OBJECTIVE The purpose of this study was to evaluate the prognostic value of combined preoperative fibrinogen-albumin ratio and platelet-lymphocyte ratio score (FAR-PLR score) in breast cancer, and to establish a nomogram based on the score as well as clinicopathological factors to predict the prognosis of breast cancer. METHODS The study cohort included 707 breast cancer patients who underwent curative resection in Taizhou Hospital of Zhejiang Province, China from January 2010 to April 2016. FAR and PLR increased by 2 at the same time, only one index increased by 1, and none increased by 0. The relationship of preoperative FAR-PLR score with overall survival time (OS) and disease free survival time (DFS) in breast cancer was analyzed by log-rank test and COX proportional risk regression model, and a nomogram was established based on the results of multivariate analysis. RESULTS The average patient follow-up time was 61.2 months. The FAR-PLR score was conversely correlated with OS and DFS (P < 0.001). In the stage I-II group and III group, the FAR-PLR scores were significantly different among high, medium and low groups of OS and DFS (P < 0.01). FAR-PLR score was also found to be a powerful predictor of prognosis in Luminal B-like subtype, Her-2 overexpression subtype, and triple-negative subtype breast cancers; the higher the FAR-PLR score, the worse the prognosis. Forest charts and multivariate COX proportional risk regression model analysis showed that preoperative FAR-PLR score was an independent risk factor of OS (HR = 1.759, 95%CI = 1.410-2.210, P = 0.000) and DFS (HR = 1.729, 95%CI = 1.385-2.158, P = 0.000) in breast cancer. Based on the COX regression analysis of multiple factors, a nomogram prediction model for the survival of breast cancer was established. The calibration curve analysis indicated that the nomogram results were highly consistent between predicted and actual outcomes. Compared to stage (C-index of OS and DFS were 0.583 and 0.588 respectively), PR (C-index of OS and DFS were 0.592 and 0.592 respectively) and FAR-PLR score (C-index of OS and DFS were 0.592 and 0.591 respectively), the nomogram showed better predictive accuracy (C-index of OS and DFS were 0.652 and 0.651 respectively). CONCLUSIONS The results of this study suggest that preoperative FAR-PLR score may be a potential new biomarker for predicting survival and prognosis of breast cancer. A prognostic nomogram model based on preoperative FAR-PLR score and clinicopathological factors may help doctors make better clinical decisions for breast cancer treatment.

中文翻译：

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术前纤维蛋白原-白蛋白比值和血小板-淋巴细胞比值联合评分对乳腺癌患者的预后价值：诺模图预后研究。

目的本研究旨在评估术前纤维蛋白原-白蛋白比率和血小板-淋巴细胞比率得分（FAR-PLR得分）相结合的预后价值，并基于该得分和临床病理因素建立诺模图预测乳腺癌的预后。方法该研究队列纳入了2010年1月至2016年4月在中​​国浙江省台州医院接受根治性切除术的707例乳腺癌患者。FAR和PLR同时增加2，只有一项指数增加1，而没有一项增加。 0.通过log-rank检验和COX比例风险回归模型分析了乳腺癌术前FAR-PLR评分与总生存时间（OS）和无病生存时间（DFS）的关系，并根据多元分析结果建立了列线图。结果患者平均随访时间为61.2个月。FAR-PLR得分与OS和DFS相关（P <0.001）。在I-II组和III组，OS和DFS的高，中，低组之间的FAR-PLR得分显着不同（P <0.01）。还发现FAR-PLR分数是Luminal B样亚型，Her-2过表达亚型和三阴性亚型乳腺癌预后的有力预测指标。FAR-PLR分数越高，预后越差。森林图和多元COX比例风险回归模型分析表明，术前FAR-PLR评分是OS（HR = 1.759，95％CI = 1.410-2.210，P = 0.000）和DFS（HR = 1.729，95％）的独立危险因素CI = 1.385-2.158，P = 0。000）。基于多种因素的COX回归分析，建立了乳腺癌生存率的诺模图预测模型。校准曲线分析表明，诺模图结果与预测结果和实际结果高度一致。与阶段（OS和DFS的C指数分别为0.583和0.588）相比，PR（OS和DFS的C指数分别为0.592和0.592）和FAR-PLR得分（OS和DFS的C指数分别为0.592和0.591）列线图显示更好的预测准确性（OS和DFS的C指数分别为0.652和0.651）。结论这项研究的结果表明，术前FAR-PLR评分可能是预测乳腺癌生存和预后的潜在新生物标记。