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Zhang X, Qiu X, Yin H, Zhao W, Song L, Zhang X, Yang L, Tao M. The combination of preoperative fibrinogen-to-albumin ratio and postoperative TNM stage (FAR-TNM) predicts the survival in gastric cancer patients after gastrectomy. Biomarkers 2023; 28:714-721. [PMID: 38059615 DOI: 10.1080/1354750x.2023.2281870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 11/05/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE There are many factors that affect the survival of patients with gastric cancer, such as TNM stage, the patient's nutritional status, inflammation, and so on. In this study, the prognostic significance of preoperative fibrinogen-to-albumin ratio (FAR) and postoperative TNM staging in patients with gastric cancer was retrospectively studied. METHODS A total of 265 patients (surgery dates from January 2007 to December 2013) were included in this retrospective study. All the patients were confirmed by pathology after operation. Categorical variables were compared using the χ2 test. Kaplan-Meier and log-rank tests were used for survival analysis. Cox proportional hazard models were used to assess prognostic factors. Nomogram was applied to predict the prognosis of overall survival (OS). RESULTS The higher the FAR value, the more lymph node metastasis, the later the TNM stage, and the shorter the survival time. We established a new scoring system, the FAR-TNM score, which combined FAR and TNM stage. The FAR-TNM score was significantly related to tumor location, tumor size, Bormann types, differentiation, operative type, vascular invasion, nerve invasion, depth of invasion, lymphatic metastasis, and advanced TNM stage. Multivariate Cox regression analysis demonstrated that tumor location, TNM stage, adjuvant chemotherapy, and FAR-TNM score were independent prognostic elements for OS in patients with GC. CONCLUSIONS The FAR-TNM score was a valuable independent prognostic indicator for GC patients after surgery, which can help clinicians to assist the treatment and long-term management of patients with gastric cancer.
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Affiliation(s)
- Xunlei Zhang
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Department of Oncology, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China
| | - Xinyue Qiu
- Department of Oncology, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China
| | - Haibing Yin
- Department of Pathology, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China
| | - Wenjing Zhao
- Cancer Research Center, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China
| | - Li Song
- Department of Oncology, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China
| | - Xingsong Zhang
- Department of Pathology, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China
| | - Lei Yang
- Department of Oncology, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China
| | - Min Tao
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
- Department of Oncology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, Jiangsu, China
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Cao W, Tang Q, Zeng J, Jin X, Zu L, Xu S. A Review of Biomarkers and Their Clinical Impact in Resected Early-Stage Non-Small-Cell Lung Cancer. Cancers (Basel) 2023; 15:4561. [PMID: 37760531 PMCID: PMC10526902 DOI: 10.3390/cancers15184561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/28/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
The postoperative survival of early-stage non-small-cell lung cancer (NSCLC) patients remains unsatisfactory. In this review, we examined the relevant literature to ascertain the prognostic effect of related indicators on early-stage NSCLC. The prognostic effects of the epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), mesenchymal-epithelial transition (MET), C-ros oncogene 1 (ROS1), or tumour protein p53 (TP53) alterations in resected NSCLC remains debatable. Kirsten rat sarcoma viral oncogene homologue (KRAS) alterations indicate unfavourable outcomes in early-stage NSCLC. Meanwhile, adjuvant or neoadjuvant EGFR-targeted agents can substantially improve prognosis in early-stage NSCLC with EGFR alterations. Based on the summary of current studies, resected NSCLC patients with overexpression of programmed death-ligand 1 (PD-L1) had worsening survival. Conversely, PD-L1 or PD-1 inhibitors can substantially improve patient survival. Considering blood biomarkers, perioperative peripheral venous circulating tumour cells (CTCs) and pulmonary venous CTCs predicted unfavourable prognoses and led to distant metastases. Similarly, patients with detectable perioperative circulating tumour DNA (ctDNA) also had reduced survival. Moreover, patients with perioperatively elevated carcinoembryonic antigen (CEA) in the circulation predicted significantly worse survival outcomes. In the future, we will incorporate mutated genes, immune checkpoints, and blood-based biomarkers by applying artificial intelligence (AI) to construct prognostic models that predict patient survival accurately and guide individualised treatment.
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Affiliation(s)
- Weibo Cao
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China; (W.C.); (Q.T.); (J.Z.); (X.J.); (L.Z.)
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Quanying Tang
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China; (W.C.); (Q.T.); (J.Z.); (X.J.); (L.Z.)
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Jingtong Zeng
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China; (W.C.); (Q.T.); (J.Z.); (X.J.); (L.Z.)
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Xin Jin
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China; (W.C.); (Q.T.); (J.Z.); (X.J.); (L.Z.)
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Lingling Zu
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China; (W.C.); (Q.T.); (J.Z.); (X.J.); (L.Z.)
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Song Xu
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China; (W.C.); (Q.T.); (J.Z.); (X.J.); (L.Z.)
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin 300052, China
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Wang X, Wang JY, Chen M, Ren J, Zhang X. Clinical association between coagulation indicators and bone metastasis in patients with gastric cancer. World J Gastrointest Oncol 2023; 15:1253-1261. [PMID: 37546561 PMCID: PMC10401464 DOI: 10.4251/wjgo.v15.i7.1253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/16/2023] [Accepted: 05/06/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Bones are one of the most common target organs for cancer metastasis. Early evaluation of bone metastasis (BM) status is clinically significant. Cancer patients often experience a hypercoagulable state.
AIM To evaluate the correlation between coagulation indicators and the burden of BM in gastric cancer (GC).
METHODS We conducted a single-center retrospective study and enrolled 454 patients. Clinical information including routine blood examination and coagulation markers were collected before any treatment. Patients were grouped according to the status of BM. Receiver operating characteristic curves were used to assess diagnostic performance and determine the optimal cutoff values of the above indicators. Cutoff values, sensitivity and specificity were based on the maximum Youden index. Univariate and multivariate logistic regression analyses were used to evaluate the relationships between biomarkers and BM.
RESULTS Of the 454 enrolled patients, 191 patients were diagnosed with BM. The receiver operating characteristic curve analysis suggested that prothrombin time (PT) [cutoff: 13.25; sensitivity: 0.651; specificity: 0.709; area under receiver operating characteristic curve (AUC) = 0.738], activated partial thromboplastin time (aPTT) (cutoff: 35.15; sensitivity: 0.640; specificity: 0.640; AUC = 0.678) and fibrin degradation products (FDP) (cutoff: 2.75; sensitivity: 0.668; specificity: 0.801; AUC = 0.768) act as novel predictors for BM. Based on multivariate logistic regression analysis, the results showed the independent correlation between PT [odds ratio (OR): 3.16; 95% confidence interval (CI): 1.612-6.194; P = 0.001], aPTT (OR: 2.234; 95%CI: 1.157-4.313; P = 0.017) and FDP (OR: 3.17; 95%CI: 1.637-6.139; P = 0.001) and BM in patients with GC. Moreover, age, carcinoembryonic antigen, erythrocyte and globulin were found to be significantly associated with BM.
CONCLUSION Coagulation markers, namely PT, aPTT and FDP, might be potential predictors for screening BM in patients with GC.
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Affiliation(s)
- Xuan Wang
- Department of Radiotherapy and Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
| | - Jing-Ya Wang
- Department of Gastroenterology, Xi'an Children's Hospital, Shaanxi Research Institute for Pediatric Diseases, The Affiliated Children's Hospital of Xi'an Jiaotong University and National Regional Medical Center for Children (Northwest), Xi'an 710003, Shaanxi Province, China
| | - Min Chen
- Department of Radiotherapy and Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
| | - Juan Ren
- Department of Radiotherapy and Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
| | - Xin Zhang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China
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Choi H, Hwang W. Perioperative Inflammatory Response and Cancer Recurrence in Lung Cancer Surgery: A Narrative Review. Front Surg 2022; 9:888630. [PMID: 35898583 PMCID: PMC9309428 DOI: 10.3389/fsurg.2022.888630] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/24/2022] [Indexed: 11/14/2022] Open
Abstract
While surgical resection is the gold standard treatment for solid tumors, cancer recurrence after surgery is common. Immunosurveillance of remnant tumor cells is an important protective mechanism. Therefore, maintenance of anti-tumor cell activity and proper levels of inflammatory mediators is crucial. An increasing body of evidence suggests that surgery itself and perioperative interventions could affect these pathophysiological responses. Various factors, such as the extent of tissue injury, perioperative medications such as anesthetics and analgesics, and perioperative management including transfusions and methods of mechanical ventilation, modulate the inflammatory response in lung cancer surgery. This narrative review summarizes the pathophysiological mechanisms involved in cancer recurrence after surgery and perioperative management related to cancer recurrence after lung cancer surgery.
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Shen Y, Xu Y, Wei J, Li W. The Prognostic Role of Circulating FPR Before Operation in Patients with BCLC A-C Hepatocellular Carcinoma: A Retrospective Cohort Study. J Hepatocell Carcinoma 2022; 9:467-476. [PMID: 35669908 PMCID: PMC9167061 DOI: 10.2147/jhc.s369168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/25/2022] [Indexed: 12/24/2022] Open
Abstract
Background This research aimed to comprehensively assess the prognostic role of fibrinogen to prealbumin ratio (FPR) in BCLC A-C HCC patients treated by TACE and RFA. Methods The research included 240 patients at stage BCLC A-C treated by TACE and RFA at Beijing Ditan Hospital of Capital Medical University from May 2011 to November 2018. Results The results showed that the size of the tumor, vascular invasion, α-foetoprotein, cirrhosis, NLR, LMR, and PLR showed prognostic value in predicting 5-year OS. Besides, FPR (95% confidence interval: 1.006–1.013, hazard ratio: 1.009) was a prognostic factor for the prediction of 5-year OS in HCC. Conclusion Our research indicated that FPR was a potential indicator for patients with BCLC A-C hepatocellular carcinoma after treatment of RFA and TACE.
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Affiliation(s)
- Yanjun Shen
- Department of Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yawen Xu
- Department of Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Jianying Wei
- Department of Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Wendong Li
- Department of Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, People’s Republic of China
- Correspondence: Wendong Li, Department of Oncology, Beijing Ditan Hospital, Capital Medical University, 8 Jingshun East Street, Chaoyang District, Beijing, People’s Republic of China, Tel +86-010-84322470, Email
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Li J, Yan S, Zhang X, Xiang M, Zhang C, Gu L, Wei X, You C, Chen S, Zeng D, Jiang J. Circulating D-Dimers Increase the Risk of Mortality and Venous Thromboembolism in Patients With Lung Cancer: A Systematic Analysis Combined With External Validation. Front Med (Lausanne) 2022; 9:853941. [PMID: 35308559 PMCID: PMC8924589 DOI: 10.3389/fmed.2022.853941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/04/2022] [Indexed: 12/14/2022] Open
Abstract
Background D-dimer is a fibrin-degrading substance that is soluble and whose degradation is produced by plasma protein-mediated degradation of cross-linked fibrin. Previous investigations have shown a link between D-dimer and the mortality in lung cancer patients. However, different investigations varied whether D-dimer could predict prognosis in these patients. Methods A meta-analysis and systematic review of all available cohort studies were performed on the link between circulating D-dimer levels and survival of lung cancer patients. Relevant studies were searched in Embase, Cochrane Library, and PubMed databases. Data from 540 lung cancer patients from the First Hospital of Soochow University and Sichuan Cancer Hospital were used for external validation. Results We finally obtained 19 eligible cohort studies with pooled HR showing that high D-dimer levels contribute to death in tumor group (HR 1.62, 95% CI: 1.39-1.88, I2 = 75.0%). Further stratified analysis showed that higher circulating D-dimer in the advanced lung cancer group was linked to a 1.91-fold risk (HR = 2.91, 95% CI: 2.24-3.78, I2 = 6.0%). Incorporation of other variables, including days of follow-up, country, design, public year, population, disease status, and quality score, into the meta-regression model, indicated that disease status was an additional source of heterogeneity (p < 0.001). External validation of 540 patients also showed that high levels of D-dimer showed a higher risk of overall mortality (HR 1.39, 95% CI: 1.13-1.72, p = 0.002) and VTE events (HR 3.98, 95% CI: 1.99-8.70, p = 0.002) in lung cancer patients. Conclusions High circulating plasma D-dimer levels independently predict long-term prognosis and the risk of venous thromboembolism in lung cancer.
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Affiliation(s)
- Jing Li
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The Affiliated Dushu Lake Hospital of Soochow University, Suzhou, China
| | - Shanle Yan
- Department of Rheumatology and Immunology, The Affiliated Dushu Lake Hospital of Soochow University, Suzhou, China
| | - Xiaohui Zhang
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Mengqi Xiang
- Department of Medical Oncology, Sichuan Cancer Hospital, Medical School, University of Electronic Science and Technology of China, Chengdu, China
| | - Chuanhua Zhang
- Department of Thoracic Surgery, Sichuan Cancer Hospital, Medical School, University of Electronic Science and Technology of China, Chengdu, China
| | - Ling Gu
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoying Wei
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The Affiliated Dushu Lake Hospital of Soochow University, Suzhou, China
| | - Chuanyun You
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shenhua Chen
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Daxiong Zeng
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The Affiliated Dushu Lake Hospital of Soochow University, Suzhou, China
| | - Junhong Jiang
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The Affiliated Dushu Lake Hospital of Soochow University, Suzhou, China
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Nenclares P, Gunn L, Soliman H, Bover M, Trinh A, Leslie I, Wong KH, Melcher A, Newbold K, Nutting CM, Ap Dafydd D, Bhide SA, Harrington K. On-treatment immune prognostic score for patients with relapsed and/or metastatic head and neck squamous cell carcinoma treated with immunotherapy. J Immunother Cancer 2021; 9:e002718. [PMID: 34103355 PMCID: PMC8190047 DOI: 10.1136/jitc-2021-002718] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Previous studies have suggested that inflammatory markers (neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH) and fibrinogen) are prognostic biomarkers in patients with a variety of solid cancers, including those treated with immune checkpoint inhibitors (ICIs). We aimed to develop a model that predicts response and survival in patients with relapsed and/or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) treated with immunotherapy. METHODS Analysis of 100 consecutive patients with unresectable R/M HNSCC who were treated with ICI. Baseline and on-treatment (day 28) NLR, fibrinogen and LDH were calculated and correlated with response, progression-free survival (PFS) and overall survival (OS) using univariate and multivariate analyses. The optimal cut-off values were derived using maximally selected log-rank statistics. RESULTS Low baseline NLR and fibrinogen levels were associated with response. There was a statistically significant correlation between on-treatment NLR and fibrinogen and best overall response. On-treatment high NLR and raised fibrinogen were significantly associated with poorer outcome. In multivariate analysis, on-treatment NLR (≥4) and on-treatment fibrinogen (≥4 ng/mL) showed a significant negative correlation with OS and PFS. Using these cut-off points, we generated an on-treatment score for OS and PFS (0-2 points). The derived scoring system shows appropriate discrimination and suitability for OS (HR 2.4, 95% CI 1.7 to 3.4, p<0.0001, Harrell's C 0.67) and PFS (HR 1.8, 95% CI 1.4 to 2.3, p<0.0001, Harrell's C 0.68). In the absence of an external validation cohort, results of fivefold cross-validation of the score and evaluation of median OS and PFS on the Kaplan-Meier survival distribution between trained and test data exhibited appropriate accuracy and concordance of the model. CONCLUSIONS NLR and fibrinogen levels are simple, inexpensive and readily available biomarkers that could be incorporated into an on-treatment scoring system and used to help predict survival and response to ICI in patients with R/M HNSCC.
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Affiliation(s)
- Pablo Nenclares
- Head and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | - Lucinda Gunn
- Head and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK
| | - Heba Soliman
- Head and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK
| | - Mateo Bover
- Head and Neck Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Amy Trinh
- Head and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK
| | - Isla Leslie
- Head and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK
| | - Kee Howe Wong
- Head and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK
| | - Alan Melcher
- Head and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | - Kate Newbold
- Head and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK
| | - Chris M Nutting
- Head and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK
| | - Derfel Ap Dafydd
- Head and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK
| | - Shreerang A Bhide
- Head and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | - Kevin Harrington
- Head and Neck Unit, Royal Marsden Hospital NHS Trust, London, UK
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
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Ma Y, Li G, Li X, Gao Y, Ding T, Yang G, Zhang Y, Nian J, Yu M, Wang X. Clinical characteristics and prognostic analysis of Lung Cancer patients with Hypercoagulability: A single-center, retrospective, real-world study. J Cancer 2021; 12:2968-2974. [PMID: 33854597 PMCID: PMC8040890 DOI: 10.7150/jca.46600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 03/01/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: We explored the clinical regularity and prognosis of lung carcinoma (LC) patients with hypercoagulability, which is often associated with the occurrence and development of tumors. Methods: This retrospective study analyzed 624 LC patients diagnosed from 2010-2017 in the Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, China. Kaplan-Meier analysis was used to estimate survival and the log-rank test was used to identify differences in survival between groups. The predictive power of a hypercoagulation model was tested using receiver operating characteristic (ROC) curve analysis. Univariate and multivariate Cox regression analyses were performed to explore independent factors associated with survival. A logistic regression model was used to explore factors related to hypercoagulability. The diagnostic power of relevant influencing factors on hypercoagulability was tested using ROC curve analysis. Results: Of 624 patients in the study, 161(25.8%) had hypercoagulability and 463 did not (normal group). The overall survival (OS) of the hypercoagulability group was significantly lower than the normal group (P < 0.0001). The ROC curve showed that the predictive power of the hypercoagulability model was better than that of a single coagulation indicator (P < 0.01). Both univariate and multivariate Cox regression analyses showed that hypercoagulability was an independent factor affecting the prognosis of LC (P<0.0001). The results of the logistic regression analysis showed that clinical stage (P < 0.05), cytokeratin 19 fragment (Cyfra211) (P < 0.05), and the platelet-to-lymphocyte ratio (PLR) (P < 0.05) were positively correlated with hypercoagulability. When combining clinical stage, Cyfra211, and the PLR to predict hypercoagulability, the area under the ROC curve was 0.797 (P < 0.01). Conclusions: In LC, hypercoagulability is an independent factor associated with poor OS and could be a prognostic factor.
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Affiliation(s)
- Yunfei Ma
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Guangda Li
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Xiaoxiao Li
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Yu Gao
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Tongjing Ding
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Guowang Yang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Yi Zhang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Jiayun Nian
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Mingwei Yu
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
| | - Xiaomin Wang
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China
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Li J, Wang Y, Li J, Che G. Prognostic Value of Pretreatment D-Dimer Level in Small-Cell Lung Cancer: A Meta-Analysis. Technol Cancer Res Treat 2021; 20:1533033821989822. [PMID: 33563114 PMCID: PMC7879000 DOI: 10.1177/1533033821989822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Purpose: Pretreatment plasma d-dimer has been reported to be a potential prognostic indicator of lung cancer. To determine the prognostic significance of pretreatment d-dimer level in predicting clinical outcomes, such as the overall survival (OS) and progression-free survival (PFS), of patients with small cell lung cancer (SCLC). Methods: A systematic search in PubMed, Web of Science, EMBASE, Cochrane Library, CNKI, SinoMed, Wanfang and VIP databases was performed to identify available studies. The pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were applied to assess the association of pretreatment d-dimer level with prognosis of SCLC patients. All statistical analyses were conducted via the STATA 12.0 version software. Results: A total of 7 studies involving 964 patients were included in this meta-analysis and all patients were from China. The results showed that elevated pretreatment d-dimer level was significantly correlated with worse OS (HR = 1.90, 95% CI: 1.55-2.34, P < 0.001) and PFS (HR = 1.52, 95% CI: 1.24-1.85, P<0.001). Subgroup analyses based on the treatment, d-dimer cut-off, detection method and source of HR were also performed to further verify the prognostic value of pretreatment d-dimer level in SCLC. Conclusions: Pretreatment blood concentration of d-dimer may deserve as a reliable factor to predict prognosis of Chinese patients with SCLC. More well-designed prospective studies with large samples are still needed to verify our findings.
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Affiliation(s)
- Jialong Li
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yan Wang
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jue Li
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Guowei Che
- Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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10
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Zhang X, Zhao W, Chen X, Zhao M, Qi X, Li G, Shen A, Yang L. Combining the Fibrinogen-to-Pre-Albumin Ratio and Prognostic Nutritional Index (FPR-PNI) Predicts the Survival in Elderly Gastric Cancer Patients After Gastrectomy. Onco Targets Ther 2020; 13:8845-8859. [PMID: 32982279 PMCID: PMC7500527 DOI: 10.2147/ott.s264199] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/17/2020] [Indexed: 01/19/2023] Open
Abstract
Background Inflammation and nutrition are important causes contributing to the progression and poor survival of gastric cancer (GC). The objective of this study is to investigate the prognostic significance of the preoperative fibrinogen-to-pre-albumin ratio (FPR) and the prognostic nutritional index (PNI) in GC patients who have undergone gastrectomy. Methods A total of 274 patients with resected pathological GC from January 2007 to December 2013 were enrolled in this retrospective study. Survival analysis was performed using Kaplan–Meier and log rank tests. Univariate and multivariate analyses were established to identify independent prognostic factors of 5-year survival. A predictive nomogram was used to predict prognosis of overall survival (OS), and its accuracy was determined by Harrell’s concordance index (C index). Results A high preoperative FPR-PNI score was significantly correlated with age, bigger tumor size, more lymphatic metastases and advanced TNM stage. Univariate analysis revealed that the GC patients with high FPR, low PNI and high FPR-PNI scores had shorter survival time. Multivariate analysis showed that FPR-PNI was an independent prognostic factor for OS in GC patients, especially in elderly patients. In the sub-analysis by age, the FPR-PNI score could significantly increase the accuracy of prognosis compared with the FPR and PNI alone in elderly GC patients. Conclusion The preoperative FPR-PNI score is an effective independent prognostic index for GC patients after surgery, especially in elderly patients.
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Affiliation(s)
- Xunlei Zhang
- Department of Oncology, Affiliated Tumor Hospital of Nantong University, Nantong Jiangsu, People's Republic of China
| | - Wenjing Zhao
- Cancer Research Center, Affiliated Tumor Hospital of Nantong University, Nantong Jiangsu, People's Republic of China
| | - Xin Chen
- Department of General Surgery, Affiliated Tumor Hospital of Nantong University, Nantong Jiangsu, People's Republic of China
| | - Min Zhao
- Department of Pathology, Affiliated Tumor Hospital of Nantong University, Nantong Jiangsu, People's Republic of China
| | - Xue Qi
- Department of Oncology, Nantong Liangchun Hospital of Traditional Chinese Medicine, Nantong, Jiangsu, People's Republic of China
| | - Guoxing Li
- Department of General Surgery, Affiliated Tumor Hospital of Nantong University, Nantong Jiangsu, People's Republic of China
| | - Aiguo Shen
- Cancer Research Center, Affiliated Tumor Hospital of Nantong University, Nantong Jiangsu, People's Republic of China
| | - Lei Yang
- Department of Oncology, Affiliated Tumor Hospital of Nantong University, Nantong Jiangsu, People's Republic of China
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11
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Liu X, Shi B. Progress in research on the role of fibrinogen in lung cancer. Open Life Sci 2020; 15:326-330. [PMID: 33817221 PMCID: PMC7874584 DOI: 10.1515/biol-2020-0035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 03/11/2020] [Accepted: 03/17/2020] [Indexed: 12/16/2022] Open
Abstract
Lung cancer is one of the most prevalent malignancies worldwide. Local recurrence and distant metastasis remain the major causes of treatment failure. It has been recognized that the process of tumor growth and metastasis involves multiple interactions between tumor and host. Various biomarkers have been used for predicting tumor recurrence, metastasis, and prognosis in patients with lung cancer. However, these biomarkers are still controversial and require further validation. The relationship between malignancy and coagulation system disorders has been explored for more than a century. Fibrinogen is the most abundant plasma coagulation factor synthesized mainly by hepatic cells. Increased plasma fibrinogen levels were observed in various carcinomas such as gastric cancer, colon cancer, and pancreatic cancer. Recent studies have also investigated the role of fibrinogen in patients with lung cancer. This review aimed to address the role of fibrinogen in lung cancer.
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Affiliation(s)
- Xing Liu
- Department of Respiratory Medicine, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, Jiangsu, China
| | - Bin Shi
- Department of Respiratory Medicine, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, Jiangsu, China
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12
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Ogura S, Nakazato T. The Prognostic Significance of Pretransplant Plasma Fibrinogen Levels in Autologous Hematopoietic Stem Cell Transplantation. Transplant Proc 2020; 53:405-407. [PMID: 32505504 DOI: 10.1016/j.transproceed.2020.02.153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 02/07/2020] [Accepted: 02/15/2020] [Indexed: 11/29/2022]
Abstract
Elevated plasma fibrinogen is associated with tumor progression and poor outcomes in several cancers. However, no studies have demonstrated the prognostic value of hyperfibrinogenemia in the setting of autologous hematopoietic stem cell transplantation (ASCT). We retrospectively reviewed 104 patients who were diagnosed with malignant lymphoma (ML) or multiple myeloma (MM) and underwent ASCT in our institution between 2007 and 2018. The patients included 63 men and 41 women with a median age of 58 years (range, 24-70 years). Forty-seven patients were diagnosed with ML, and 57 patients were diagnosed with MM. The median follow-up period was 59 months. The median pretransplant plasma fibrinogen levels were 336 mg/dL in ML patients and 320 mg/dL in MM patients. The Kaplan-Meier method revealed that patients with pretransplant hyperfibrinogenemia had a significantly shorter 5-year overall survival (OS) than those without hyperfibrinogenemia (5-year OS: 34.3% vs 81.0%, P < .001). Among 27 patients with diffuse large B cell lymphoma, patients with pretransplant hyperfibrinogenemia (n = 12) had a significantly shorter OS than those without hyperfibrinogenemia (n = 15) (5-year OS: 40.0% vs 80.2%, P = .006). Among 57 MM patients, there was no significant difference in the 5-year OS between the high-fibrinogen group and the low-fibrinogen group (5-year OS: 77.1% vs 50.4%, P = .17). Our study suggested that pretransplant hyperfibrinogenemia was associated with a poor survival in patients with lymphoma who underwent ASCT. Because our results are based on a small-sized analysis, further large-scale prospective studies are warranted to verify this conclusion.
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Affiliation(s)
- Shinji Ogura
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan
| | - Tomonori Nakazato
- Department of Hematology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.
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13
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Zhang Y, Cao J, Deng Y, Huang Y, Li R, Lin G, Dong M, Huang Z. Pretreatment plasma fibrinogen level as a prognostic biomarker for patients with lung cancer. Clinics (Sao Paulo) 2020; 75:e993. [PMID: 32130355 PMCID: PMC7026942 DOI: 10.6061/clinics/2020/e993] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 07/21/2019] [Indexed: 01/01/2023] Open
Abstract
Many researchers have shown that pretreatment plasma fibrinogen levels are closely correlated with the prognosis of patients with lung cancer (LC). In this study, we thus performed a meta-analysis to systematically assess the prognostic value of pretreatment plasma fibrinogen levels in LC patients. A computerized systematic search in PubMed, EMBASE, Web of Science and China National Knowledge Infrastructure (CNKI) was performed up to March 15, 2018. Studies with available data on the prognostic value of plasma fibrinogen in LC patients were eligible for inclusion. The pooled hazard ratios (HRs) and odd ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the correlation between pretreatment plasma fibrinogen levels and prognosis as well as clinicopathological characteristics. A total of 17 studies with 6,460 LC patients were included in this meta-analysis. A higher pretreatment plasma fibrinogen level was significantly associated with worse overall survival (OS) (HR: 1.57; 95% CI: 1.39-1.77; p=0.001), disease-free survival (DFS) (HR: 1.53; 95% CI: 1.33-1.76; p=0.003), and progression-free survival (PFS) (HR: 3.14; 95% CI: 2.15-4.59; p<0.001). Furthermore, our subgroup and sensitivity analyses demonstrated that the pooled HR for OS was robust and reliable. In addition, we also found that a higher fibrinogen level predicted advanced TNM stage (III-IV) (OR=2.18, 95% CI: 1.79-2.66; p<0.001) and a higher incidence of lymph node metastasis (OR=1.74, 95% CI: 1.44-2.10; p=0.02). Our study suggested that higher pretreatment plasma fibrinogen levels predict worse prognoses in LC patients.
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Affiliation(s)
- Yi Zhang
- Department of Hepatic Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Junyan Cao
- Department of Medical Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yinan Deng
- Department of Hepatic Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yiming Huang
- Department of Hepatic Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Rong Li
- Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Guozhen Lin
- Department of Hepatic Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Min Dong
- Department of Medical Oncology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou 510000, Guangdong, China
- *Corresponding authors. E-mail: /
| | - Zenan Huang
- Breast Cancer Center, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Tianhe District, Guangzhou 510000, Guangdong, China
- *Corresponding authors. E-mail: /
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Yan M, Pan XT, Cheng X, Lu Y. Characteristics and significance of changes of thrombomodulin and plasma protein C in patients with cancer before and after PICC. Indian J Cancer 2019; 57:27-30. [PMID: 31736467 DOI: 10.4103/ijc.ijc_252_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective This study aimed to evaluate the changes and clinical significance of thrombomodulin (TM) and plasma protein C (PC) in patients with cancer before and after peripherally inserted central catheter placement (PICC). Materials and Methods The levels of plasma TM and PC in 35 patients with cancer before and after PICC were measured by enzyme-linked immunosorbent assay, and the significance of the differences was analyzed. Results TM was 3.57 ± 1.01 μg/L at 1 day after catheterization, which was significantly lower than the value of 4.41 ± 1.26 μg/L before catheterization; these values were 4.30 ± 1.81 and 4.73 ± 0.97 μg/L at 30 and 90 days after catheterization, respectively (F = 4.14,P < 0.05). PC was 3.32 ± 1.35 μg/L at 1 day after catheterization, which was significantly lower than the value of 5.32 ± 2.12 μg/L before catheterization; these values were 4.64 ± 2.44 and 5.83 ± 3.14 μg/L at 30 and 90 days after catheterization, respectively (F = 6.28,P < 0.01). There were no significant differences in platelet (PLT) counts, plasma D-D, and coagulation parameters among the four time points before and after catheterization. There was a positive correlation between TM and PC (r = 0.5420,P < 0.01) on day 1 after PICC line insertion. The levels of TM and PC were not related to PLT, plasma D-dimer, or various coagulation parameters. Conclusions The levels of TM and PC in the patients 1 day after PICC were significantly decreased and showed a positive correlation, but were not related to PLT, plasma D-dimer, or coagulation function.
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Affiliation(s)
- Min Yan
- Department of Hematology and Oncology, Taicang Hospital Affiliated to Suzhou University, Taicang, China
| | - Xiang-Tao Pan
- Department of Hematology and Oncology, Taicang Hospital Affiliated to Suzhou University, Taicang, China
| | - Xu Cheng
- Department of Hematology and Oncology, Taicang Hospital Affiliated to Suzhou University, Taicang, China
| | - Ye Lu
- Department of Hematology and Oncology, Taicang Hospital Affiliated to Suzhou University, Taicang, China
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Huang C, Liu Z, Xiao L, Xia Y, Huang J, Luo H, Zong Z, Zhu Z. Clinical Significance of Serum CA125, CA19-9, CA72-4, and Fibrinogen-to-Lymphocyte Ratio in Gastric Cancer With Peritoneal Dissemination. Front Oncol 2019; 9:1159. [PMID: 31750248 PMCID: PMC6848261 DOI: 10.3389/fonc.2019.01159] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 10/17/2019] [Indexed: 12/24/2022] Open
Abstract
Background: Relevant serum tumor markers have been indicated to be associated with peritoneal dissemination (PD) of gastric cancer (GC). Fibrinogen has been shown to play an important role in the systemic inflammatory response (SIR) and in tumor progression. However, the clinical significance of the fibrinogen-to-lymphocyte ratio (FLR) in GC with PD has not been studied. Methods: The clinical data of 391 patients with GC were collected, including 86 cases of PD. Then, 1:3 matching was performed by propensity score matching (PSM), and the clinical data of the matched 344 patients were analyzed by univariate and multivariate conditional logistic regression. Classification tree analysis was used to obtain the decision rules and a random forest algorithm to extract the important risk factors of PD in GC. A nomogram model for risk assessment of PD in GC was established by using the rms package of R software. Results: Univariate analysis showed that the factors related to PD in GC were: carbohydrate antigen (CA) 125 (P < 0.0001), CA19-9 (P < 0.0001), CA72-4 (P < 0.0001), FLR (P < 0.0001), neutrophil-to-lymphocyte ratio (NLR) (P < 0.0001), albumin-to- lymphocyte ratio (ALR) (P < 0.0001), platelet-to-lymphocyte ratio (PLR) (P = 0.013), and carcinoembryonic antigen (CEA) (P = 0.031). Conditional logistic regression found that CA125 (OR: 1.046; P < 0.0001), CA19-9 (OR: 1.002; P < 0.0001), and FLR (OR: 1.266; P = 0.024) were independent risk factors for GC with PD. The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the decision rules for detecting PD of GC were 89.5, 77.4, 94.0, 82.8, and 91.8%, respectively. According to the important variables identified by the classification tree and random forest algorithm, the risk assessment model of PD in GC was established. The accuracy, sensitivity, and specificity of the model were 91, 89.5, and 79.5%, respectively. Conclusion: CA125 > 17.3 U/ml, CA19-9 > 27.315 U/ml, and FLR > 2.555 were the risk factors for GC with PD. The decision rules and nomogram model constructed by CA125, CA19-9, CA72-4, and FLR can correctly predict the risk of PD in GC.
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Affiliation(s)
- Chao Huang
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zitao Liu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Li Xiao
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yongqiang Xia
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jun Huang
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hongliang Luo
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhen Zong
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhengming Zhu
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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16
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Zhang K, Xu Y, Tan S, Wang X, Du M, Liu L. The association between plasma fibrinogen levels and lung cancer: a meta-analysis. J Thorac Dis 2019; 11:4492-4500. [PMID: 31903237 DOI: 10.21037/jtd.2019.11.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Published studies have presented an inconsistent association between plasma fibrinogen level and poor prognosis or clinicopathological characteristics in lung cancer. Methods In the absence of significant quality difference, combined hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated according to overall survival (OS), progression-free survival (PFS) and disease-free survival (DFS). Risk ratio (RR), odds ratio (OR) and standardized mean difference (SMD) with CIs were pooled to appraise the effect of plasma fibrinogen on clinicopathological characteristics. Furthermore, we directly combined the P values to estimate the association of plasma fibrinogen and tumor size. We adjusted the publication bias using trim-and fill method. Results Twenty studies with 6,494 patients were contained in meta-analysis. The pooled data indicated that elevated fibrinogen level associated with poor prognosis in lung cancer. Typically, the pooled HRs were 1.44 (95% CI, 1.34-1.55), 1.49 (95% CI, 1.24-1.80) and 1.69 (95% CI, 1.31-2.17) for OS, PFS and DFS of lung cancer, respectively. In addition, the combined ORs were 1.50 (95% CI, 1.23-1.84) and 2.01 (95% CI, 1.66-2.44) for lymph node metastasis and III-IV stage; and the combined RR was 2.15 (95% CI, 1.11-4.15) for disease control rate (DCR). Moreover, patients with distant metastasis or III-IV stage had significantly higher plasma fibrinogen level (SMD: 0.20, 95% CI, 0.04-0.36; SMD: 0.31, 95% CI, 0.18-0.44, respectively). Conclusions The summary results indicated that plasma fibrinogen was a marker of prognosis and clinicopathological characteristics in lung cancer.
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Affiliation(s)
- Ke Zhang
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Ye Xu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Shanyue Tan
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xueyan Wang
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Mulong Du
- Department of Genetic Toxicology, The Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China.,Department of Biostatistics, Nanjing Medical University, Nanjing 211166, China
| | - Lingxiang Liu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Bian NN, Shi XY, Qi HY, Hu X, Ge Y, An GY, Feng GS. The relationship of plasma fibrinogen with clinicopathological stages and tumor markers in patients with non-small cell lung cancer. Medicine (Baltimore) 2019; 98:e16764. [PMID: 31393394 PMCID: PMC6708950 DOI: 10.1097/md.0000000000016764] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Numerous studies have shown that the blood of cancer patients are generally in hypercoagulable statement. The aim of the present research is to study the relationships of plasma fibrinogen (Fbg) levels with clinicopathological stages (CS) and tumor markers of non-small cell lung cancer (NSCLC).Baseline information, plasma Fbg levels, CS, and expression level of tumor markers were collected from medical records retrospectively. Unitary linear regression was used to analyze the relationships between continuous variables and Fbg, and multiple linear regression was used to analyze the relationships between categorical variables and Fbg. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (Version 4) for NSCLC were adopted to evaluate CS.A total of 652 NSCLC patients were included. Compared with the females, male patients had higher mean plasma Fbg levels (P < .001). The later the N stages (P = .002), M stages (P = .002), and CS (P = .001) were, the higher the average plasma Fbg levels were. The levels of squamous cell carcinoma antigen (P = .001), carbohydrate antigen 125 (P = .041), and neuron-specific enolase (P < .001) were positively correlated with plasma Fbg concentration. The plasma level of Fbg in lung adenocarcinoma patients (P < .001) was the lowest, while that of lung squamous cell carcinoma patients (P < .001) was the highest in NSCLC patients.The plasma Fbg concentration is related to gender, CS, and tumor markers in patients with NSCLC.
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Affiliation(s)
| | - Xin-Yu Shi
- Department of Respiratory Medicine, Beijing Chao-yang Hospital Affiliated to Capital Medical University, Beijing, China
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18
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Deng HY, Zheng X, Jiang R, Wang RL, Zhou J, Qiu XM. Preoperative D-dimer level is an independent prognostic factor for non-small cell lung cancer after surgical resection: a systematic review and meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:366. [PMID: 31555680 DOI: 10.21037/atm.2019.05.35] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Whether high preoperative D-dimer level has any impact on long-term survival of patients with surgically treated non-small cell lung cancer (NSCLC) remains unclear. Therefore, we conducted the first meta-analysis focusing specifically on prognostic value of high preoperative D-dimer level in NSCLC patients after surgical resection comprehensively. Methods We conducted a systematic search for relevant studies in PubMed, Embase, and Web of Science on January 28, 2019. Data for analysis consisted of hazard ratio (HR) with 95% confidence interval (CI) of overall survival (OS) and disease-free survival (DFS) from multivariate analysis and were analyzed by using the STATA 12.0 package. Results Finally, we included a total of 6 cohort studies consisting of 1,817 patients with surgically treated NSCLC for analysis. Our meta-analysis found that NSCLC patients with high preoperative D-dimer level had a significantly worse OS (random effects: HR =2.04; 95% CI: 1.30-3.20; P=0.002; I2=67.4%) and DFS (fixed effects: HR =1.98; 95% CI: 1.41-2.78; P<0.001; I2=0.0%) than these with normal preoperative D-dimer level after surgery. However, potential heterogeneity and publication bias was observed during analysis. Conclusions High pretreatment level of D-dimer remains to be an independent predictor of poor prognosis in NSCLC patients after surgery. Further well-conducted studies with appropriate adjustments are needed to confirm and update our conclusions.
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Affiliation(s)
- Han-Yu Deng
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xi Zheng
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Rui Jiang
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Rui-Lan Wang
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jie Zhou
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiao-Ming Qiu
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
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Kaseda K, Asakura K, Kazama A, Ozawa Y. Correction to: Prognostic significance of preoperative plasma D-dimer level in patients with surgically resected clinical stage I non-small cell lung cancer: a retrospective cohort study. J Cardiothorac Surg 2019; 14:114. [PMID: 31221171 PMCID: PMC6587265 DOI: 10.1186/s13019-019-0935-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 06/13/2019] [Indexed: 12/16/2022] Open
Affiliation(s)
- Kaoru Kaseda
- Department of Thoracic Surgery, Sagamihara Kyodo Hospital, 2-8-18 Hashimoto, Midori-ku, Sagamihara, Kanagawa, 252-5188, Japan.
| | - Keisuke Asakura
- Department of Thoracic Surgery, Sagamihara Kyodo Hospital, 2-8-18 Hashimoto, Midori-ku, Sagamihara, Kanagawa, 252-5188, Japan
| | - Akio Kazama
- Department of Pathology, Sagamihara Kyodo Hospital, 2-8-18 Hashimoto, Midori-ku, Sagamihara, Kanagawa, 252-5188, Japan
| | - Yukihiko Ozawa
- Yuai Clinic, 1-6-2 Kitashinyokohama, Kohoku-Ku, Yokohama, Kanagawa, 223-0059, Japan
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Hou C, Jiang F, Ma H, Zhu Q, Wang Z, Zhao B, Xue T, Tan S, Yang R, Qian Y, Luo X, Zhao M, Xu X, Chen L, Li J. Prognostic role of preoperative platelet, fibrinogen, and D-dimer levels in patients with non-small cell lung cancer: A multicenter prospective study. Thorac Cancer 2019; 10:304-311. [PMID: 30609303 PMCID: PMC6360242 DOI: 10.1111/1759-7714.12956] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 11/29/2018] [Accepted: 11/30/2018] [Indexed: 12/31/2022] Open
Abstract
Background The relationships between coagulation factors and non‐small cell lung cancer (NSCLC) prognosis have been intensively studied. However, no previous study has investigated the combined effects of preoperative platelet (PLT), fibrinogen (FIB), and D‐dimer (D‐D) levels on the prognosis of NSCLC. Methods A multicenter prospective study was conducted over seven hospitals. A total of 395 patients diagnosed with operable NSCLC for the first time were included and followed‐up until disease progression or the end of the study. Baseline demographic and clinicopathological information, and preoperative coagulation test results were collected for each patient. Univariate and multilevel survival analyses were conducted using Cox regression and shared frailty models. Results Multilevel analyses revealed that there was a marginally significant association between elevated PLT level (> 215 × 109/L) and unfavorable progression‐free survival (PFS) (hazard ratio 2.42, P = 0.05), whereas preoperative FIB and D‐D were not significant prognostic factors for PFS (P = 0.31 and 0.30, respectively). Compared to patients with one elevation of the three coagulation factors, patients with at least two elevations of the three factors had a significantly higher risk of cancer progression (hazard ratio 4.62, P = 0.02). Conclusion The number of elevated preoperative coagulation factors may have a significant effect on PFS and could be used to predict the prognosis of NSCLC patients after surgery. Future studies are warranted to further investigate the interactions between these three coagulation factors.
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Affiliation(s)
- Can Hou
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Feng Jiang
- Department of Thoracic Surgery, Jiangsu Cancer Hospital, Nanjing, China
| | - Haitao Ma
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Quan Zhu
- Department of Thoracic Surgery, Jiangsu Province Hospital, Nanjing, China
| | - Zhonglin Wang
- Department of Cardiothoracic Surgery, The First People's Hospital of Changzhou, Changzhou, China
| | - Biao Zhao
- Department of Integrated Chinese and Western Medicine, Sichuan Cancer Hospital, Chengdu, China
| | - Tao Xue
- Department of Cardiothoracic Surgery, Zhongda Hospital Southeast University, Nanjing, China
| | - Sheng Tan
- Department of Cardiothoracic Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Rusong Yang
- Department of Thoracic Surgery, Nanjing Chest Hospital, Nanjing, China
| | - Yongxiang Qian
- Department of Cardiothoracic Surgery, The First People's Hospital of Changzhou, Changzhou, China
| | - Xuan Luo
- National Engineering and Research Center for Natural Medicine, Chengdu, China
| | - Ming Zhao
- National Engineering and Research Center for Natural Medicine, Chengdu, China
| | - Xing Xu
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, China
| | - Liang Chen
- Department of Thoracic Surgery, Jiangsu Province Hospital, Nanjing, China
| | - Jiayuan Li
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University, Chengdu, China
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Gong J, Xu L, Li Z, Hu X, Liu J, Teng Y, Jin B, Zhao M, Shi J, Guo T, Shi X, Cheng Y, Liu Y, Qu X. A Clinical Prognostic Score to Predict Survival of Advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC) Patients Receiving First-Line Chemotherapy: A Retrospective Analysis. Med Sci Monit 2018; 24:8264-8271. [PMID: 30446633 PMCID: PMC6252050 DOI: 10.12659/msm.911026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Although several complicated models have been built to evaluate the prognosis of NSCLC patients receiving chemotherapy, simple economic models are still needed to give a preliminary survival assessment of these patients. MATERIAL AND METHODS This study retrospectively assessed the clinical and biological parameters of 223 patients with advanced NSCLC. Univariate and multivariate analyses of overall survival (OS) and progression-free survival (PFS) for the parameters and the prognostic score were assessed. RESULTS Performance status (PS) score=1, smoking history, fibrinogenemia, thrombocytosis, increased lactate dehydrogenase (LDH) level, and anemia were independent predictors of poor prognosis in the univariate analysis of OS and were assessed in multivariate analysis. There was a significant difference in PS=1 (HR=2.134, p<0.0001), increased LDH level (HR=1.508, p=0.014), thrombocytosis (HR=1.547, p=0.012), and smoking history (HR=1.491, p=0.008), based on which the patients were classified into 3 risk groups: low risk (0-1 points), moderate risk (2 points), and high risk (3-5 points). At p values of <0.0001, the median OS was 565, 340, and 273 days and the median progression-free survival was 250, 209, and 135 days, respectively in these 3 risk groups. CONCLUSIONS We established a new prognostic score model using PS, LDH level, PLT count, and smoking history to predict the survival of patients receiving first-line chemotherapy for advanced NSCLC, which might be useful in clinical practice.
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Affiliation(s)
- Jing Gong
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Ling Xu
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Zhi Li
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Xuejun Hu
- Department of Respiratory and Infectious Disease of Geriatrics, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Jing Liu
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Yuee Teng
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Bo Jin
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Mingfang Zhao
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Jing Shi
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Tianshu Guo
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Xiaonan Shi
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Yu Cheng
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Yunpeng Liu
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
| | - Xiujuan Qu
- Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland).,Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang, Liaoning, China (mainland)
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Huang G, Jiang H, Lin Y, Wu Y, Cai W, Shi B, Luo Y, Jian Z, Zhou X. Prognostic value of plasma fibrinogen in hepatocellular carcinoma: a meta-analysis. Cancer Manag Res 2018; 10:5027-5041. [PMID: 30464603 PMCID: PMC6214315 DOI: 10.2147/cmar.s175780] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Elevated plasma fibrinogen levels have been associated with tumor progression in several malignancies. Our study aims to characterize the clinical significance of elevated plasma fibrinogen levels in patients with hepatocellular carcinoma (HCC). Materials and methods Relevant published articles were systematically searched in electronic databases including PubMed, Embase, and Web of Science. The pooled differences in plasma fibrinogen levels among HCC, cirrhotic, and control groups were expressed as weighted mean differences (WMDs) and their corresponding 95% CIs. The associations between elevated fibrinogen and overall survival (OS) and disease-free survival (DFS)/recurrence-free survival (RFS) were expressed as HRs and their 95% CIs, whereas the associations between elevated fibrinogen and various types of clinical characteristic of patients with HCC were expressed as ORs and their corresponding 95% CIs. Results Results showed that the plasma fibrinogen levels in patients with HCC were not significantly different than that in healthy controls (WMD = 0.50, 95% CI = [−0.82, 1.82], P = 0.457) or patients with cirrhosis (WMD = −0.62, 95% CI = [−1.56, 0.33], P = 0.200). However, our results showed that compared to those with normal levels, patients with HCC and elevated plasma fibrinogen levels showed poorer OS (HR = 2.08, 95% CI = [1.67, 2.59], P < 0.0001) and DFS/RFS (HR = 1.90, 95% CI = [1.52, 2.37], P < 0.0001). Results of trial sequential analysis of the OS indicated that currently available studies were sufficient to validate the negative prognostic value of elevated plasma fibrinogen in patients with HCC. Clinicopathological analyses showed that high plasma fibrinogen levels were associated with tumor progression as indicated by advanced tumor stage, larger tumor size, increased tumor number, and the presence of vascular invasion. Conclusion Elevated plasma fibrinogen levels are associated with poor prognosis and advanced tumor progression. Plasma fibrinogen may serve as a negative prognostic biomarker in patients with HCC.
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Affiliation(s)
- Guanqun Huang
- Department of General Surgery, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510700, People's Republic of China
| | - Hui Jiang
- Department of Abdominal Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510700, People's Republic of China,
| | - Ye Lin
- Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, People's Republic of China,
| | - Yanpeng Wu
- Department of General Surgery, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510700, People's Republic of China
| | - Weilong Cai
- Department of General Surgery, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510700, People's Republic of China
| | - Boyun Shi
- Department of Abdominal Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510700, People's Republic of China,
| | - Yuanwei Luo
- Department of General Surgery, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510700, People's Republic of China
| | - Zhixiang Jian
- Department of General Surgery, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, People's Republic of China,
| | - Xinke Zhou
- Department of Abdominal Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510700, People's Republic of China,
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Zhong H, Qian Y, Fang S, Wang Y, Tang Y, Gu W. Prognostic Value of Plasma Fibrinogen in Lung Cancer Patients: A Meta-Analysis. J Cancer 2018; 9:3904-3911. [PMID: 30410594 PMCID: PMC6218779 DOI: 10.7150/jca.26360] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/17/2018] [Indexed: 12/12/2022] Open
Abstract
Background: The prognostic role of plasma fibrinogen in lung cancer remains controversial. The aim of this meta-analysis was to assess the prognostic value of plasma fibrinogen in lung cancer. Methods: We performed a systematic literature search to identify eligible studies in PubMed, Embase and the Cochrane Library database. The hazard ratios (HR) and their 95% confidence intervals (CI) were collected from these eligible studies and were used to assess the relationship between plasma fibrinogen and lung cancer. Results: A total of 16 studies including 6,881 patients were selected in this meta-analysis. The results showed that elevated plasma fibrinogen in lung cancer patients was correlated with poor overall survival (OS) (HR = 1.38, 95% CI: 1.22-1.55, P < 0.001) and disease-free survival (DFS) / progress-free survival (PFS). (HR = 1.29, 95% CI: 1.01-1.65, P = 0.042). When stratified by cut-off value for OS and DFS/PFS, there was no significant heterogeneity. And the results of “cut-off value ≥ 400mg/dl” group showed that the high level of fibrinogen in serum was associated with worse OS and DFS/PFS of lung cancer. In further subgroup analysis by tumor histology, high plasma fibrinogen was also associated with worse OS in non-small cell lung cancer (NSCLC) (HR = 1.32, 95% CI: 1.14-1.53, P < 0.001). However, there was no significant association between high plasma fibrinogen and poor DFS in NSCLC patients (HR = 1.24, 95% CI: 0.97-1.57, P = 0.08). The Egger's regression test indicated evidence of publication bias for DFS/PFS. Conclusions: Elevated plasma fibrinogen, particularly defined as a plasma fibrinogen concentration of ≥ 400mg/dl, could be a promising indicator for worse OS in lung cancer patients, including NSCLC.
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Affiliation(s)
- Hai Zhong
- Department of Respiration, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yingying Qian
- Department of Respiration, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Surong Fang
- Department of Respiration, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Ying Wang
- Department of Respiration, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yun Tang
- Department of Respiration, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Wei Gu
- Department of Respiration, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
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24
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Zhang C, Jia Y, Jia Y, Zhang X, Li K. Prognostic and predictive value of plasma D-dimer levels in patients with small-cell lung cancer. Int J Clin Oncol 2018; 23:1070-1075. [PMID: 30168089 DOI: 10.1007/s10147-018-1320-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 07/18/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND To investigate the predictive value of plasma D-dimer levels for short-term therapeutic effect and progression-free survival (PFS) in patients with small-cell lung cancer (SCLC); and to analyze the correlation between baseline plasma D-dimer levels and other clinicopathological features. The aim of the study was to investigate whether the levels of plasma D-dimer could serve as a predictive and prognostic factor in patients with SCLC. METHODS A retrospective review of the clinicopathological data of 160 patients with pathologically confirmed SCLC, who were treated at the Department of Thoracic Oncology of Tianjin Medical University Tumor Institute and Hospital between June 2011 and June 2016, was performed. At the same time, we collected 100 patients with benign pulmonary diseases as a control group. The correlations between baseline plasma D-dimer levels and other clinical features, therapeutic effect and PFS were analyzed statistically. RESULTS The level of plasma D-dimer in patients with SCLC was significantly higher than that of patients with benign pulmonary diseases (P = 0.001). The PFS of patients with elevated D-dimer levels before therapy were significantly shorter than that of patients with normal D-dimer levels (6.0 versus 7.5 months, P = 0.013). The patients whose plasma D-dimer level always (before and after treatment) in the normal range have the best prognosis, and continuously elevated D-dimer carried out a poor prognosis (8.0 versus 5.0 months). According to multivariate analysis, elevated D-dimer level was confirmed to be an independent prognostic factor for worse survival (P = 0.029). The level of D-dimer was associated with tumor stage, the level of neuron-specific enolase, the presence of distant metastasis, hyponatremia, and the Karnofsky performance status score; and levels decreased when therapy was effective, but increased when the disease progressed. CONCLUSIONS High levels of baseline plasma D-dimer may indicate advanced disease stage and poor prognosis. Therefore, plasma D-dimer levels could serve as a predictive and prognostic factor in patients with SCLC.
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Affiliation(s)
- Cuicui Zhang
- Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China
- National Clinical Research Center for Cancer, Tianjin, 300060, People's Republic of China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, People's Republic of China
- Tianin's Clinical Research Center for Cancer, Tianjin, 300060, People's Republic of China
- Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Rd, Tiyuanbei, Hexi District, Tianjin, People's Republic of China
| | - Yongsheng Jia
- Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China
- National Clinical Research Center for Cancer, Tianjin, 300060, People's Republic of China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, People's Republic of China
- Tianin's Clinical Research Center for Cancer, Tianjin, 300060, People's Republic of China
- Thyroid and Neck Department, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China
| | - Yanan Jia
- Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China
- National Clinical Research Center for Cancer, Tianjin, 300060, People's Republic of China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, People's Republic of China
- Tianin's Clinical Research Center for Cancer, Tianjin, 300060, People's Republic of China
- Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Rd, Tiyuanbei, Hexi District, Tianjin, People's Republic of China
| | - Xiaoling Zhang
- Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China
- National Clinical Research Center for Cancer, Tianjin, 300060, People's Republic of China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, People's Republic of China
- Tianin's Clinical Research Center for Cancer, Tianjin, 300060, People's Republic of China
- Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Rd, Tiyuanbei, Hexi District, Tianjin, People's Republic of China
| | - Kai Li
- Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China.
- National Clinical Research Center for Cancer, Tianjin, 300060, People's Republic of China.
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, People's Republic of China.
- Tianin's Clinical Research Center for Cancer, Tianjin, 300060, People's Republic of China.
- Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Rd, Tiyuanbei, Hexi District, Tianjin, People's Republic of China.
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25
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Niu JY, Tian T, Zhu HY, Liang JH, Wu W, Cao L, Lu RN, Wang L, Li JY, Xu W. Hyperfibrinogenemia is a poor prognostic factor in diffuse large B cell lymphoma. Ann Hematol 2018; 97:1841-1849. [PMID: 29860562 DOI: 10.1007/s00277-018-3382-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 05/22/2018] [Indexed: 12/15/2022]
Abstract
Diffuse large B cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphomas worldwide. Previous studies indicated that hyperfibrinogenemia was a poor predictor in various tumors. The purpose of our study was to evaluate the prognostic effect of hyperfibrinogenemia in DLBCL. Data of 228 patients, who were diagnosed with DLBCL in our hospital between May 2009 and February 2016, were analyzed retrospectively. The Kaplan-Meier method and Cox regression were performed to find prognostic factors associated with progression-free survival (PFS) and overall survival (OS). Receiver operator characteristic (ROC) curve and the areas under the curve were used to evaluate the predictive accuracy of predictors. Comparison of characters between groups indicated that patients with high National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI) score (4-8) and advanced stage (III-IV) were more likely to suffer from hyperfibrinogenemia. The Kaplan-Meier method revealed that patients with hyperfibrinogenemia showed inferior PFS (P < 0.001) and OS (P < 0.001) than those without hyperfibrinogenemia. Multivariate analysis showed that hyperfibrinogenemia was an independent prognostic factor associated with poor outcomes (HR = 1.90, 95% CI: 1.15-3.16 for PFS, P = 0.013; HR = 2.65, 95% CI: 1.46-4.79 for OS, P = 0.001). We combined hyperfibrinogenemia and NCCN-IPI to build a new prognostic index (NPI). The NPI was demonstrated to have a superior predictive effect on prognosis (P = 0.0194 for PFS, P = 0.0034 for OS). Hyperfibrinogenemia was demonstrated to be able to predict poor outcome in DLBCL, especially for patients with advanced stage and high NCCN-IPI score. Adding hyperfibrinogenemia to NCCN-IPI could significantly improve the predictive effect of NCCN-IPI.
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Affiliation(s)
- Jun-Ying Niu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.,Key Laboratory of Hematology, Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Tian Tian
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.,Key Laboratory of Hematology, Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Hua-Yuan Zhu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.,Key Laboratory of Hematology, Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Jin-Hua Liang
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.,Key Laboratory of Hematology, Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Wei Wu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.,Key Laboratory of Hematology, Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Lei Cao
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.,Key Laboratory of Hematology, Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Rui-Nan Lu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.,Key Laboratory of Hematology, Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Li Wang
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.,Key Laboratory of Hematology, Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Jian-Yong Li
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.,Key Laboratory of Hematology, Nanjing Medical University, Nanjing, 210029, China.,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China
| | - Wei Xu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China. .,Key Laboratory of Hematology, Nanjing Medical University, Nanjing, 210029, China. .,Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing, 210029, China.
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Zhang F, Zhang Y, Ke C, Li A, Wang W, Yang K, Liu H, Xie H, Deng K, Zhao W, Yang C, Lou G, Hou Y, Li K. Predicting ovarian cancer recurrence by plasma metabolic profiles before and after surgery. Metabolomics 2018; 14:65. [PMID: 30830339 DOI: 10.1007/s11306-018-1354-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 01/13/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Previous metabolomic studies have revealed that plasma metabolic signatures may predict epithelial ovarian cancer (EOC) recurrence. However, few studies have performed metabolic profiling of pre- and post-operative specimens to investigate EOC prognostic biomarkers. OBJECTIVE The aims of our study were to compare the predictive performance of pre- and post-operative specimens and to create a better model for recurrence by combining biomarkers from both metabolic signatures. METHODS Thirty-five paired plasma samples were collected from 35 EOC patients before and after surgery. The patients were followed-up until December, 2016 to obtain recurrence information. Metabolomics using rapid resolution liquid chromatography-mass spectrometry was performed to identify metabolic signatures related to EOC recurrence. The support vector machine model was employed to predict EOC recurrence using identified biomarkers. RESULTS Global metabolomic profiles distinguished recurrent from non-recurrent EOC using both pre- and post-operative plasma. Ten common significant biomarkers, hydroxyphenyllactic acid, uric acid, creatinine, lysine, 3-(3,5-diiodo-4-hydroxyphenyl) lactate, phosphohydroxypyruvic acid, carnitine, coproporphyrinogen, L-beta-aspartyl-L-glutamic acid and 24,25-hydroxyvitamin D3, were identified as predictive biomarkers for EOC recurrence. The area under the receiver operating characteristic (AUC) values in pre- and post-operative plasma were 0.815 and 0.909, respectively; the AUC value after combining the two sets reached 0.964. CONCLUSION Plasma metabolomic analysis could be used to predict EOC recurrence. While post-operative biomarkers have a predictive advantage over pre-operative biomarkers, combining pre- and post-operative biomarkers showed the best predictive performance and has great potential for predicting recurrent EOC.
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Affiliation(s)
- Fan Zhang
- Department of Biostatistics, Public Health School, Harbin Medical University, Harbin, China
| | - Yuanyuan Zhang
- Department of Biostatistics, Public Health School, Harbin Medical University, Harbin, China
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Ang Li
- Department of Biostatistics, Public Health School, Harbin Medical University, Harbin, China
| | - Wenjie Wang
- Department of Biostatistics, Public Health School, Harbin Medical University, Harbin, China
| | - Kai Yang
- Department of Biostatistics, Public Health School, Harbin Medical University, Harbin, China
| | - Huijuan Liu
- Department of Biostatistics, Public Health School, Harbin Medical University, Harbin, China
| | - Hongyu Xie
- Department of Biostatistics, Public Health School, Harbin Medical University, Harbin, China
| | - Kui Deng
- Department of Biostatistics, Public Health School, Harbin Medical University, Harbin, China
| | - Weiwei Zhao
- Department of Biostatistics, Public Health School, Harbin Medical University, Harbin, China
| | - Chunyan Yang
- Department of Biostatistics, Public Health School, Harbin Medical University, Harbin, China
| | - Ge Lou
- Department of Gynecology Oncology, The Affiliated Tumor Hospital of Harbin Medical University, Harbin, China.
| | - Yan Hou
- Department of Biostatistics, Public Health School, Harbin Medical University, Harbin, China.
| | - Kang Li
- Department of Biostatistics, Public Health School, Harbin Medical University, Harbin, China.
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Lu ZL, Chen YJ, Jing XY, Wang NN, Zhang T, Hu CJ. Detection and Identification of Serum Peptides Biomarker in Papillary Thyroid Cancer. Med Sci Monit 2018; 24:1581-1587. [PMID: 29549708 PMCID: PMC5870111 DOI: 10.12659/msm.907768] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background Papillary thyroid cancer (PTC) is currently the most commonly diagnosed endocrine malignancy. In addition, the sex- and age-adjusted incidence of PTC has exhibited a greater increase over the last 2 decades than in many other malignancies. Thus, discovering noninvasive specific serum biomarker to distinguish PTC from cancer-free controls in its early stages remains an important goal. Material/Methods Serum samples from 88 PTC patients and 80 cancer-free controls were randomly allocated into training or validation sets. Serum peptide profiling was performed by matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF-MS) after using weak cation exchange magnetic beads (WCX-MB), and the results were evaluated by use of ClinProTools™ Software. To distinguish PTC from cancer-free controls, quick classifier (QC), supervised neural network (SNN), and genetic algorithm (GA) models were established. The models were blindly validated to verify their diagnostic capabilities. The most discriminative peaks were subsequently identified with a nano-liquid chromatography-electrospray ionization-tandem mass spectrometry system. Results Six peptide ions were identified as the most discriminative peaks between the PTC and cancer-free control samples. The QC model exhibited satisfactory sensitivity and specificity among the 3 models that were validated. Two peaks, at m/z 2671.17 and m/z 1464.68, were identified as fragments of the alpha chain of fibrinogen, while a peak at m/z 1738.92 was a fragment of complement component 4A/B. Conclusions MS combined with ClinProTools™ software was able to detect peptide biomarkers in PTC patients. In addition, the constructed classification models provided a serum peptidome pattern for distinguishing PTC from cancer-free controls. Both fibrinogen α and complement C4A/B were identified as potential markers for diagnosis of PTC.
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Affiliation(s)
- Zhao-Lian Lu
- School of Graduate, Second Military Medicinal University, Shanghai, China (mainland).,Department of Laboratory Medicine, General Hospital of Jinan Military Command Region, Jinan, Shandong, China (mainland)
| | - Ying-Jian Chen
- Department of Laboratory Medicine, General Hospital of Jinan Military Command Region, Jinan, Shandong, China (mainland)
| | - Xin-Yan Jing
- Department of Laboratory Medicine, General Hospital of Jinan Military Command Region, Jinan, Shandong, China (mainland)
| | - Na-Na Wang
- Department of Laboratory Medicine, General Hospital of Jinan Military Command Region, Jinan, Shandong, China (mainland)
| | - Ting Zhang
- Department of Laboratory Medicine, General Hospital of Jinan Military Command Region, Jinan, Shandong, China (mainland)
| | - Cheng-Jin Hu
- Department of Laboratory Medicine, General Hospital of Jinan Military Command Region, Jinan, Shandong, China (mainland)
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Fu SJ, Ji F, Han M, Chen MG, Wang XP, Ju WQ, Zhao Q, Wu LW, Ren QQ, Guo ZY, Wang DP, Zhu XF, Ma Y, He XS. Prognostic value of combined preoperative fibrinogen and neutrophil-lymphocyte ratio in patients with hepatocellular carcinoma after liver transplantation. Oncotarget 2018; 8:4301-4312. [PMID: 27935864 PMCID: PMC5354833 DOI: 10.18632/oncotarget.13804] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 11/02/2016] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Elevated plasma fibrinogen (Fib) correlated with patient's prognosis in several solid tumors. However, few studies have illuminated the relationship between preoperative Fib and prognosis of HCC after liver transplantation. We aimed to clarify the prognostic value of Fib and whether the prognostic accuracy can be enhanced by the combination of Fib and neutrophil-lymphocyte ratio (NLR). RESULTS Fib was correlated with Child-pugh stage, alpha-fetoprotein (AFP), size of largest tumor, macro- and micro-vascular invasion. Univariate analysis showed preoperative Fib, AFP, NLR, size of largest tumor, tumor number, macro- and micro- vascular invasion were significantly associated with disease-free survival (DFS) and overall survival (OS) in HCC patients with liver transplantation. After multivariate analysis, only Fib and macro-vascular invasion were independently correlated with DFS and OS. Survival analysis showed that preoperative Fib > 2.345 g/L predicted poor prognosis of patients HCC after liver transplantation. Preoperative Fib showed prognostic value in various subgroups of HCC. Furthermore, the predictive range was expanded by the combination of Fib and NLR. MATERIALS AND METHODS Data were collected retrospectively from 130 HCC patients who underwent liver transplantation. Preoperative Fib, NLR and clinicopathologic variables were analyzed. The survival analysis was performed by the Kaplan-Meier method, and compared by the log-rank test. Univariate and multivariate analyses were performed to identify the prognostic factors for DFS and OS. CONCLUSIONS Preoperative Fib is an independent effective predictor of prognosis for HCC patients, higher levels of Fib predict poorer outcomes and the combination of Fib and NLR enlarges the prognostic accuracy of testing.
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Affiliation(s)
- Shun-Jun Fu
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120, China
| | - Fei Ji
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China
| | - Ming Han
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China
| | - Mao-Gen Chen
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China
| | - Xiao-Ping Wang
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China
| | - Wei-Qiang Ju
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China
| | - Qiang Zhao
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China
| | - Lin-Wei Wu
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China
| | - Qing-Qi Ren
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China
| | - Zhi-Yong Guo
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China
| | - Dong-Ping Wang
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China
| | - Xiao-Feng Zhu
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China
| | - Yi Ma
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China
| | - Xiao-Shun He
- Organ Transplant Center, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial Key Laboratory of Organ Donation and Transplant Immunology, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.,Guangdong Provincial International Cooperation Base of Science and Technology (Organ Transplantation), the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China
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Liang Y, He D, Wu L, Ding X, Wang X, Wang B, Zhang R, Liang H. Elevated preoperative plasma D-dimer dose not adversely affect survival of gastric cancer after gastrectomy with curative intent: A propensity score analysis. Chin J Cancer Res 2018; 30:254-262. [PMID: 29861610 DOI: 10.21147/j.issn.1000-9604.2018.02.08] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective Elevated plasma D-dimer has been reported to be associated with advanced tumor stage and poor survival in several types of malignancies. The purpose of this study was to assess the potential impact of preoperative plasma D-dimer level (PDL) on overall survival (OS) of gastric cancer (GC) patients undergoing curative surgery by applying propensity score analysis. Methods A total of 1,025 curatively resected GC patients in Tianjin Medical University Cancer Institute & Hospital were enrolled. Patients were categorized into two groups based on preoperative PDL: the elevated group (EG) and the normal group (NG). To overcome bias due to the different distribution of covariates for the two groups, a one-to-one match was applied using propensity score analysis, after matching, prognostic factors were analyzed. Results In analysis for the whole study series, patients in the EG were more likely to have a larger proportion of tumor size ≥5 cm (67.5% vs. 55.8%, P=0.006), elder mean age (64.0±10.8 years vs. 60.5±11.6 years, P<0.001) and advanced tumor (T), node (N), and TNM stage. Patients with elevated PDL demonstrated a significantly lower 5-year OS than those with normal PDL (27.0%vs. 42.6%, P<0.001), however, the PDL was not an independent prognostic factor for OS in multivariate analysis [hazard ratio: 1.13, 95% confidence interval (95% CI): 0.92-1.39, P=0.236]. After matching, 163 patients in the EG and 163 patients in the NG had the same characteristics. The 5-year OS rate for patients in the EG was 27.0% compared with 25.8% for those in the NG (P=0.809, log-rank). Conclusions The poor prognosis of GC patients with elevated preoperative PDL was due to the advanced tumor stage and elder age rather than the elevated D-dimer itself.
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Affiliation(s)
- Yuexiang Liang
- Department of Gastrointestinal Oncology, the First Affiliated Hospital of Hainan Medical College, Haikou 570100, China
| | - Donglei He
- Department of Gastrointestinal Oncology, the First Affiliated Hospital of Hainan Medical College, Haikou 570100, China
| | - Liangliang Wu
- Department of Gastric Cancer, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Cancer for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Xuewei Ding
- Department of Gastric Cancer, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Cancer for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Xiaona Wang
- Department of Gastric Cancer, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Cancer for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Baogui Wang
- Department of Gastric Cancer, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Cancer for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Rupeng Zhang
- Department of Gastric Cancer, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Cancer for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Han Liang
- Department of Gastric Cancer, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center of Cancer, Tianjin's Clinical Research Cancer for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
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30
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Yoo BC, Lee JH, Kim KH, Lin W, Kim JH, Park JB, Park HJ, Shin SH, Yoo H, Kwon JW, Gwak HS. Cerebrospinal fluid metabolomic profiles can discriminate patients with leptomeningeal carcinomatosis from patients at high risk for leptomeningeal metastasis. Oncotarget 2017; 8:101203-101214. [PMID: 29254157 PMCID: PMC5731867 DOI: 10.18632/oncotarget.20983] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 08/28/2017] [Indexed: 12/16/2022] Open
Abstract
Purpose Early diagnosis of leptomeningeal carcinomatosis (LMC) is necessary to improve outcomes of this formidable disease. However, cerebrospinal fluid (CSF) cytology is frequently false negative. We examined whether CSF metabolome profiles can be used to differentiate patients with LMC from patients having a risk for development of LMC. Results A total of 10,905 LMIs were evaluated using PCA-DA. The LMIs defined Group 2 with a sensitivity of 85% and a specificity of 91%. After selecting 33 LMIs, including diacetylspermine and fibrinogen fragments, the CSF metabolomics profile had a sensitivity of 100% and a specificity of 93% for discriminating Group 1b from the other groups. After selecting 21 LMIs, including phosphatidylcholine, the CSF metabolomics profile differentiated LMC (Group 2) patients from the high-risk groups of Group 3 and Group 4 with 100% sensitivity and 100% specificity. Materials and Methods We prospectively collected CSF from five groups of patients: Group 1a, systemic cancer; Group 1b, no tumor; Group 2, LMC; Group 3, brain metastasis; Group 4, brain tumor other than brain metastasis. All metabolites in the CSF samples were detected as low-mass ions (LMIs) using mass spectrometry. Principal component analysis-based discriminant analysis (PCA-DA) and two search algorithms were used to select the LMIs that differentiated the patient groups of interest from controls. Conclusions Analysis of CSF metabolite profiles could be used to diagnose LMC and exclude patients at high-risk of LMC with a 100% accuracy. We expect a future validation trial to evaluate CSF metabolic profiles supporting CSF cytology.
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Affiliation(s)
- Byong Chul Yoo
- Biomarker Branch, Research Institute, National Cancer Center, Goyang, Republic of Korea
| | - Jun Hwa Lee
- Biomarker Branch, Research Institute, National Cancer Center, Goyang, Republic of Korea
| | - Kyung-Hee Kim
- Biomarker Branch, Research Institute, National Cancer Center, Goyang, Republic of Korea
| | - Weiwei Lin
- Department of Cancer Biomedical Science, National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Jong Heon Kim
- Department of Cancer Biomedical Science, National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Jong Bae Park
- Department of Cancer Biomedical Science, National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, Republic of Korea
| | - Hyun Jin Park
- Center for Pediatric Cancer, National Cancer Center, Goyang, Republic of Korea
| | - Sang Hoon Shin
- Neuro-oncology Clinic, National Cancer Center, Goyang, Republic of Korea
| | - Heon Yoo
- Neuro-oncology Clinic, National Cancer Center, Goyang, Republic of Korea
| | - Ji Woong Kwon
- Neuro-oncology Clinic, National Cancer Center, Goyang, Republic of Korea
| | - Ho-Shin Gwak
- Department of Cancer Biomedical Science, National Cancer Center, Graduate School of Cancer Science and Policy, Goyang, Republic of Korea.,Neuro-oncology Clinic, National Cancer Center, Goyang, Republic of Korea
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31
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Wang YQ, Zhi QJ, Wang XY, Yue DS, Li K, Jiang RC. Prognostic value of combined platelet, fibrinogen, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in patients with lung adenosquamous cancer. Oncol Lett 2017; 14:4331-4338. [PMID: 28943947 DOI: 10.3892/ol.2017.6660] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 05/19/2017] [Indexed: 12/14/2022] Open
Abstract
The aim of the present study was to investigate the prognostic value of the combined platelet (PLT), fibrinogen (FBG), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) (CO-NPF) for postoperative outcomes in patients with lung adenosquamous cancer (ASC). Test results from patients who presented at The Cancer Institute and Hospital of Tianjin Medical University between January 2005 and December 2013 were retrospectively reviewed. CO-NPF was scored between 0 and 4 according to increased PLT, FBG, NLR and PLR prior to being split into two groups based on the presence (≥2) or absence (<2) of the combination of increased inflammatory indexes. In total, data from 134 patients with ASC were reviewed for the present study. Multivariate analysis identified that increased CO-NPF (P=0.001 and P<0.001, respectively), PLR (P=0.011 and P=0.001, respectively) and FBG (P=0.001 and P<0.001, respectively) were independently associated with shorter disease-free survival (DFS) and overall survival (OS). NLR (P=0.006) and PLT (P=0.001) were independent prognostic factors for OS. The area under the receiver operating characteristic curves of CO-NPF (area under the curve, 0.652, P=0.008, 95% confidence interval, 0.551-0.752) was increased compared with NLR, PLR, PLT and FBG individually, suggesting that CO-NPF has greater predictive value. CO-NPF was significantly and independently associated with shorter DFS and OS, and had greater predictive value compared with NLR, PLR, PLT and FBG in patients with ASC who underwent surgery.
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Affiliation(s)
- Yu-Qian Wang
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Hexi, Tianjin 300060, P.R. China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Hexi, Tianjin 300060, P.R. China.,Department of Thoracic Oncology, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Hexi, Tianjin 300060, P.R. China
| | - Qiong-Jie Zhi
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Hexi, Tianjin 300060, P.R. China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Hexi, Tianjin 300060, P.R. China.,Department of Thoracic Oncology, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Hexi, Tianjin 300060, P.R. China
| | - Xin-Yue Wang
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Hexi, Tianjin 300060, P.R. China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Hexi, Tianjin 300060, P.R. China.,Department of Thoracic Oncology, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Hexi, Tianjin 300060, P.R. China
| | - Dong-Sheng Yue
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Hexi, Tianjin 300060, P.R. China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Hexi, Tianjin 300060, P.R. China.,Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Hexi, Tianjin 300060, P.R. China
| | - Kai Li
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Hexi, Tianjin 300060, P.R. China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Hexi, Tianjin 300060, P.R. China.,Department of Thoracic Oncology, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Hexi, Tianjin 300060, P.R. China
| | - Ri-Cheng Jiang
- Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Hexi, Tianjin 300060, P.R. China.,Key Laboratory of Cancer Prevention and Therapy, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Hexi, Tianjin 300060, P.R. China.,Department of Thoracic Oncology, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Hexi, Tianjin 300060, P.R. China
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32
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Chen P, Wang C, Cheng B, Nesa EU, Liu Y, Jia Y, Qu Y, Jiang Z, Han J, Cheng Y. Plasma fibrinogen and serum albumin levels (FA score) act as a promising prognostic indicator in non-small cell lung cancer. Onco Targets Ther 2017; 10:3107-3118. [PMID: 28790844 PMCID: PMC5488757 DOI: 10.2147/ott.s138854] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Evidence implies that preoperative plasma fibrinogen and serum albumin are associated with cancer prognosis. We aimed to explore the prognostic values of the score based on plasma fibrinogen and serum albumin levels (FA score) in non-small cell lung cancer (NSCLC), and to compare that with prognostic nutritional index (PNI). PATIENTS AND METHODS In all, 182 patients pathologically diagnosed with NSCLC were included in this study. Kaplan-Meier survival analysis and multivariate analysis were used in the prognostic analyses. RESULTS High FA score was related to smoking (P=0.005), poor differential grade (P=0.002), and advanced T stage (P<0.001) and tumor, node, and metastases stage (P=0.011). Low PNI showed association with advanced T stage (P=0.030). Kaplan-Meier survival analysis indicated that high FA score and low PNI were associated with poor progression-free survival (PFS; for the FA score, P<0.001; for PNI, P=0.001) and overall survival (OS; for the FA score, P<0.001; for PNI, P=0.013), respectively. Multivariate analysis revealed that FA score was an independent predictor for PFS (P=0.003) and OS (P=0.001) in NSCLC patients. CONCLUSION The FA score could act as a more promising prognostic predictor than PNI in NSCLC patients who underwent pneumonectomy.
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Affiliation(s)
- Pengxiang Chen
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
| | - Cong Wang
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
| | - Bo Cheng
- Medical College of Qingdao University, Qingdao
| | - Effat Un Nesa
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
| | - Yuan Liu
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
| | - Yibin Jia
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
| | - Yan Qu
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
| | - Ziying Jiang
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
| | - Jie Han
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, People's Republic of China
| | - Yufeng Cheng
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
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Zhang X, Long Q. Elevated serum plasma fibrinogen is associated with advanced tumor stage and poor survival in hepatocellular carcinoma patients. Medicine (Baltimore) 2017; 96:e6694. [PMID: 28445272 PMCID: PMC5413237 DOI: 10.1097/md.0000000000006694] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Hyperfibrinogenemia has been reported to be a predictor of poor prognosis in cancer patients, and in hepatocellular carcinoma (HCC) patients, survival remains uncertain and unpredictable. The aim of the present study was to evaluate the association between the level of plasma fibrinogen and overall survival in HCC patients.Overall, 308 patients with histologically proven HCC were included in our study. Univariate and multivariate analyses were performed to identify predictive risk factors for the rates of overall survival and tumor recurrence.Patients in the high-fibrinogen-level group were more likely to have advanced stage HCC, portal vein invasion, and tumors that were greater in number and larger in diameter than were patients in the low-fibrinogen-level group (all P < .05). The long-term overall survival rate of patients in the high-fibrinogen group was much lower than that of patients in the normal-fibrinogen group (P = .008), and similar outcomes were observed in the subgroup of patients who underwent radical therapies for HCC (P = .003). The results of the univariate and multivariate analyses indicated that high plasma fibrinogen remained independently associated with poorer overall survival. In addition, high plasma fibrinogen levels were associated with nonresponse to transarterial chemoembolization (TACE) (P < .001).Elevated plasma fibrinogen was independently associated with advanced HCC stage, poor prognosis, and nonresponse to TACE and may, therefore, serve as a valuable clinical biomarker for predicting prognosis in HCC patients.
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Zeng Q, Xue N, Dai D, Xing S, He X, Li S, Du Y, Huang C, Li L, Liu W. A Nomogram based on Inflammatory Factors C-Reactive Protein and Fibrinogen to Predict the Prognostic Value in Patients with Resected Non-Small Cell Lung Cancer. J Cancer 2017; 8:744-753. [PMID: 28382136 PMCID: PMC5381162 DOI: 10.7150/jca.17423] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 11/29/2016] [Indexed: 12/13/2022] Open
Abstract
Purpose: This study aimed to develop an effective nomogram for predicting survival in surgically treated non-small cell lung cancer patients. Methods: We retrospectively evaluated 856 NSCLC in this study. Cox regression analyses were performed to identify significant prognostic factors for developing a nomogram to predict overall survival (OS). The discriminative ability was assessed with the concordance index (C-index). Results: On multivariate analysis of the 856 cohort, independent factors for survival were CRP, fibrinogen, tumor status, nodal status, distant metastasis and clinical stage, which were entered into the nomogram. The C-index of the established nomogram 0.720 (95% CI: 0.671-0.769) was higher than that of the seventh edition TNM staging system 0.689 (95% CI: 0.668-0.709) for predicting OS (P < 0.05). Compared with patients with low CRP levels (< 8.6 g/L) and low fibrinogen levels (< 3.7 g/L), patients with high CRP and fibrinogen levels had shorter OS. Subgroup analyses revealed that the nomogram was a favorable prognostic parameter in stage I-IV NSCLC (P < 0.05). Conclusion: A nomogram integrating CRP and fibrinogen, which could be convenient and feasible to obtain from the serum preoperatively, may assist in risk stratification for individual patient with resected NSCLC.
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Affiliation(s)
- Qiuyao Zeng
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;; Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ning Xue
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;; Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Danian Dai
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;; Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
| | - Shan Xing
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;; Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xia He
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;; Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Shibing Li
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;; Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yi Du
- School of Medical Laboratory Science, Guangdong Medical University, Dongguan, China
| | - Chumei Huang
- Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Linfang Li
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;; Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Wanli Liu
- State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;; Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, Guangzhou, China
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35
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Sevoflurane attenuates platelets activation of patients undergoing lung cancer surgery and suppresses platelets-induced invasion of lung cancer cells. J Clin Anesth 2016; 35:304-312. [PMID: 27871548 DOI: 10.1016/j.jclinane.2016.08.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 07/29/2016] [Accepted: 08/09/2016] [Indexed: 02/07/2023]
Abstract
STUDY OBJECTIVE Platelets play a pivotal role in metastasis of tumor cells. The aim of this study is to explore the effects of sevoflurane and isoflurane on platelets activation of patients undergoing lung cancer surgery, and the effects of sevoflurane and isoflurane on platelets-induced invasion of lung cancer cells. DESIGN Prospective and randomized study, and in vitro experiment. SETTING University-affiliated teaching hospital and laboratory. PATIENTS Forty-six patients scheduled for lung cancer radical surgery. INTERVENTIONS Patients were randomized to two groups of 23 patients each and were received sevoflurane (group SEV) or isoflurane (group ISO) during surgery, respectively. In vitro, lung cancer cells were treated with platelets in the presence or absence anesthetics. MEASUREMENTS Platelets activation were determined by detecting glycoproteinIIb/IIIa (GPIIb/IIIa), CD62P, and platelets aggregation rate (PAR) pre-, intra-, and postoperatively. Invasion ability of lung cancer cells were evaluated by Transwell assay. RESULTS The levels of GPIIb/IIIa, CD62P, and PAR were reduced markedly in group SEV during perioperative period compared with group ISO. In vitro, activated platelets contributed profoundly to the invasive ability of lung cancer cells. Sevoflurane, but not isoflurane, inhibited platelets-induced invasion of lung cancer cells. Furthermore, sevoflurane suppressed the platelets activity in vitro. CONCLUSION Sevoflurane attenuates platelets activation of patients undergoing lung cancer surgery. In vitro, sevoflurane suppresses platelets-induced invasion of lung cancer cells via decreasing platelets activity.
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Ma C, Lu B, Diao C, Zhao K, Wang X, Ma B, Lu B, Sun E. Preoperative neutrophil-lymphocyte ratio and fibrinogen level in patients distinguish between muscle-invasive bladder cancer and non-muscle-invasive bladder cancer. Onco Targets Ther 2016; 9:4917-22. [PMID: 27540305 PMCID: PMC4982501 DOI: 10.2147/ott.s107445] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION The aim of this study was to explore if the preoperative neutrophil-lymphocyte ratio (NLR) and fibrinogen level can help in distinguishing between muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC). METHODS We identified 669 patients who underwent surgery at our institution, and evaluated their preoperative NLRs and fibrinogen levels. Patients were divided into two groups, NMIBC (group-I) and MIBC (group-II), according to the postoperative pathology. For the intergroup comparison, data obtained from the two groups were evaluated using independent samples t-test. The cutoff value of the NLR, fibrinogen level, and integrated NLR and fibrinogen level was determined with receiver operating characteristic (ROC) curve. RESULTS The mean NLRs of group-I and group-II were found as 2.71±2.46 and 4.66±8.00, respectively (P<0.001). The fibrinogen levels of the two groups were ~3.13±0.70 g/L and 3.41±0.84 g/L, respectively (P=0.001). Whether the NLR, fibrinogen level, and integrated NLR and fibrinogen level can help in distinguishing between MIBC and NMIBC was evaluated with ROC curve. The cutoff value of NLR was estimated as 2.01 according to the Youden index. With this value, sensitivity was found as 67.1%, specificity was 52.7%, and area under receiver operating characteristic (ROC) curve (AUC) was 0.601 (P=0.031). The cutoff value of fibrinogen level was estimated as 3.17 g/L according to the Youden index. Accordingly, sensitivity was found as 58%, specificity was 58%, and AUC was 0.60 (P=0.001). The cutoff value of integrated NLR and fibrinogen level was found as 0.166; the sensitivity was found as 86%, specificity was 42%, and AUC was 0.801 (P=0.01). CONCLUSION The data obtained in this study suggested that 67.1% of Ta-T1 tumors were likely to be invasive if the NLR was >2.01 and 58% were likely to be invasive if the fibrinogen level was >3.17 g/L. When we used both the NLR and fibrinogen level to distinguish between the MIBC and NMIBC, sensitivity was found to be 86%, and specificity was 42%.
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Affiliation(s)
- Chengquan Ma
- Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Bingxin Lu
- Tianjin Key Lab of Urology Basic Science, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Chengwen Diao
- Tianjin Key Lab of Urology Basic Science, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Kun Zhao
- Tianjin Key Lab of Urology Basic Science, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Xinpeng Wang
- Tianjin Key Lab of Urology Basic Science, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Baojing Ma
- Tianjin Key Lab of Urology Basic Science, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Baojian Lu
- Tianjin Key Lab of Urology Basic Science, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
| | - Erlin Sun
- Tianjin Key Lab of Urology Basic Science, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China
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Yu X, Hu F, Yao Q, Li C, Zhang H, Xue Y. Serum fibrinogen levels are positively correlated with advanced tumor stage and poor survival in patients with gastric cancer undergoing gastrectomy: a large cohort retrospective study. BMC Cancer 2016; 16:480. [PMID: 27418164 PMCID: PMC4946212 DOI: 10.1186/s12885-016-2510-z] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 06/22/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Platelet and blood coagulation abnormalities frequently occur in cancer patients. Fibrinogen is an important hemostatic factor that regulates the hemostatic pathway. Hyperfibrinogenemia is increasing recognized as an important risk factor influencing cancer development and outcome. However, few reports have investigated the prognostic potential of fibrinogen for predicting the survival of gastric cancer (GC) patients. The primary aim of this study was to evaluate the usefulness of preoperative serum fibrinogen as a biomarker for predicating tumor progression and survival of patients with GC. PATIENTS AND METHODS This retrospective study was conducted in GC patients who underwent gastrectomy from 2005 to 2007. Patient demographics, clinicopathological characteristics, preoperative plasma fibrinogen levels and median survival time (MST) were analyzed. Univariate and multivariate proportional hazard analysis of risk factors were used. RESULTS This study included 1196 patients (885 males and 311 females) with GC, more than half of whom had advanced GCs. Radical lymph node dissection was performed in 71.6 % of these patients. MST was 41.9 ± 32.4 months. Patient survival was significantly affected by family GC history (p <0.05), lymph node dissection mode (p <0.001), tumor size (≥5 cm; p <0.001), tumor location (p < 0.001), poor tumor differentiation (p <0.001), tumor histologic classification (p <0.001), extent of tumor invasion (p <0.001), number of metastatic lymph nodes (p <0.001), advanced stage of disease (p <0.001), extended operation duration (>150 min; p <0.001), higher operative bleeding volume (>200 ml; p <0.001), postoperative transfusion, preoperative serum fibrinogen levels, CEA levels and CA 19-9 levels (p <0.001). Multivariate analysis indicated that the independent prognostic factors significantly associated with poor survival included non-radical lymph node dissection, palliative lymph node dissection, multi-organ involvement, advanced TNM stages, poor tumor differentiation, higher preoperative serum fibrinogen levelsand higher CA19-9 levels. CONCLUSIONS Serum fibrinogen levels are positively correlated with advanced tumor stages and poor survival in GC patients undergoing gastrectomy. Preoperative plasma fibrinogen levels are an independent risk factor for survival in these patients. Serum fibrinogen is a useful biomarker for patients with clinically advanced GC.
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Affiliation(s)
- Xuefeng Yu
- Harbin Medical University Cancer Hospital, Haping Rd. #150, Harbin, 150040, Helongjiang Province, People's Republic of China
| | - Fulan Hu
- Harbin Medical University Public Health College, Harbin, 150081, Helongjiang Province, People's Republic of China
| | - Qiang Yao
- Harbin Medical University Cancer Hospital, Haping Rd. #150, Harbin, 150040, Helongjiang Province, People's Republic of China
| | - Chunfeng Li
- Harbin Medical University Cancer Hospital, Haping Rd. #150, Harbin, 150040, Helongjiang Province, People's Republic of China
| | - Hongfeng Zhang
- Harbin Medical University Cancer Hospital, Haping Rd. #150, Harbin, 150040, Helongjiang Province, People's Republic of China
| | - Yingwei Xue
- Harbin Medical University Cancer Hospital, Haping Rd. #150, Harbin, 150040, Helongjiang Province, People's Republic of China.
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Yu W, Wang Y, Shen B. An elevated preoperative plasma fibrinogen level is associated with poor overall survival in Chinese gastric cancer patients. Cancer Epidemiol 2016; 42:39-45. [PMID: 27010728 DOI: 10.1016/j.canep.2016.03.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 03/09/2016] [Accepted: 03/11/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To investigate the association between preoperative plasma fibrinogen level and overall survival (OS) in a cohort of Chinese gastric cancer patients who underwent gastrectomy. METHODS A retrospective cohort study was conducted among 1090 gastric cancer patients treated between January 2003 and December 2011 who were eligible for inclusion criteria. Plasma fibrinogen level was routinely measured before surgeries. The optional cut-off value for fibrinogen level was estimated by receiver operating characteristic (ROC) curve analysis. OS was evaluated using Kaplan-Meier curve. Univariate and multivariate Cox regression models were performed to determine correlations between preoperative plasma fibrinogen level and OS. RESULTS Enrolled subjects who returned for at least one follow-up visit had been followed for a median of 44.0 months (interquartile range, 62.0 months). An optimal cut-off value of 3.9g/L was determined for preoperative plasma fibrinogen level. Lymph node dissection method, tumor location, invasion depth, lymph node metastasis, differentiation, distant metastasis, CA199 and plasma fibrinogen level remained statistically significant with OS in multivariate analysis. Plasma fibrinogen level was significantly associated with age, tumor size, lymph node dissection method, invasion depth, lymph node metastasis, TNM stage and CEA. CONCLUSIONS Elevated preoperative plasma fibrinogen was independently associated with poor prognosis and may serve as a clinically useful biomarker for risk assessment and treatment choice in Chinese gastric cancer patients.
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Affiliation(s)
- Weijun Yu
- Department of General Surgery, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China
| | - Yongfeng Wang
- Department of General Surgery, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China
| | - Boming Shen
- Department of General Surgery, Qingpu Branch of Zhongshan Hospital, Fudan University, Shanghai 201700, China.
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Perisanidis C, Psyrri A, Cohen EE, Engelmann J, Heinze G, Perisanidis B, Stift A, Filipits M, Kornek G, Nkenke E. Prognostic role of pretreatment plasma fibrinogen in patients with solid tumors: A systematic review and meta-analysis. Cancer Treat Rev 2016; 41:960-70. [PMID: 26604093 DOI: 10.1016/j.ctrv.2015.10.002] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 10/06/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Plasma fibrinogen may be involved in several stages of cancer progression. Clinical studies have demonstrated that pretreatment plasma fibrinogen is associated with poor survival in various cancers. The aim of this meta-analysis was to examine the prognostic effect of circulating fibrinogen in solid tumors. MATERIALS AND METHODS We searched Medline, EMBASE, Cochrane Database of Systematic Reviews, and meeting proceedings to identify studies assessing the effect of pretreatment plasma fibrinogen on survival of cancer patients. Pooled multivariable-adjusted hazard ratios (HRs) for overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS) were estimated using random-effects models. RESULTS Data from 52 observational studies and 15,371 patients were summarized. An elevated baseline plasma fibrinogen was significantly associated with worse OS (pooled HR = 1.69; 95% CI = 1.48–1.92). The highest negative effect of elevated plasma fibrinogen on OS was demonstrated in renal cell carcinoma (pooled HR = 2.22), followed by head and neck cancer (pooled HR = 2.02), and colorectal cancer (pooled HR = 1.89). The adverse prognostic impact of high plasma fibrinogen remained in both non-metastatic and metastatic disease and patients of different ethnicity. Patients with high baseline fibrinogen had a significantly shorter DFS (pooled HR = 1.52) and CSS (pooled HR = 2.50). CONCLUSIONS An elevated pretreatment plasma fibrinogen significantly correlates with decreased survival in patients with solid tumors. Future clinical trials are warranted to determine whether plasma fibrinogen could be incorporated in cancer staging systems and whether fibrinogen-lowering therapies have a favorable effect on disease recurrence and mortality.
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The preoperative plasma fibrinogen level is an independent prognostic factor for overall survival of breast cancer patients who underwent surgical treatment. Breast 2015; 24:745-50. [PMID: 26482138 DOI: 10.1016/j.breast.2015.09.007] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 09/03/2015] [Accepted: 09/15/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Previous studies have suggested that plasma fibrinogen contributes to tumor cell proliferation, progression and metastasis. The current study was performed to evaluate the prognostic relevance of preoperative plasma fibrinogen in breast cancer patients. METHOD Data of 2073 consecutive breast cancer patients, who underwent surgery between January 2002 and December 2008 at the Sun Yat-sen University Cancer Center, were retrospectively evaluated. Plasma fibrinogen levels were routinely measured before surgeries. Participants were grouped by the cutoff value estimated by the receiver operating characteristic (ROC) curve analysis. Overall survival (OS) was assessed using Kaplan-Meier analysis, and multivariate Cox proportional hazards regression model was performed to evaluate the independent prognostic value of plasma fibrinogen level. RESULTS The optimal cutoff value of preoperative plasma fibrinogen was determined to be 2.83 g/L. The Kaplan-Meier analysis showed that patients with high fibrinogen levels had shorter OS than patients with low fibrinogen levels (p < 0.001). Multivariate analysis suggested preoperative plasma fibrinogen as an independent prognostic factor for OS in breast cancer patients (HR = 1.475, 95% confidence interval (CI): 1.177-1.848, p = 0.001). Subgroup analyses revealed that plasma fibrinogen level was an unfavorable prognostic parameter in stage II-III, Luminal subtypes and triple-negative breast cancer patients. CONCLUSION Elevated preoperative plasma fibrinogen was independently associated with poor prognosis in breast cancer patients and may serve as a valuable parameter for risk assessment in breast cancer patients.
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Li H, Zhao T, Ji X, Liang S, Wang Z, Yang Y, Yin J, Wang R. Hyperfibrinogenemia predicts poor prognosis in patients with advanced biliary tract cancer. Tumour Biol 2015; 37:3535-42. [PMID: 26453118 DOI: 10.1007/s13277-015-4184-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 10/01/2015] [Indexed: 12/11/2022] Open
Abstract
Hyperfibrinogenemia reportedly predicts poor prognosis in several cancers but has not been reviewed for biliary tract cancer (BTC). The aim of the present study was to evaluate associations between baseline plasma fibrinogen concentrations, clinicopathological characteristics, and survival parameters in patients with BTC. Data for 127 patients with BTC diagnosed at the Zhongshan Affiliated Hospital of Dalian University (Liaoning, China) from January 2011 to December 2014 were retrospectively evaluated. Associations between baseline fibrinogen concentrations, selected clinicopathological characteristics, and the prognostic value were examined using SPSS software. Data for 37 patients (29.1 % of study cohort) who had undergone curative intent surgery and 90 (70.9 %) with advanced biliary tract cancer (ABTC) were analyzed. The mean plasma fibrinogen concentration 4.0 ± 0.9 g/L for the entire cohort. The percentages with hyperfibrinogenemia (>4 g/L) were 45.7, 37.8, and 48.9 % overall and in the surgical and ABTC groups, respectively. Hyperfibrinogenemia was associated with performance status (PS) and neutrophil/lymphocyte ratio in the entire cohort but not with other relevant clinicopathological factors. Log-rank test indicated that baseline hyperfibrinogenemia was associated with decreased progression-free survival (PFS) and overall survival (OS) for patients with unresectable ABTC (P > 0.05). Multivariate analysis showed that poor PS and baseline hyperfibrinogenemia were independently associated with worse survival (HR: 1.39, 95 % CI: 1.02-1.90, P = 0.04; HR: 1.75.95 %, 95 % CI: 1.01-3.01, P = 0.04, respectively). Baseline hyperfibrinogenemia is an independent predictor of poor prognosis in patients with ABTC. Baseline plasma fibrinogen concentrations may be a readily available and inexpensive prognostic biomarker in patients with ABTC; this needs further validation in large prospective clinical trials.
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Affiliation(s)
- Heming Li
- Department of Oncology, Zhongshan Hospital of Dalian University, No. 6, Liberation Street, Zhongshan District, Dalian, 116001, People's Republic of China
| | - Tong Zhao
- Department of Oncology, Zhongshan Hospital of Dalian University, No. 6, Liberation Street, Zhongshan District, Dalian, 116001, People's Republic of China
| | - Xuening Ji
- Department of Oncology, Zhongshan Hospital of Dalian University, No. 6, Liberation Street, Zhongshan District, Dalian, 116001, People's Republic of China
| | - Shanshan Liang
- Department of Oncology, Zhongshan Hospital of Dalian University, No. 6, Liberation Street, Zhongshan District, Dalian, 116001, People's Republic of China
| | - Zhe Wang
- Department of Oncology, Zhongshan Hospital of Dalian University, No. 6, Liberation Street, Zhongshan District, Dalian, 116001, People's Republic of China
| | - Yulong Yang
- Department of Oncology, Zhongshan Hospital of Dalian University, No. 6, Liberation Street, Zhongshan District, Dalian, 116001, People's Republic of China
| | - Jiajun Yin
- Department of Oncology, Zhongshan Hospital of Dalian University, No. 6, Liberation Street, Zhongshan District, Dalian, 116001, People's Republic of China
| | - Ruoyu Wang
- Department of Oncology, Zhongshan Hospital of Dalian University, No. 6, Liberation Street, Zhongshan District, Dalian, 116001, People's Republic of China.
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