International Journal of General Medicine (May 2021)

The Prognostic Role and Nomogram Establishment of a Novel Prognostic Score Combining with Fibrinogen and Albumin Levels in Patients with WHO Grade II/III Gliomas

  • Jia T,
  • Zhang R,
  • Kong F,
  • Zhang Q,
  • Xi Z

Journal volume & issue
Vol. Volume 14
pp. 2137 – 2145

Abstract

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Tianshu Jia,1 Rui Zhang,1 Fanfei Kong,2 Qianjiao Zhang,3 Zhuo Xi1 1Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China; 2Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, People’s Republic of China; 3Pain Department, The People’s Hospital of Liaoning Province, Shenyang, People’s Republic of ChinaCorrespondence: Zhuo XiDepartment of Neurosurgery, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang, People’s Republic of ChinaTel +86 189 4025 8425Email [email protected]: World Health Organization (WHO) Grades II and III gliomas [also known as low grade gliomas (LGGs)] displayed different malignant behaviors and survival outcomes compared to Grade IV gliomas. This study aimed to identify the prognostic predictive value of a novel cumulative prognostic score [combined with fibrinogen and albumin levels (FA score)], establish and validate a point-based nomogram in LGG patients.Patients and Methods: A total of 91 patients who underwent total glioma resection at Shengjing Hospital of China Medical University between 2011 and 2013 were enrolled to establish a prognostic nomogram. All patients were histologically diagnosed as grades II/III, and never received radiotherapy or chemotherapy before surgery. Data collection included patient characteristics, clinicopathological factors, and preoperative hematology results. The performance of the nomogram was subsequently validated by the concordance index (c-index), calibration curve, and receiver operating characteristic (ROC) curve.Results: The FA score was negatively associated with the overall survival (OS) of LGG patients (p < 0.001). The results of multivariate analysis showed that FA score [p = 0.006, HR = 1.92, 95% confidence interval (CI): 1.21– 3.05], age (p = 0.002, HR = 3.014, 95% CI:1.52– 5.97), and white blood count (p < 0.001, HR = 4.24, 95% CI: 2.08– 8.67) were independent prognostic factors for overall survival (OS). The study established a nomogram to predict OS with a c-index of 0.783 (95% CI, 0.72– 0.84).Conclusion: FA score might be a potential prognostic biomarker for LGG patients, and a reliable point-based nomogram will help clinicians to decide on the best treatment plans.Keywords: prognostics, fibrinogen, albumin, low-grade gliomas, nomogram

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