A Nomogram Based on Fibrinogen-to-Neutrophil Ratio as a Novel Predictor of Lymph Node Metastasis in Patients with Cervical Cancer and Type 2 Diabetes Mellitus

Hongying Kuang,1,* Dongxia Yang,2,* Ruoyao Lin,3 Yaling Tang,4 Yongli Luo,3 Shuwen Wang,5 Tingting Xia,5 Ge Lou,6 Hong Chen4 1Department of Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150040, People’s Republi...

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Main Authors: Kuang H, Yang D, Lin R, Tang Y, Luo Y, Wang S, Xia T, Lou G, Chen H
Format: Article
Language:English
Published: Dove Medical Press 2025-05-01
Series:Cancer Management and Research
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Online Access:https://www.dovepress.com/a-nomogram-based-on-fibrinogen-to-neutrophil-ratio-as-a-novel-predicto-peer-reviewed-fulltext-article-CMAR
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author Kuang H
Yang D
Lin R
Tang Y
Luo Y
Wang S
Xia T
Lou G
Chen H
author_facet Kuang H
Yang D
Lin R
Tang Y
Luo Y
Wang S
Xia T
Lou G
Chen H
author_sort Kuang H
collection DOAJ
description Hongying Kuang,1,* Dongxia Yang,2,* Ruoyao Lin,3 Yaling Tang,4 Yongli Luo,3 Shuwen Wang,5 Tingting Xia,5 Ge Lou,6 Hong Chen4 1Department of Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150040, People’s Republic of China; 2Department of Gynecology, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150001, People’s Republic of China; 3Department of Clinical Medicine, School of Medicine, Xiamen University, Xiamen, Fujian, 361005, People’s Republic of China; 4Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, 361003, People’s Republic of China; 5Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen, Fujian, 361003, People’s Republic of China; 6Department of Gynecology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hong Chen, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, No. 150 Shanggu Street, Siming District, Xiamen, Fujian, 361003, People’s Republic of China, Tel +86 0592213 7307, Email jianguang09@163.comBackground: The rising incidence of cervical cancer among individuals with diabetes is a matter of significant concern, presenting profound implications for the health status and quality of life worldwide. In patients diagnosed with early-stage cervical cancer, the extent of lymph node involvement has emerged as a critical prognostic factor influencing recurrence risk and survival outcomes. Therefore, the precise prediction of pelvic lymph node metastasis is essential for an accurate assessment of prognosis. The preoperative identification of lymph node metastasis constitutes a pivotal element in the formulation of personalized treatment strategies. It has been demonstrated that inflammatory markers such as neutrophils, lymphocytes, and fibrinogen significantly contribute to cancer progression and prognostic evaluations. In this regard, we propose the fibrinogen-to-neutrophil ratio (FNR) as an innovative and promising biomarker for evaluating pelvic lymph node metastasis in cervical cancer patients with type 2 diabetes.Methods: The study was conducted on 141 patients diagnosed with cervical cancer and concomitant type 2 diabetes, who were treated at the First Affiliated Hospital of Xiamen University. The patients were randomly divided into a training set (n=98) and a validation set (n=43), with a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors, and a prognostic model was established based on these findings. The model’s effectiveness was evaluated.Results: A nomogram that integrates multiple factors, including FNR, triglycerides, maximum diameter, and total protein, demonstrates superior potential in predicting pelvic lymph node metastasis in patients with type 2 diabetes and cervical cancer, compared to the use of a single biomarker.Conclusion: As a comprehensive biomarker, FNR shows significant potential in offering a more thorough and reliable approach for identifying cervical cancer patients with diabetes who are at an elevated risk of lymph node metastasis.Keywords: cervical cancer, diabetes mellitus, pelvic lymph node metastasis, fibrinogen-to-neutrophil ratio, inflammatory biomarkers, preoperative prediction
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spelling doaj-art-35f785867a6e4b949f28480c4ffa5e652025-08-20T02:15:29ZengDove Medical PressCancer Management and Research1179-13222025-05-01Volume 17Issue 1933954102849A Nomogram Based on Fibrinogen-to-Neutrophil Ratio as a Novel Predictor of Lymph Node Metastasis in Patients with Cervical Cancer and Type 2 Diabetes MellitusKuang H0Yang D1Lin R2Tang Y3Luo YWang S4Xia TLou G5Chen H6gynecologyDepartment of GynecologyMedical departmentgynecologyThe First Affiliated Hospital of Xiamen UniversityDepartment of GynecologyDepartment of Obstetrics and GynecologyHongying Kuang,1,* Dongxia Yang,2,* Ruoyao Lin,3 Yaling Tang,4 Yongli Luo,3 Shuwen Wang,5 Tingting Xia,5 Ge Lou,6 Hong Chen4 1Department of Gynecology, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150040, People’s Republic of China; 2Department of Gynecology, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150001, People’s Republic of China; 3Department of Clinical Medicine, School of Medicine, Xiamen University, Xiamen, Fujian, 361005, People’s Republic of China; 4Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, 361003, People’s Republic of China; 5Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen, Fujian, 361003, People’s Republic of China; 6Department of Gynecology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, 150081, People’s Republic of China*These authors contributed equally to this workCorrespondence: Hong Chen, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, No. 150 Shanggu Street, Siming District, Xiamen, Fujian, 361003, People’s Republic of China, Tel +86 0592213 7307, Email jianguang09@163.comBackground: The rising incidence of cervical cancer among individuals with diabetes is a matter of significant concern, presenting profound implications for the health status and quality of life worldwide. In patients diagnosed with early-stage cervical cancer, the extent of lymph node involvement has emerged as a critical prognostic factor influencing recurrence risk and survival outcomes. Therefore, the precise prediction of pelvic lymph node metastasis is essential for an accurate assessment of prognosis. The preoperative identification of lymph node metastasis constitutes a pivotal element in the formulation of personalized treatment strategies. It has been demonstrated that inflammatory markers such as neutrophils, lymphocytes, and fibrinogen significantly contribute to cancer progression and prognostic evaluations. In this regard, we propose the fibrinogen-to-neutrophil ratio (FNR) as an innovative and promising biomarker for evaluating pelvic lymph node metastasis in cervical cancer patients with type 2 diabetes.Methods: The study was conducted on 141 patients diagnosed with cervical cancer and concomitant type 2 diabetes, who were treated at the First Affiliated Hospital of Xiamen University. The patients were randomly divided into a training set (n=98) and a validation set (n=43), with a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors, and a prognostic model was established based on these findings. The model’s effectiveness was evaluated.Results: A nomogram that integrates multiple factors, including FNR, triglycerides, maximum diameter, and total protein, demonstrates superior potential in predicting pelvic lymph node metastasis in patients with type 2 diabetes and cervical cancer, compared to the use of a single biomarker.Conclusion: As a comprehensive biomarker, FNR shows significant potential in offering a more thorough and reliable approach for identifying cervical cancer patients with diabetes who are at an elevated risk of lymph node metastasis.Keywords: cervical cancer, diabetes mellitus, pelvic lymph node metastasis, fibrinogen-to-neutrophil ratio, inflammatory biomarkers, preoperative predictionhttps://www.dovepress.com/a-nomogram-based-on-fibrinogen-to-neutrophil-ratio-as-a-novel-predicto-peer-reviewed-fulltext-article-CMARCervical CancerDiabetes MellitusPelvic Lymph Node MetastasisFibrinogen-To-Neutrophil RatioInflammatory BiomarkersPreoperative Prediction
spellingShingle Kuang H
Yang D
Lin R
Tang Y
Luo Y
Wang S
Xia T
Lou G
Chen H
A Nomogram Based on Fibrinogen-to-Neutrophil Ratio as a Novel Predictor of Lymph Node Metastasis in Patients with Cervical Cancer and Type 2 Diabetes Mellitus
Cancer Management and Research
Cervical Cancer
Diabetes Mellitus
Pelvic Lymph Node Metastasis
Fibrinogen-To-Neutrophil Ratio
Inflammatory Biomarkers
Preoperative Prediction
title A Nomogram Based on Fibrinogen-to-Neutrophil Ratio as a Novel Predictor of Lymph Node Metastasis in Patients with Cervical Cancer and Type 2 Diabetes Mellitus
title_full A Nomogram Based on Fibrinogen-to-Neutrophil Ratio as a Novel Predictor of Lymph Node Metastasis in Patients with Cervical Cancer and Type 2 Diabetes Mellitus
title_fullStr A Nomogram Based on Fibrinogen-to-Neutrophil Ratio as a Novel Predictor of Lymph Node Metastasis in Patients with Cervical Cancer and Type 2 Diabetes Mellitus
title_full_unstemmed A Nomogram Based on Fibrinogen-to-Neutrophil Ratio as a Novel Predictor of Lymph Node Metastasis in Patients with Cervical Cancer and Type 2 Diabetes Mellitus
title_short A Nomogram Based on Fibrinogen-to-Neutrophil Ratio as a Novel Predictor of Lymph Node Metastasis in Patients with Cervical Cancer and Type 2 Diabetes Mellitus
title_sort nomogram based on fibrinogen to neutrophil ratio as a novel predictor of lymph node metastasis in patients with cervical cancer and type 2 diabetes mellitus
topic Cervical Cancer
Diabetes Mellitus
Pelvic Lymph Node Metastasis
Fibrinogen-To-Neutrophil Ratio
Inflammatory Biomarkers
Preoperative Prediction
url https://www.dovepress.com/a-nomogram-based-on-fibrinogen-to-neutrophil-ratio-as-a-novel-predicto-peer-reviewed-fulltext-article-CMAR
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