{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T16:15:04Z","timestamp":1773332104585,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,2,4]],"date-time":"2020-02-04T00:00:00Z","timestamp":1580774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,2,4]],"date-time":"2020-02-04T00:00:00Z","timestamp":1580774400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,2,4]],"date-time":"2020-02-04T00:00:00Z","timestamp":1580774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"name":"Startup Fund for Scientific Research, Fujian Medical University","award":["2017XQ1028"],"award-info":[{"award-number":["2017XQ1028"]}]},{"DOI":"10.13039\/501100017682","name":"Construction Project of Fujian Province Minimally Invasive Medical Center","doi-asserted-by":"crossref","award":["[2017]171"],"award-info":[{"award-number":["[2017]171"]}],"id":[{"id":"10.13039\/501100017682","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Young and Middle-aged Backbone Training Project in the Health System of Fujian province","award":["2019-ZQN-45"],"award-info":[{"award-number":["2019-ZQN-45"]}]},{"name":"Joint Funds for the Innovation of Science and Technology, Fujian province","award":["2018Y9030"],"award-info":[{"award-number":["2018Y9030"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Coagulation and inflammation play important roles in tumor progression. This study aimed to explore the prognostic impact of combined analysis of fibrinogen and neutrophil\u2010to\u2010lymphocyte (NLR) ratio (F\u2010NLR score) in locally advanced rectal cancer (LARC) receiving preoperative chemoradiotherapy (pCRT) and radical surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Totally 317 patients were included. X\u2010tile analysis was used to determine the optimal cutoff values of preoperative fibrinogen and NLR. F\u2010NLR scores were defined as 2 (both high fibrinogen and NLR), 1 (one of these abnormalities), or 0 (neither abnormality). Time\u2010dependent ROC analysis was used to evaluate the predictive accuracy of fibrinogen, NLR, and F\u2010NLR score. Cox regression analysis was performed to evaluate the prognostic impact of the F\u2010NLR score. A predictive nomogram for disease\u2010free survival (DFS) was developed and validated internally.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and seventeen (36.9%), 156 (49.2%), and 44 (13.9%) patients had F\u2010NLR score of 0, 1, and 2, respectively. Higher F\u2010NLR score was associated with poorly differentiated tumors, deeper tumor invasion, lymph node metastasis, and more advanced pTNM stage (all <jats:italic>P\u2009<\/jats:italic>&lt;\u20090.05). The 5\u2010year OS rates in the F\u2010NLR 0, 1, and 2\u00a0groups were 93.6%, 87.3%, and 68.4%, respectively (<jats:italic>P\u2009<\/jats:italic>&lt;\u20090.001), while the 5\u2010year DFS rates were 91.8%, 76.8%, and 56.1%, respectively (<jats:italic>P\u2009<\/jats:italic>&lt;\u20090.001). Cox regression analysis demonstrated that F\u2010NLR score (F\u2010NLR 1, HR\u2009=\u20092.021, <jats:italic>P\u2009<\/jats:italic>=\u20090.046; F\u2010NLR 2, HR\u2009=\u20093.356, <jats:italic>P\u2009<\/jats:italic>=\u20090.002), pTNM stage III (HR\u2009=\u20093.109, <jats:italic>P\u2009<\/jats:italic>=\u20090.009), and circumferential resection margin (CRM) involvement (HR\u2009=\u20093.120, <jats:italic>P\u2009<\/jats:italic>=\u20090.021) were independently associated with DFS. A nomogram for DFS was developed (C\u2010index 0.708).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>F\u2010NLR score is a promising predictor for disease recurrence in LARC patients after pCRT.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05407-3","type":"journal-article","created":{"date-parts":[[2020,2,4]],"date-time":"2020-02-04T17:45:25Z","timestamp":1580838325000},"page":"1975-1984","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Combination of Preoperative Plasma Fibrinogen and Neutrophil\u2010to\u2010Lymphocyte Ratio (the F\u2010NLR Score) as a Prognostic Marker of Locally Advanced Rectal Cancer Following Preoperative Chemoradiotherapy"],"prefix":"10.1002","volume":"44","author":[{"given":"Yanwu","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Fujian Medical University Union Hospital 29 Xinquan Road 350001 Fuzhou Fujian People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiyi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Fujian Medical University Union Hospital 29 Xinquan Road 350001 Fuzhou Fujian People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhekun","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Fujian Medical University Union Hospital 29 Xinquan Road 350001 Fuzhou Fujian People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiming","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Fujian Medical University Union Hospital 29 Xinquan Road 350001 Fuzhou Fujian People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingrong","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Fujian Medical University Union Hospital 29 Xinquan Road 350001 Fuzhou Fujian People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Fujian Medical University Union Hospital 29 Xinquan Road 350001 Fuzhou Fujian People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pan","family":"Chi","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Fujian Medical University Union Hospital 29 Xinquan Road 350001 Fuzhou Fujian People's Republic of China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,2,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(11)70097\u20103"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.40.1836"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(15)00159\u2010X"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2011.02.013"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju124"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.28536"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12075"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957\u2010015\u20100543\u20104"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S175780"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.7150\/jca.26360"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010010\u20101054\u2010y"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.5754\/hge11133"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2015.4049"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/cas.13127"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcp.26239"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078\u20100432.CCR\u201004\u20100713"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1349\u20107006.2009.01115.x"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31826fcbdb"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2015.10.002"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.306853"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008\u20105472.CAN\u201009\u20103465"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2012.08.003"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc2748"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2014.90"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2013.05.006"}],"container-title":["World 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