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Background
Hyperfibrinogenemia is a common problem associated with various carcinomas, and is accompanied by hypercoagulablity. In advanced non-small-cell lung cancer (NSCLC) it remains unclear whether or not chemotherapy-induced changes in fibrinogen level relate to chemotherapeutic response and prognosis. The purposes of this study were to: 1) an...
Contexts in source publication
Context 1
... shown in Table 4, pre-and post-chemotherapy CEA levels were measured in 145 patients and 88 of these patients (60.69 %) presented with elevated levels. Post- chemotherapy CEA levels were significantly lower (p = 0.015) than pre-chemotherapy levels in the DCR group, but were comparable (p = 0.35) in the PD group (Table 4). ...
Context 2
... shown in Table 4, pre-and post-chemotherapy CEA levels were measured in 145 patients and 88 of these patients (60.69 %) presented with elevated levels. Post- chemotherapy CEA levels were significantly lower (p = 0.015) than pre-chemotherapy levels in the DCR group, but were comparable (p = 0.35) in the PD group (Table 4). As shown in Table 5, pre-and post- chemotherapy CA125 levels were measured in 114 patients and 69 patients (55.2 %) presented with elevated levels. ...
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Background: Fibrinogen may play an important role in the survival of trauma patients; however, its role in traumatic brain injury (TBI) and its correlation with disease prognosis remain poorly understood. The aims of this study were to determine the incidence of TBI-associated hypofibrinogenemia in patients with TBI and to evaluate the prognostic v...
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Background:
Fibrinogen may play an important role in the survival of trauma patients; however, its role in traumatic brain injury (TBI) and its correlation with disease prognosis remain poorly understood. The aims of this study were to determine the incidence of TBI-associated hypofibrinogenemia in patients with TBI and to evaluate the prognostic...
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Background: Fibrinogen may play an important role in the survival of trauma patients; however, its role in traumatic brain injury (TBI) and its correlation with disease prognosis remain poorly understood. The aims of this study were to determine the incidence of TBI-associated hypofibrinogenemia in patients with TBI and to evaluate the prognostic v...
Citations
... Fibrinogen is known to be a key biomarker in the regulation of inflammation, tumor cell proliferation, migration, and angiogenesis (13). Moreover, high levels of fibrinogen in the plasma are associated with shorter survival in a variety of cancers (14)(15)(16)(17). Furthermore, C-reactive protein (CRP) was found to be an inflammation-related biomarker that can predict survival in GBM (18). ...
Objective: The present study investigates a score based on baseline C-reactive protein (CRP) and fibrinogen values (FC score) in 173 consecutive glioblastoma (GBM) patients.
Methods: The optimal cut-off value for fibrinogen and CRP was defined as 3.5 g/dl and 3.0 mg/L, respectively, according to previous reports. Patients with elevated CRP and fibrinogen were classified with a score of 2, those with an elevation of only one of these parameters were allocated a score of 1, and those without any abnormalities were assigned a score of 0.
Results: No significant differences in age, gender, tumor area, molecular pathology, physical status, or extent of resection were identified among the three groups defined by this score. Univariate survival analysis demonstrated that a high baseline FC score (≥1) is significantly associated with a shortened overall survival (OS) (HR: 1.52, 95% CI: 1.05–2.20, p = 0.027). A multivariate Cox regression analysis considering age (>65/≤65), extent of resection (GTR/STR), MGMT promoter status (hypermethylated/non-hypermethylated), and FC score (0/≥1) confirmed that an elevated FC score (≥1) is an independent predictor of shortened OS (HR: 1.71, 95% CI: 1.16–2.51, p = 0.006).
Conclusions: The baseline fibrinogen and CRP score thus serves as an independent predictor of OS in GBM. Further investigations of the role of inflammation in the prediction of a prognosis are needed.
... Fibrinogen has been considered an important regulator and biomarker of DovePress inflammation, and its association with tumor progression and patient prognosis has been identified in several cancers. [26][27][28][29] However, to date, the value of fibrinogen in skull base chordoma patients has been unclear. Our results indicate that patients with high fibrinogen tend to have poor PFS and OS. ...
Objective
Inflammation and malnutrition have been shown to be correlated with tumor progression and a poor prognosis in various cancers. However, the clinical implications of biomarkers of inflammation and malnutrition in chordoma have not been elucidated. We attempted to characterize the fibrinogen and albumin levels in skull base chordoma and investigate their correlations with clinicopathological data and survival.
Methods
The preoperative levels of fibrinogen and albumin were assessed in 183 primary skull base chordoma patients. The cutoff values were determined by X-tile software, and their correlations with patient prognosis were further explored using the Kaplan–Meier curve and Cox proportional hazards regression analysis. In addition, the predictive performances of these markers in survival were evaluated by receiver operating characteristic curves.
Results
The values of fibrinogen and albumin in skull base chordoma patients ranged from 1.73 to 7.40 and 37.6 to 53.0 g/L, respectively. The optimal cutoff values for fibrinogen and albumin were 3.29 and 44.60 g/L, respectively. Fibrinogen and albumin were correlated with the patient age and tumor pathology types. Albumin, but not fibrinogen, was associated with the patients’ progression-free survival and overall survival. Importantly, the FA score, which combines fibrinogen and albumin, could independently predict both progression-free survival and overall survival, and enhanced the performance of fibrinogen or albumin in survival prediction in skull base chordoma.
Conclusion
Our data reveal the clinical prognostic role of albumin and suggest that the FA score may be a valuable prognostic grading system in skull base chordoma.
... In this analysis, cut-off value of plasma fibrinogen was 4.0 g/L in eight studies. Besides, 16 (15)(16)(17)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32), four (22,26,29,31) and 3 studies (25,29,33) were estimated by HR and corresponding 95% CI for OS, PFS and DFS, respectively. Two studies were evaluated by OR for histology (29,33), differentiation (29,33), chemotherapy response (DCR and ORR) (26,31) and performance status (26,33) and four (24,29,33,34) and three articles (24,29,33) for stage and lymph node metastasis, respectively. ...
... In this analysis, cut-off value of plasma fibrinogen was 4.0 g/L in eight studies. Besides, 16 (15)(16)(17)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32), four (22,26,29,31) and 3 studies (25,29,33) were estimated by HR and corresponding 95% CI for OS, PFS and DFS, respectively. Two studies were evaluated by OR for histology (29,33), differentiation (29,33), chemotherapy response (DCR and ORR) (26,31) and performance status (26,33) and four (24,29,33,34) and three articles (24,29,33) for stage and lymph node metastasis, respectively. ...
... Two studies were evaluated by OR for histology (29,33), differentiation (29,33), chemotherapy response (DCR and ORR) (26,31) and performance status (26,33) and four (24,29,33,34) and three articles (24,29,33) for stage and lymph node metastasis, respectively. Furthermore, SMD was applied to appraise the effect of fibrinogen on clinicopathological characteristics, in which four studies (16,31,35,36) for histology and three for distant metastasis (16,24,35), tumor stage (24,35,36) and two for stage (24,35) ( Table 1). Fourteen studies (15,(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) investigated elevated plasma fibrinogen as an indicator of poor OS, and the other two studies (16,17) showed no significant impact on OS. ...
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.
... In recent years, some survival prognostic factors and prediction models for European NSCLC patients have been reported, indicating that stage IV (versus prior stage), lower performance status (PS), elevated white blood cells (WBCs), distant metastasis, abnormal absolute neutrophil count, age >60, male sex, anemia, abnormal lactate dehydrogenase (LDH) level, and increased tumor markers may be independent negative prognostic factors for survival [4,6,7]. In recent years, coagulation parameters represented by fibrinogen [8], platelets [9], and prevalent inflammatory prognostic indexes such as Glasgow prognostic score 10 (composed of albumin and CRP) have also been verified to predict poor survival. Based on these results, we performed this retrospective analysis using clinical characteristics, blood routine tests, and coagulation parameters, which were easily identified clinical factors influencing the outcomes of patients who received standard first-line chemotherapy, aiming to build a simple model that could be utilized as a part of everyday clinical practice for prediction of long-term survival. ...
... Fg is a vital component in the connection between malignancy and coagulation, the level of which has prognostic significance in lung cancer, especially in Asian countries [20][21][22]. Zhao et al. [8] reported that chemotherapy-induced reduction in plasma Fg level may be a promising biomarker, and a higher level of Fg (³4.4 g/L) was positively correlated with shorter OS. ...
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/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.
... The full texts of the remaining 35 studies were further evaluated. Finally, only 16 studies were included in this meta-analysis [14][15][16][17][25][26][27][28][29][30][31][32][33][34][35][36]. ...
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.
... Serum albumin levels reflect the SIR of host and nutritional status [14][15][16] . Recently, accumulating researches have shown that both fibrinogen and serum albumin are important prognostic predictors in various cancers, and elevated plasma fibrinogen and lower serum albumin levels are significantly correlated with shorter survival in tumor patients [17][18][19][20][21] . From the results of the above studies, we can naturally hypothesize that the fibrinogen-to-albumin ratio (FAR) might be more powerful than elevated fibrinogen or lower serum albumin level in predicting the prognosis of patients with malignant tumors. ...
AIM
To investigate the prognostic role of fibrinogen-to-albumin ratio (FAR) on patients with gallbladder cancer (GBC) in this study.
METHODS
One hundred and fifty-four GBC patients were retrospectively analyzed, who received potentially curative cholecystectomy in our institute from March 2005 to December 2017. Receiver operating characteristic curve (ROC curve) was used to determine the optimal cut-offs for these biomarkers. In addition, Kaplan-Meier survival analysis as well as multivariate analysis were applied for prognostic analyses.
RESULTS
ROC curve revealed that the optimal cut-off value for FAR was 0.08. FAR was significantly correlated with age (P = 0.045), jaundice (P < 0.001), differentiation (P = 0.002), resection margin status (P < 0.001), T stage (P < 0.001), TNM stage (P < 0.001), and CA199 (P < 0.001) as well as albumin levels (P < 0.001). Multivariate analysis indicated that the resection margin status [hazard ratio (HR): 2.343, 95% confidence interval (CI): 1.532-3.581, P < 0.001], TNM stage (P = 0.035), albumin level (HR = 0.595, 95%CI: 0.385-0.921, P = 0.020) and FAR (HR: 2.813, 95%CI: 1.765-4.484, P < 0.001) were independent prognostic factors in GBC patients.
CONCLUSION
An elevated preoperative FAR was significantly correlated with unfavorable overall survival in GBC patients, while an elevated preoperative albumin level was a protective prognostic factor for patients with GBC. The preoperative FAR could be used to predict the prognosis of GBC patients, which was easily accessible, cost-effective and noninvasive.
... In clinical application, serum tumor biomarkers can be used as prognostic indicators in NSCLC. 31,32 Chiu et al 33 revealed that changes of CEA, CA125, and CA19-9 levels at 4 weeks after treatment with gefitinib can predict the survival of patients with advanced NSCLC, and unexpectedly, the authors found no correlation between CEA and OS or PFS. Ma et al 34,35 investigated the predictive value of CYFRA21-1 and other serum biomarkers in patients with NSCLC and identified that CYFRA21-1 was an independent prognostic factor for OS. ...
SP70 is a novel tumor biomarker in patients with nonsmall cell lung cancer (NSCLC). However, its role as a marker for predicting the response to chemotherapy for patients with advanced NSCLC has not been investigated. A total of 152 patients were enrolled. Serum SP70, carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21‐1), and neuron‐specific enolase (NSE) were detected before and after 2 cycles of chemotherapy. The correlation between serum tumor biomarker levels and chemotherapy responses and their association with epidermal growth factor receptor (EGFR) mutation status and progression‐free survival (PFS) were analyzed. Serum SP70 levels were significantly decreased after chemotherapy in the partial remission (PR) group (P < .001) and increased in the progressive disease (PD) group (P < .001), but not significantly changed in the stable disease (SD) group (P = .114). Although similar changes were observed on CEA and CYFRA21‐1 levels but not NSE, ROC analysis demonstrated that SP70 is superior to the others. Additionally, patients with EGFR mutation had higher serum SP70 levels and tissue SP70 expression than patients without EGFR mutation (P = .014 and P = .002, respectively). The median PFS of patients with decreased SP70 levels after chemotherapy was longer than that of patients with stable or increased serum SP70 level (24 months vs 12 months vs 2 months, P < .001), and the differences of all other 3 tumor markers were not obvious. Serum SP70 is a sensitive and real‐time indicator of chemotherapeutic efficacy in patients with advanced NSCLC and related to PFS.
... Tumor-induced coagulation and fibrin formation have been reported as prerequisite to tumor angiogenesis, metastasis and invasion, with cross-linked fibrin in the extracellular matrix providing the basis for endothelial cell and tumor cell migration during angiogenesis and invasion [4,5]. Various investigations have reported that D-dimer levels, reflecting the degree of coagulation and fibrinolytic activation, correlate with tumor stage, response to chemotherapy and prognosis for several types of cancer [6][7][8][9], including non-small cell lung cancer (NSCLC) [9][10][11]. However, the relevance of D-dimer level for primary lung cancer has yet to be established. ...
Background
Plasma D-dimer level, a marker of hypercoagulation, has been reported to be associated with survival in several types of cancers. The present study aimed to evaluate the prognostic significance of preoperative D-dimer levels in patients with surgically resected clinical stage I non-small cell lung cancer (NSCLC). Methods
Participants comprised 237 patients with surgically resected clinical stage I NSCLC. In addition to factors such as age, sex, and smoking status, the association between preoperative D-dimer level and survival was explored. ResultsPatients were divided into two groups according to D-dimer level: Group A, ≤ 1.0 μg/ml (n = 170); and Group B, > 1.0 μg/ml (n = 67). The 5-year recurrence-free survival rate was 81.6% for Group A and 66.6% for Group B (p < 0.001). The 5-year overall survival rate was 93.6% for Group A and 84.7% for Group B (p = 0.002). Multivariate survival analysis identified D-dimer level as an independent prognostic factor, along with age, maximum standardized uptake value of the primary tumor, and pathological stage. Conclusions
Preoperative D-dimer level is an independent prognostic factor in patients with surgically resected clinical stage I NSCLC.
... Many studies have reported an association between blood coagulation abnormalities and several malignancies, and hypercoagulation is associated with a poor prognosis. [4][5][6][7][8] Indeed, activation of the coagulation system and procoagulant changes have been associated with angiogenesis and tumor cell invasion, cancer progression, and metastasis. 9 Fibrinogen (Fbg), a plasma coagulation factor synthesized by the hepatocytes, is an acute-phase reactant protein and a proinflammatory marker that plays an important role in platelet aggregation, increasing plasma viscosity, vasoconstriction, growth factor release, and fibrin deposition. ...
... 11,21 In patients with advanced NSCLC, serum Fbg alterations are useful to identify those who will benefit from preoperative chemotherapy. 6 It is well known that SCLC does not share the biological characteristics of NSCLC, 16 hence the importance of verifying the eventual prognostic impact of Fbg in SCLC. The present study showed that plasma Fbg level and survival are associated, as in other cancers and NSCLC. ...
Background:
Elevated plasma fibrinogen (Fbg) levels contribute to tumor progression and metastasis; however, limited research on Fbg in small cell lung cancer (SCLC) has been conducted. This study evaluated the prognostic value of Fbg levels in patients with SCLC.
Methods:
Data on plasma Fbg level, clinical features, and overall survival were retrospectively collected. Kaplan-Meier estimates and log-rank tests were used to analyze the relationship between Fbg level and survival. Multivariate analyses were performed to determine independent prognostic factors. Subgroup analyses were performed based on extensive/limited disease and Eastern Cooperative Oncology Group status.
Results:
A total of 120 patients with SCLC were included. The one, three, and five-year survival rates for the entire cohort were 48.3%, 9.2%, and 1.7%, respectively. Univariate analyses revealed that age, alcohol use, clinical stage, pleural effusion, Eastern Cooperative Oncology Group grade, and Fbg and lactate dehydrogenase levels were associated with survival (P < 0.05). The median survival time for patients with high Fbg levels (> 400 mg/dL) was shorter than for those with low Fbg levels (8 vs. 14 months; P = 0.013). Furthermore, multivariate analysis revealed that Fbg was negatively and independently associated with SCLC prognosis (hazard ratio 1.505, 95% confidence interval 1.018-2.226; P = 0.041). Higher Fbg levels were associated with shorter survival in the extensive disease subgroup (7 vs. 12 months; P = 0.004).
Conclusions:
Elevated plasma Fbg was an independent factor associated with poor outcomes in SCLC patients and could serve as a prognostic biomarker.
... 22 With regard to chemotherapy, treatment response and the plasma fibrinogen level were shown to correlate with each other in lung cancer and esophageal cancer. 23,24 There has been very few studies on the correlation between the plasma fibrinogen level and breast cancer patients receiving neoadjuvant chemotherapy followed by radical mastectomy. ...
... We had investigated the correlation between pretreatment plasma fibrinogen levels and clinicopathological parameters in our previous study. 23 The preoperative plasma fibrinogen levels had no association with any clinicopathological parameters (Table 2), may be limited by the size of the sample and short-time follow-up. So, we focused on the changes in plasma fibrinogen levels after neoadjuvant chemotherapy. ...
Neoadjuvant chemotherapy has been established as standard treatments for advanced breast cancer among multidisciplinary therapies. A simple and instructive biomarker for the postoperative recurrence and metastasis is needed to evaluate the therapeutic effect. Plasma fibrinogen level has been shown to be associated with tumor progression and poor outcomes in breast cancer patients. This study aims to further evaluate the clinical and prognostic value of plasma fibrinogen level as a biomarker in breast cancer patients receiving neoadjuvant chemotherapy. In this study, data of 67 patients were retrospectively collected and analyzed to identify the relationship between the plasma fibrinogen level and the clinical progression and outcome of these patients. Patients with increased plasma fibrinogen level after neoadjuvant chemotherapy had significantly shorter disease-free survival and overall survival (p < 0.001 and p = 0.001, respectively). In a univariate survival analysis, molecular type (p = 0.0004/p = 0.005), clinical response (p = 0.008/p = 0.015), and changes in plasma fibrinogen level (p = 0.012/p = 0.007) were associated with disease-free survival and overall survival, and all of them, molecular type (p = 0.0003/p = 0.005), clinical response (p = 0.027/p = 0.021), and changes in plasma fibrinogen level (p = 0.035/p = 0.025), were associated with disease-free survival and overall survival in a multivariate survival analysis, respectively. The plasma fibrinogen level was found to be a possible biomarker for clinical response to chemotherapy and postoperative metastasis or death in advanced breast cancer patients who received neoadjuvant chemotherapy.
