Preoperative Neutrophil-Lymphocyte Ratio (NLR)-Binding Fibrinogen-Albumin Ratio (FAR) Is Superior to Platelet-Lymphocyte Ratio (PLR)-Binding Fibrinogen-Albumin Ratio (FAR) and Lymphocyte-Monocyte (LMR)-Binding Fibrinogen-Albumin Ratio (FAR) as Predictors of Survival in Surgical Patients with Colorectal Adenocarcinoma

BACKGROUND: Studies have revealed that having systemic inflammation is linked to worse survival rates across a range of malignancies. This study aimed to evaluate the predictive significance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) in combination with fibrinogen-to-albumin ratio (FAR) in surgical patients with colorectal adenocarcinoma (CRC). MATERIAL/METHODS: From January 2010 to December 2016, 200 patients with CRC had their preoperative NLR, PLR, LMR, and FAR assessed. Following that, univariate and multivariate analytic techniques were used to establish the prognostic value of these 4 indicators. Plotting the receiver operating characteristic (ROC) curves allowed researchers to assess whether the NLR-FAR, PLR-FAR, and LMR-FAR could be applied to predict survival. RESULTS: High preoperative NLR (≥3.9 vs <3.9, P<0.001), high preoperative PLR (≥106 vs <106, P=0.039), low preoperative LMR (≥4.2 vs <4.2, P<0.001), and high preoperative FAR (≥0.09 vs <0.09, P=0.028) were significantly associated with worse overall survival in multivariate analysis, which was also confirmed with survival curves. The prediction outcomes of the combined components outperformed those of a single index. NLR-FAR outperformed PLR-FAR and LMR-FAR as a predictor of CRC, with an area under the curve (AUC) of 97.24% (95% confidence interval (CI)=0.9535 to 0.9915, P<0.0001), 92.57% (95% CI=0.8880 to 0.9634, P<0.0001), and 90.26% (95% CI=0.8515 to 0.9538, P<0.0001). CONCLUSIONS: In patients with CRC, preoperative NLR, PLR, LMR, and FAR can be utilized as independent predictors of overall survival. Additionally, in the combined detection findings, NLR and FAR performed better as predictors of CRC patients than PLR-FAR and LMR-FAR.