Prognostic value of AFR,NLR and PLR for locally advanced gastric cancer after laparoscopic radical gastrectomy

HUANG Chuanjiang; ZHAO Xiaojun; YOU Xiaolan; LIU Guiyuan; CHENG Zhiyi

doi:10.3969/j.issn.2095-8331.2025.05.011

Abstract：Objective To assess the predictive value of the albumin-to-fibrinogen ratio(AFR),neutrophil-to-lymphocyte ratio(NLR),and platelet-to-lymphocyte ratio(PLR)as prognostic predictors for locally advanced gastric cancer after laparoscopic radical gastrectomy.Methods The study employed a retrospective cohort design,from May 2019 to May 2022,107 patients with locally advanced gastric cancer treated by laparoscopic radical gastrectomy were selected from Taizhou People's Hospital Affiliated to Nanjing Medical University,and their peripheral blood AFR,NLR and PLR were detected within one week before operation.Identification of the optimal AFR,NLR and PLR cut-off values for 3-year mortality prediction was performed via receiver operating characteristic(ROC)curve analysis.Based on the optimal cut-off values,patients were stratified into high-and low-risk groups for AFR,NLR and PLR,respectively.Subsequently,the associations of these stratified groups with patient survival and prognosis were analyzed,followed by assessment of independent factors influencing postoperative prognosis.Results ROC curve analysis showed that the optimal cut-off values of AFR,NLR and PLR were 14.80,2.67 and 186.18,respectively.Cox univariate and multivariate analysis showed that age,tumor size,pathological differentiation,AFR,NLR and PLR were all influencing factors for the prognosis of patients with locally advanced gastric cancer after laparoscopic radical surgery(P<0.05).Conclusion Preoperative AFR,NLR and PLR demonstrate significant prognostic value and may serve as potential biomarkers for locally advanced gastric cancer patients undergoing laparoscopic radical gastrectomy.