Prognostic value of preoperative white blood cell to hemoglobin ratio and fibrinogen to albumin ratio in patients with colorectal cancer

Abstract

The prognostic value of preoperative white blood cell to hemoglobin ratio (WHR) and fibrinogen to albumin ratio (FAR) in colorectal cancer (CRC) is unknown. The purpose of this study was to analyze the correlation between preoperative WHR and FAR and the prognosis of CRC patients. The retrospective study analyzed the medical records of 207 patients with colorectal cancer who were admitted to Linyi People's Hospital between June 1, 2017 and June 1, 2021. The receiver operator curve was used to determine the cutoff value of 4.604 for WHR and 0.086 for FAR, and the patients were divided into high and low groups for comparative analysis of clinical data. Cox proportional hazards regression models were used to assess independent risk factors for disease-free survival (DFS) and overall survival (OS) in univariate and multifactorial analyses. Kaplan-Meier methods were used for survival analysis and logrank tests were used to assess survival differences. Multifactorial Cox analysis showed that tumor pathological stage (HR = 6.224, 95% CI:3.063-12.647, P < .001), and WHR (HR = 3.681, 95% CI:1.768-7.401, P < .001) were the independent risk factors for DFS in CRC patients. Tumor pathological stage (HR = 4.080, 95% CI:1.992-8.360, P < .001), and WHR (HR = 3.397, 95% CI:1.662-6.940, P = .001) were independent risk factors for OS. High levels of WHR and high levels of FAR were associated with lower DFS (P < .001) and OS (P < .001).CRC patients with both higher WHR and FAR had significantly lower DFS (P < .001) and OS (P < .001). DFS and OS may be shorter in CRC patients with high WHR and high FAR, perhaps associated with poor prognosis in CRC patients, and WHR and FAR may be potential CRC prognostic markers.

Figure 1.

ROC curves of WHR, FAR. FAR = fibrinogen to albumin ratio, ROC = receiver operator curve, WHR=white blood cell to hemoglobin ratio.

Figure 2.

Kaplan–Meier analysis curves of WHR and FAR on DFS and OS in colorectal cancer patients.(A) Kaplan–Meier analysis curve of WHR on DFS in colorectal cancer patients. (B) Kaplan–Meier analysis curve of WHR on OS in colorectal cancer patients. (C) Kaplan–Meier analysis curve of FAR on DFS in colorectal cancer patients. (D) Kaplan–Meier analysis curve of FAR on OS in colorectal cancer patients. DFS = disease-free survival, FAR = fibrinogen to albumin ratio, OS = overall survival, ROC = receiver operator curve, WHR=white blood cell to hemoglobin ratio.

Figure 3.

Kaplan–Meier analysis curves for DFS (A) and OS (B) after WHR combined with FAR. DFS = disease-free survival, FAR = fibrinogen to albumin ratio, OS = overall survival, WHR=white blood cell to hemoglobin ratio.