	18 (11.7)	42 (27.3)	0.002
Moderate-well	53 (34.4)	41 (26.6)
Resection margin status
Negative	55 (35.7)	41 (26.6)	< 0.001
Positive	16 (10.4)	42 (27.3)
Maximum tumor diameter (cm)
≤ 2.45	37 (24.0)	31 (20.1)	0.075
> 2.45	34 (22.1)	52 (33.8)
T stage
Tis-T1a	8 (5.2)	2 (1.3)	< 0.001
T1b-T2b	24 (15.6)	5 (3.2)
T3	36 (23.4)	67 (43.5)
T4	3 (1.9)	9 (5.8)
N stage
N0	48 (31.2)	50 (32.5)	0.623
N1	19 (12.3)	28 (18.2)
N2	4 (2.6)	5 (3.2)
Distant metastasis
Absent	68 (44.2)	74 (48.1)	0.145
Present	3 (1.9)	9 (5.8)
TNM stage
0-Istage	14 (9.1)	2 (1.3)	< 0.001
IIA-IIB stage	14 (9.1)	2 (1.3)
IIIA-IIIB stage	35 (22.7)	57 (37.0)
IVA-IVB stage	8 (5.2)	22 (14.3)
CA199 (U/mL)
≤ 39	43 (27.9)	23 (14.9)	< 0.001
> 39	28 (18.2)	60 (39.0)
Fibrinogen concentration (g/L)
≤ 3.47g/L	59 (38.3)	16 (10.4)	< 0.001
> 3.47 g/L	12 (7.8)	67 (43.5)
Albumin levels (g/L)
≤ 40.5g/L	21 (13.6)	55 (35.7)	< 0.001
> 40.5 g/L	50 (32.5)	28 (18.2)

Table 5 Univariate analysis of overall survival in gallbladder cancer patients

Characteristics	HR (95%CI)	P value
Age (yr)	1.473 (0.973-2.230)	0.067
≤ 60
> 60
Sex	0.995 (0.670-1.477)	0.981
Male
Female
Cholecystolithiasis	1.198 (0.814-1.764)	0.360
Absent
Present
Diabetes	1.028 (0.651-1.623)	0.906
Absent
Present
Jaundice	2.598 (1.644-4.106)	< 0.001
Absent
Present
Blood groups	-	0.113
A
B
AB
O
Pathological types	-	0.165
Adenosquamous carcinoma
Adenocarcinoma
Papillocarcinoma
Degree of differentiation	1.527 (1.031-2.261)	0.035
Poor
Moderate-well
Resection margin status	3.683 (2.468-5.496)	< 0.001
Negative
Positive
Maximum tumor diameter (cm)	1.101 (0.744-1.630)	0.631
≤ 2.45
> 2.45
T stage	-	< 0.001
Tis-T1a
T1b-T2b
T3
T4
N stage	-	< 0.001
0
1
2
Distant metastasis	2.550 (1.388-4.684)	0.003
Absent
Present
TNM stage	-	< 0.001
0-Istage
IIA-IIB stage
IIIA-IIIB stage
IVA-IVB stage
CA199 (U/mL)	3.125 (2.010-4.858)	< 0.001
≤ 39
> 39
Fibrinogen concentration (g/L)	2.795 (1.853-4.214)	< 0.001
≤ 3.47
> 3.47
Albumin levels (g/L)	0.391(0.259-0.590)	< 0.001
≤ 40.5
> 40.5
FAR	4.626(2.987-7.165)	< 0.001
≤ 0.08
> 0.08

FAR: Fibrinogen to albumin ratio; HR: Hazard ratio; CI: Confidence interval.

Table 6 Multivariate analysis for overall survival in gallbladder cancer patients

Characteristics	HR (95%CI)	Wald	P value
Resection margin status	2.343 (1.532-3.581)		< 0.001
Negative
Positive
TNM stage		8.595	0.035
IIA-IIB stage/0-1stage	1.209 (0.287-5.095)	0.067	0.796
IIIA-IIIB stage/0-1 stage	3.401 (1.033-11.202)	4.051	0.044
IVA-IVB stage/0-1 stage	4.014 (1.142-14.107)	4.696	0.030
FAR	2.813 (1.765-4.484)		< 0.001
≤ 0.08
> 0.08
Albumin levels (g/L)	0.595 (0.385-0.921)		0.020
≤ 40.5
> 40.5

FAR: Fibrinogen to albumin ratio; HR: Hazard ratio; CI: Confidence interval.