Clinical and prognostic significance of plasma fibrinogen in lung cancer
Journal Title: Journal of Cancer Research & Therapy - Year 2014, Vol 2, Issue 1
Abstract
Objectives: Hyperfibrinogenemia is a common problem associated with various carcinomas. The recent studies have shown that high plasma fibrinogen concentration is associated with invasion, growth and metastases of cancer. Furthermore, the recent studies focus on the prognostic significance of fibrinogen in the patients with advanced NSCLC (stage IIIB -IV). However, the prognostic significance of the plasma fibrinogen levels in early stage NSCLC patients (stage I -IIIA) still remains unclear. In addition, it remains unclear whether or not chemotherapy-induced changes in fibrinogen level relate to the prognosis. The aims of this study were to 1) further explore the relationship between the plasma fibrinogen concentration and the stage and metastases of lung cancer 2) evaluate the prognostic significance of the basal plasma fibrinogen level in patients with lung cancer 3) explore the prognostic value of the change in fibrinogen levels between pre and post-chemotherapy. Methods: In this retrospective study, the data from 370 patients with lung cancer were enrolled into this study. The plasma fibrinogen levels were compared with the clinical and prognostic significance of lung cancer. The association between the plasma fibrinogen level and clinical-prognostic characteristics were analyzed using SPSS 17.0 software. Results: 1) The median pre-treatment plasma fibrinogen levels were 4.20g/L. Pre-treatment plasma fibrinogen levels correlated significantly with gender (p = 0.013). A higher plasma fibrinogen concentration was associated with squamous cell carcinoma versus adenocarcinoma (4.83±1.50 g/L versus 4.15±1.30 g/L; P<0.001), there was a significant association between plasma fibrinogen level and metastases of lung cancer, pointing a higher plasma fibrinogen level in lymph nodes or distant organ metastases (p < 0.001). 2) Patients with low plasma fibrinogen concentration demonstrates higher overall survival compared with those with high plasma fibrinogen concentration (median, 19 months versus 35 months; P <0.001). In addition, a similar result was observed in 194 early stage NSCLC (stage I -IIIA) (P <0.001). Univariate and multivariate analysis revealed that higher levels of fibrinogen (FIB≥4.20 g/L), age, distant metastases and pathological types were positively associated with shorter overall survival (OS). 3) In addition, there was a significant link between the elevation by more than 15% in the plasma fibrinogen level after receiving short-term chemotherapy and shorter overall survival (OS). Conclusion: 1) This study shows high plasma fibrinogen concentration is associated with lymph nodes or distant organ metastases in lung cancer. 2) Furthermore, our results indicate a significant relevance between high pre-treatment plasma fibrinogen concentration and poor prognosis in patients with lung cancer. 3) In addition, we find that the patients with a low plasma fibrinogen level will have a shorter OS if the plasma fibrinogen level increases significantly after receiving short-term chemotherapy. Interestingly, we also find that the patients with a high plasma fibrinogen level will have a longer OS if the plasma fibrinogen level decreases significantly after receiving short-term chemotherapy, which indicate the change of the plasma fibrinogen level after receiving short-term chemotherapy may be used as an independent prognostic factor.
Authors and Affiliations
Chen YS, Zeng DH, Li HR, Wu YL, Lin X, Xu NL
Body composition, somatotype and risk of premenopausal breast cancer: a case-control study in Uruguay
In order to analyze detailed anthropometric characterisation for risk of breast cancer (BC) in premenopausal Uruguayan women, a case-control study was carried out at the Pereira Rossell Women’s Hospital, Montevideo, wher...
Burden, quality of life and distress of the main caregiver in head and neck, cervix and rectal cancer patients
Purpose: Based on Portuguese experience, current practice does not focus sufficiently on the caregiver needs through caring of the cancer patient. Understanding the impact of different tumor types on caregiver burden, qu...
The implementation of randomized trials in the treatment of advanced ovarian cancer with HIPEC: waiting for new evidence
Ovarian cancer (OC) is one of the most frequent mortality causes among female neoplasms. A lot of data is available on the efficiency and the relative safety of the different treatments. In the last twenty years the over...
The positive sentinel lymph node biopsy- can we predict which patients will benefit from further surgery?
Introduction: Although sentinel lymph node biopsy (SLNB) is the gold standard for clinical and radiological negative axillae in breast cancer, the subsequent management of positive nodes is currently under scrutiny with...
Outcomes of social support programs in brain cancer survivors in an Australian community cohort: a prospective study
This study evaluated the impact of social support programs on improving cancer related disability, neuro-cognitive dysfunction and enhancing participation (quality of life (QoL), social reintegration) in brain tumour (BT...