Abstract: OBJECTIVE: To investigate significance of fibrinogen (FIB), fibrinogen to albumin ratio (FAR) and serum tumor markers in the diagnosis and clinical progression of esophageal squamous cell carcinoma (ESCC). METHODS: Sixty-six ESCC patients who were admitted to the Fourth Hospital of Hebei Medical University from April 2018 to October 2021 were selected as the ESCC group. Clinicopathological data and laboratory test indexes of these patients at initial diagnosis were collected. Clinicopathological data,blood routine, coagulation function, biochemistry, serum tumor markers[including Carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC-Ag)] and other laboratory test indicators were collected at the time of initial diagnosis of ESCC patients. Another 30 healthy patients without benign and malignant tumors and cardiovascular diseases were selected as the control group. The differences among indicators between the two groups were compared,and expression levels of different results in different TNM stages were analyzed, and ROC curves was made to evaluate the predictive value of FIB, FAR, CEA and SCC- Ag for clinical propression of EXCC. Correlations between these indicators and clinicopathological features were analyzed. RESULTS: FIB, FAR, ratios of fibrinogen to prealbumin (FPR), ratios of neutrophil to lymphocyte (NLR) NLR and ratios of platelets to lymphocytes (PLR) in the ESCC group were significantly higher than those in the control group (P<0.05). The levels of FIB, FAR, CEA and SCC-Ag in stage III-IV were significantly higher than those in stage I-II. Meanwhile, ROC curves showed that FIB, FAR, CEA and SCC-Ag had predictive values for the clinical progression of ESCC (P<0.05),and combined detection of the four had higher diagnostic value for the clinical progress of ESCC. N stage and TNM stage in high FIB,FAR and SCC-Ag groups (which is object to the cut off value of ROC curve) were significantly higher than those in the low FIB,FAR and SCC-Ag groups (P<0.05). The maximum tumor diameters and T stages of patients with high FAR values were also significantly higher than those of patients with low values (P<0.05). TNM stages of patients with high CEA values were significantly higher than that of patients with low values, and male patients were more than female patients (P<0.05). CONCLUSION: Levels of plasma FIB,FAR,and serum CEA,SCC-Ag were closely related to the diagnosis and clinical progress of ESCC. Compared with detection of tumor markers in serum alone,the combined detection of the four methods showed better clinical efficacy in differentiating the clinical progress of ESCC,therefore,they are worthy of clinical applications.

Key words: FIB, FAR, serum tumor markers, esophageal squamous cell carcinoma, tumor progression