Efficacy of the albumin-to-fibrinogen ratio as a predictive marker of advanced-stage cervical cancer

Background: Cervical cancer is the fourth most prevalent cause of mortality from cancer in women worldwide. Inflammation is a significant predictor of cancer. Indications of inflammation include a high fibrinogen level and a low albumin level. Increased fibrinogen levels have been connected to the development and spread of cancer as well as a pro-inflammatory condition. The albumin/fibrinogen ratio (AFR), which is a combination of albumin and fibrinogen, has been proposed as a novel marker of inflammation. Therefore, this study aimed to evaluate the efficacy of the albumin-to-fibrinogen ratio as a predictive marker of advanced-stage cervical cancer. Methods: This was a prospective observational study conducted in the department of gynecological oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from July 2022 to June 2023. In our study, we included 70 women with biopsy-proven cervical cancer attending the inpatient and outpatient departments of the gynecological oncology department at BSMMU. Results: The mean age of the patients was 45.37±9.54 years. The mean albumin to fibrinogen ratio was lower in the advanced-stage group (9.77±1.21) compared to that in the early-stage group (10.74±1.54) and the difference between the two groups was statistically highly significant (p=0.005). Considering 10.7 as the cut-off value (by ROC curve) we found the sensitivity, specificity, PPV, and NPV for AFR<10.7 was 85.71%, 62.86%, 69.77%, and 81.48%, respectively. Conclusions: Our study findings show that the albumin-to-fibrinogen ratio (AFR) emerges as a promising prognostic marker to differentiate between advanced and early-stage cases and could aid in clinical decision-making.