1
|
Yu Z, Yuan M, Chen G. The clinical association between coagulation indexes, platelet-related parameters, and bone metastasis of newly diagnosed prostate cancer. Eur J Med Res 2023; 28:587. [PMID: 38093347 PMCID: PMC10720219 DOI: 10.1186/s40001-023-01562-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND At present, much evidence shows that many cancers have a high risk of thrombosis. Several studies have shown the prognostic value of platelet-related parameters and coagulation indexes in prostate cancer (PCa). However, the association between platelet-related parameters, coagulation indexes and bone metastasis of Pca is unclear. METHODS A total of 234 pathologically diagnosed patients with Pca were consecutively collected and stratified into the bone metastasis group and non-bone metastasis group according to the results of the bone scan. ROC curve analysis was used to explore the auxiliary predictive value of single and combined parameters for bone metastasis in Pca patients. Univariate and multivariate Logistic regression analyses were used to determine the relationship between platelet-related parameters, coagulation indexes, and bone metastasis of Pca. RESULTS Platelet count (PLT), fibrinogen (Fib), prostate-specific antigen (PSA), and D-dimer (DD) levels of the bone metastasis group were significantly higher than the non-bone metastasis group (P = 0.010, P < 0.001, P < 0.001, and P < 0.001, respectively). This study confirmed that PLT, PSA, DD and Fib have auxiliary predictive value for prostate cancer bone metastasis. After the combination of PLT, PSA, DD and Fib, the area under the curve, sensitivity and specificity increased significantly. The univariate logistic analysis demonstrated that PLT (OR: 1.008, P = 0.011), DD (OR: 2.690, P < 0.001), PSA (OR: 1.073, P < 0.001), Gleason score (OR: 7.060, P < 0.001), and Fib (OR: 2.082, P < 0.001) were significantly positively correlated with bone metastasis of Pca. Multivariate analysis showed that PSA (OR: 1.075, P < 0.001), DD (OR: 2.152, P < 0.001), Gleason score (OR: 2.904, P < 0.001), and Fib (OR: 1.706, P < 0.001) were independent risk factors for bone metastasis of Pca after adjusting for Age, BMI and other confounding factors. CONCLUSIONS Higher platelet, D-dimer, prostate-specific antigen, Gleason score, and fibrinogen levels may predict a worse prognosis in patients with Pca. PLT, DD, and Fib, as readily available and relatively inexpensive indicators, help predict bone metastasis of Pca. It is suggested that PLT, DD and Fib may be helpful in the risk stratification of Pca.
Collapse
Affiliation(s)
- Zhiwei Yu
- Department of Urology, Ji Ning Third People's Hospital, No. 99 Jianshexi Road, Yanzhou District, Jining, 272100, Shandong, China
| | - Mingxue Yuan
- Department of Breast and Thyroid, Ji Ning Third People's Hospital, No. 99 Jianshexi Road, Yanzhou District, Jining, 272100, Shandong, China
| | - Guojun Chen
- Qinghai University Affiliated Hospital, No. 29 Tongren Road, Xining, 810012, Qinghai, China.
| |
Collapse
|
2
|
Zuo D, Yang L, Jin Y, Qi H, Liu Y, Ren L. Machine learning-based models for the prediction of breast cancer recurrence risk. BMC Med Inform Decis Mak 2023; 23:276. [PMID: 38031071 PMCID: PMC10688055 DOI: 10.1186/s12911-023-02377-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/17/2023] [Indexed: 12/01/2023] Open
Abstract
Breast cancer is the most common malignancy diagnosed in women worldwide. The prevalence and incidence of breast cancer is increasing every year; therefore, early diagnosis along with suitable relapse detection is an important strategy for prognosis improvement. This study aimed to compare different machine algorithms to select the best model for predicting breast cancer recurrence. The prediction model was developed by using eleven different machine learning (ML) algorithms, including logistic regression (LR), random forest (RF), support vector classification (SVC), extreme gradient boosting (XGBoost), gradient boosting decision tree (GBDT), decision tree, multilayer perceptron (MLP), linear discriminant analysis (LDA), adaptive boosting (AdaBoost), Gaussian naive Bayes (GaussianNB), and light gradient boosting machine (LightGBM), to predict breast cancer recurrence. The area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and F1 score were used to evaluate the performance of the prognostic model. Based on performance, the optimal ML was selected, and feature importance was ranked by Shapley Additive Explanation (SHAP) values. Compared to the other 10 algorithms, the results showed that the AdaBoost algorithm had the best prediction performance for successfully predicting breast cancer recurrence and was adopted in the establishment of the prediction model. Moreover, CA125, CEA, Fbg, and tumor diameter were found to be the most important features in our dataset to predict breast cancer recurrence. More importantly, our study is the first to use the SHAP method to improve the interpretability of clinicians to predict the recurrence model of breast cancer based on the AdaBoost algorithm. The AdaBoost algorithm offers a clinical decision support model and successfully identifies the recurrence of breast cancer.
Collapse
Affiliation(s)
- Duo Zuo
- Department of Clinical Laboratory, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, China
- National Clinical Research Center for Cancer, Tianjin, 300060, China
- Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, 300060, China
| | - Lexin Yang
- Department of Clinical Laboratory, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, China
- National Clinical Research Center for Cancer, Tianjin, 300060, China
- Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, 300060, China
| | - Yu Jin
- Department of Clinical Laboratory, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, China
- Tongji University Cancer Center, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China
| | - Huan Qi
- China Mobile Group Tianjin Company Limited, Tianjin, 300308, China
| | - Yahui Liu
- Department of Clinical Laboratory, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, China
- National Clinical Research Center for Cancer, Tianjin, 300060, China
- Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, 300060, China
| | - Li Ren
- Department of Clinical Laboratory, Tianjin Medical University Cancer Institute & Hospital, Tianjin, 300060, China.
- National Clinical Research Center for Cancer, Tianjin, 300060, China.
- Tianjin's Clinical Research Center for Cancer, Tianjin, 300060, China.
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China.
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, 300060, China.
| |
Collapse
|
3
|
Xu R, Yang T, Yan B, You J, Li F, Zuo Q. Pretreatment fibrinogen levels are associated with survival outcome in patients with cancer using immunotherapy as a second‑line treatment. Oncol Lett 2023; 25:269. [PMID: 37216167 PMCID: PMC10193380 DOI: 10.3892/ol.2023.13855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 04/04/2023] [Indexed: 05/24/2023] Open
Abstract
The present study aimed to investigate the predictive value of pretreatment fibrinogen (FIB) levels in patients with cancer who received immunotherapy as a second-line treatment. A total of 61 patients with stage III-IV cancer were included. The cut-off value of FIB for predicting overall survival (OS) was determined by receiver operating characteristic curve analysis. The prognostic value of pretreatment FIB on progression-free survival (PFS) and OS was determined by univariate and multivariate analyses. Based on a cut-off point of 3.47 g/l, patients were divided into low pretreatment FIB (<3.47 g/l) and high pretreatment FIB (≥3.47 g/l) groups. A high pretreatment FIB level was more common in older patients (P=0.03). Kaplan-Meier analysis showed that patients with high pretreatment FIB levels had shorter PFS and OS times than patients with low FIB levels (P<0.05). In multivariate analysis, pretreatment FIB was an independent prognostic factor for OS [hazard ratio (HR), 6.06; 95% CI, 2.01-18.28; P<0.01] and OS from the initiation of second-line treatment (HR, 3.69; 95% CI, 1.28-10.63; P=0.02). Overall, FIB is associated with survival outcome in patients with cancer who are administered immunotherapy as a second-line treatment.
Collapse
Affiliation(s)
- Rui Xu
- Department of Oncology, Hainan Hospital of People's Liberation Army General Hospital, Sanya, Hainan 572013, P.R. China
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Tao Yang
- Department of Oncology, Hainan Hospital of People's Liberation Army General Hospital, Sanya, Hainan 572013, P.R. China
| | - Bing Yan
- Department of Oncology, Hainan Hospital of People's Liberation Army General Hospital, Sanya, Hainan 572013, P.R. China
| | - Junhao You
- Department of Oncology, Hainan Hospital of People's Liberation Army General Hospital, Sanya, Hainan 572013, P.R. China
| | - Fang Li
- Department of Oncology, Hainan Hospital of People's Liberation Army General Hospital, Sanya, Hainan 572013, P.R. China
| | - Qiang Zuo
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| |
Collapse
|
4
|
Zhang J, Zeng F, Jiang S, Tang H, Zhang J. Preoperative prediction model of microvascular invasion in patients with hepatocellular carcinoma. HPB (Oxford) 2023; 25:45-53. [PMID: 36085261 DOI: 10.1016/j.hpb.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 07/23/2022] [Accepted: 08/15/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Microvascular invasion (MVI) is an adverse factor for the prognosis of patients with hepatocellular carcinoma (HCC). We aimed to construct a preoperative prediction model for MVI, thereby providing a reference for clinicians in formulating treatment options for HCC. METHODS A total of 360 patients with non-metastatic HCC were retrospectively enrolled. We used logistic regression analysis to screen out independent risk factors for MVI and further constructed a predictive model for MVI. The performance of the model was evaluated by receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA). RESULTS Logistic regression analysis revealed that fibrinogen (>4 g/L) (OR: 6.529), alpha-fetoprotein (≥ 400 ng/mL) (OR: 2.676), cirrhosis (OR: 2.25), tumor size (OR: 1.239), and poor tumor border (OR: 3.126) were independent risk factors of MVI. The prediction model of MVI had C-index of 0.746 and 0.772 in the training and validation cohorts, respectively. The calibration curves showed good agreement between actual and predicted MVI risk. Finally, DCA reveals that this model has good clinical utility. CONCLUSION The nomogram-based model we established can predict the preoperative MVI well and provides reference for surgeons to make clinical treatment decisions.
Collapse
Affiliation(s)
- Jianfeng Zhang
- Department of Liver Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, China
| | - Fanxin Zeng
- Department of Liver Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, China
| | - Shijie Jiang
- Department of Liver Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, China
| | - Hui Tang
- Department of Liver Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, China.
| | - Jian Zhang
- Department of Liver Transplantation, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, China.
| |
Collapse
|
5
|
Demir O, Demirag G, Aslan G. Prospective evaluation of hematological parameters in preoperative renal cell cancer patients. BMC Urol 2022; 22:201. [PMID: 36496365 PMCID: PMC9741773 DOI: 10.1186/s12894-022-01118-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 10/04/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Of all the genitourinary cancers, renal cell carcinoma (RCC) is still the most common malignancy with high mortality rates. There are still insufficient biomarkers to predict disease prognosis. Systemic inflammation markers play an important role in tumor development and growth. There are studies which show the relationship of fibrinogen and albumin individually with cancer prognosis in many cancers. Fibrinogen/albumin ratio(FAR), on the other hand, has prognostic importance like other inflammation indicators in cancer. Therefore, we investigated whether FAR had a potential value in evaluating the prognosis of patients with nonmetastatic kidney cancer or not. METHODS A total of 72 patients who had nephrectomy operation at 19 Mayıs University, Faculty of Medicine between January 2019 and January 2021 and who did not have distant metastasis were included in the study. FAR was calculated from the blood taken from the patients before the nephrectomy operation. The cut-off value was found for this FAR by receiver operating characteristic(ROC) curve analysis. The patients were divided into 2 groups as high- and low-FAR according to this cut-off value. Kaplan Meier test was used to evaluate the predictive value of clinicopathological parameters for overall survival (OS). The Log-rank test was used to determine whether there was a relationship between the preoperative FAR and the clinico-pathological data of the patients. RESULTS The best cutoff value for the FAR was 0.114. A FAR > 0.114 was associated with higher Fuhrman Grade (FG) (P < 0.0001) and later pathological T stage (P < 0.0001). Patients with a high FAR (> 0.114) had worse OS [Std. Error 2.932, 95% confidence interval (CI): 73.659-85.154, P < 0.0001]. In addition, a positive significant correlation was found between high grade and platelet lymphocyte ratio (p < 0,020). Furthermore, a significant correlation was found between the pathology t stage of the patients and the platelet lymphocyte ratio (p: 0.020). CONCLUSIONS The preoperative FAR is an independent prognostic factor of OS in renal cancer patients. A FAR > 0.114 was significantly related to decreased survival in renal cancer patients. In addition, the platelet-lymphocyte ratio seems to be related to OS, as well as FAR. Further studies are required on this subject.
Collapse
Affiliation(s)
- Ozden Demir
- grid.411049.90000 0004 0574 2310Faculty of Medicine, Department of Medical Oncology, Ondokuz Mayıs University, Samsun, Turkey
| | - Guzin Demirag
- grid.411049.90000 0004 0574 2310Faculty of Medicine, Department of Medical Oncology, Ondokuz Mayıs University, Samsun, Turkey
| | - Gokhan Aslan
- grid.411049.90000 0004 0574 2310Faculty of Medicine, Department of Internal Medicine, Ondokuz Mayıs University, Samsun, Turkey
| |
Collapse
|
6
|
Li Q, Kong F, Ma J, Wang Y, Wang C, Yang H, Li Y, Ma X. Nomograms Based on Fibrinogen, Albumin, Neutrophil-Lymphocyte Ratio, and Carbohydrate Antigen 125 for Predicting Endometrial Cancer Prognosis. Cancers (Basel) 2022; 14:cancers14225632. [PMID: 36428725 PMCID: PMC9688634 DOI: 10.3390/cancers14225632] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background: This study aimed to determine the prognostic value of the preoperative levels of fibrinogen, albumin (ALB), neutrophil−lymphocyte ratio (NLR), and carbohydrate antigen 125 (CA125) in endometrial cancer and to establish nomograms for predicting patient survival. Methods: Patients with endometrial cancer (n = 1483) who underwent surgery were included in this study, and their preoperative fibrinogen, ALB, NLR, and CA125 levels and clinicopathological characteristics were collected. Patients were randomized into a training cohort (70%, n = 1038) and an external validation cohort (30%, n = 445). The Cox regression analysis was performed using the data for the patients in the training cohort to identify independent prognostic factors; nomograms for predicting prognosis were established and validated. Results: High fibrinogen (≥3.185 g/L), NLR (≥2.521 g/L), and CA125 (≥35 U/mL) levels and low ALB (<4.185 g/L) levels were independently associated with poor progression-free survival (PFS) and poor overall survival (OS) in patients with endometrial cancer. Prognostic prediction model nomograms were developed and validated based on these results. Calibration curves and C-indexes underscored the good predictive power of the nomograms, and both the net reclassification index (NRI) and integrated discrimination improvement (IDI) values of the prognostic prediction model nomograms were improved. Conclusions: Nomograms that are developed based on preoperative fibrinogen, ALB, NLR, and CA125 levels accurately predict PFS and OS in patients with endometrial cancer.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Yan Li
- Correspondence: (Y.L.); (X.M.); Tel.: +86-18904001666 (Y.L.); +86-18940254799 (X.M.)
| | - Xiaoxin Ma
- Correspondence: (Y.L.); (X.M.); Tel.: +86-18904001666 (Y.L.); +86-18940254799 (X.M.)
| |
Collapse
|
7
|
Yang Q, Liang D, Yu Y, Lv F. The Prognostic Significance of the Fibrinogen-to-Albumin Ratio in Patients With Triple-Negative Breast Cancer: A Retrospective Study. Front Surg 2022; 9:916298. [PMID: 35774393 PMCID: PMC9237393 DOI: 10.3389/fsurg.2022.916298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 05/24/2022] [Indexed: 12/03/2022] Open
Abstract
Objective This study aims to investigate the potential prognostic value of fibrinogen-to-albumin ratio (FAR) in patients with triple-negative breast cancer (TNBC). Methods This study used a retrospective design and enrolled 224 patients with TNBC treated between January 2009 and December 2014 at the Henan Provincial People’s Hospital. The receiver operating characteristic curve (ROC) was used to determine the optimal cut-off value for FAR. The associations between TNBC and clinicopathologic categorical variables by FAR were analyzed using the Chi-square test or Fisher’s exact test. The survival time and survival curve were determined by Kaplan-Meier survival analysis and compared using the Log-rank method. The potential prognostic factors were determined using univariate and multivariate Cox proportional hazard regression models. Prognostic nomogram was established on the basis of the multivariate analyses. The calibration curves were used to assess the predictive performance. Results The optimal cut-off value for FAR based on the overall survival (OS) was 0.066, as evaluated by the ROC. The 224 included patients were divided into low FAR group (<0.066) and high FAR group (≥0.066). Univariate and multivariate models shown that FAR was an potential prognostic factor for disease-free survival (DFS) and OS in patients with TNBC. The median DFS and OS of the low FAR group were longer than those of the high FAR group (χ2 = 15.080, P = 0.0001; χ2 = 13.140, P = 0.0003), including for pre-menopausal patients, and those with pathological stages I + II, and lymph vessel invasion. A nomogram based on the potential prognostic factors was efficient in predicting 3-, and 5-year DFS and OS survival probabilities. Conclusions The FAR, which is tested routinely and is characterized by its simplicity, objectivity, and inexpensiveness, is a potential prognostic factor of TNBC, and is potentially applicable in clinical practice.
Collapse
|
8
|
Hou S, Jin C, Yang M, Chu H, Shi B, Xie R, Chen Y, Lin N. Prognostic value of hematological pre-albumin to fibrinogen ratio in patients with glioma. World Neurosurg 2022; 160:e442-e453. [PMID: 35051638 DOI: 10.1016/j.wneu.2022.01.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/11/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Hematological biomarkers that reflect host nutritional and inflammation status have been identified to be independent prognostic factors in various malignancies. The aim of the present study was to determine the predictive value of preoperative albumin (ALB), fibrinogen (FIB), pre-albumin (pALB), Albumin to fibrinogen ratio (AFR) and pre-albumin to fibrinogen ratio (PFR) for the prognosis of patients with glioma. METHOD X-tile software was used to identify cut-off values of these parameters. Kaplan-Meier survival analysis, univariate and multivariate analyses based on Cox proportional hazards regression model were used to determine whether these markers were associated with the prognosis of patients with glioma. In addition, the Harrell concordance index with variables was used to evaluate the prognostic accuracy. RESULTS The results indicated that PFR (HR = 2.827, 95% CI: 1.353-6.122, p = 0.006) is the only independent prognostic factor in patients of glioma along with clinicopathological grade and age. C-index of predicted nomogram including PFR (0.719) for glioma patients was higher than that without PFR (0.699). CONCLUSIONS Our findings demonstrated that circulating preoperative PFR might be a potential negative independent prognostic biomarker for glioma individuals.
Collapse
Affiliation(s)
- Shiqiang Hou
- Department of Neurosurgery, The affiliated Chuzhou hospital of Anhui Medical University, The First People's Hospital Chuzhou, Chuzhou 239000, China
| | - Chunjing Jin
- Laboratory Medicine Center, The affiliated Chuzhou hospital of Anhui Medical University, The First People's Hospital Chuzhou, Chuzhou 239000, China
| | - Minfeng Yang
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong 999007, China
| | - Haidan Chu
- Laboratory Medicine Center, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - Beitian Shi
- Department of Neurosurgery, The affiliated Chuzhou hospital of Anhui Medical University, The First People's Hospital Chuzhou, Chuzhou 239000, China
| | - Ruiyu Xie
- Laboratory Medicine Center, The affiliated Chuzhou hospital of Anhui Medical University, The First People's Hospital Chuzhou, Chuzhou 239000, China
| | - Yinan Chen
- Department of Neurosurgery, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, Hefei 230036, China.
| | - Ning Lin
- Department of Neurosurgery, The affiliated Chuzhou hospital of Anhui Medical University, The First People's Hospital Chuzhou, Chuzhou 239000, China.
| |
Collapse
|
9
|
Falanga A, Marchetti M, Russo L. Hemostatic Biomarkers and Cancer Prognosis: Where Do We Stand? Semin Thromb Hemost 2021; 47:962-971. [PMID: 34450680 DOI: 10.1055/s-0041-1733925] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Cancer patients are characterized by hypercoagulable state and an increased rate of thrombotic events, the most common being venous thromboembolism. Several hemostatic pathways that are significantly implicated in mechanisms of thromboembolic disease are also involved in growth, invasion, and metastatic spread of malignant cells as well in tumor-induced neo-angiogenesis. This close connection between cancer and the hemostatic system has prompted numerous studies on the role of alterations in the level plasma biomarkers of the different compartments of hemostasis in predicting cancer prognosis. In this review, we collect the results of several exemplificative studies that have evaluated clotting activation biomarkers in relation to different cancer outcomes with a final emphasis on current research and forthcoming directions in this field.
Collapse
Affiliation(s)
- Anna Falanga
- Division of Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy.,Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy
| | - Marina Marchetti
- Division of Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Laura Russo
- Division of Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy
| |
Collapse
|
10
|
Izuegbuna OO, Agodirin OS, Olawumi HO, Olatoke SA. Plasma D-Dimer and Fibrinogen Levels Correlates with Tumor Size and Disease Progression in Nigerian Breast Cancer Patients. Cancer Invest 2021; 39:597-606. [PMID: 33843402 DOI: 10.1080/07357907.2021.1909059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Fourty-five breast cancer patients and 50 apparently healthy sex-matched controls from the University of Ilorin Teaching Hospital were enrolled in this study. Plasma D-dimer and fibrinogen were found to be significantly higher than controls; APTT was significantly shorter than the controls. D-dimer and fibrinogen were also significantly positively correlated with ECOG, disease stage, lymph node involvement, and tumor size. On multivariate analysis, D-dimer and fibrinogen were found to be independently related to lymph node involvement. This study shows that plasma D-dimer and fibrinogen levels are elevated in breast cancer patients, and both are markers of disease progression.
Collapse
Affiliation(s)
- Ogochukwu O Izuegbuna
- Department of Haematology and Blood Transfusion, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Olayide S Agodirin
- Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Hannah O Olawumi
- Department of Haematology and Blood Transfusion, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Samuel A Olatoke
- Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| |
Collapse
|
11
|
Wang Y, Wang Y, Chen R, Tang Z, Peng Y, Jin Y, Lan A, Ding N, Dai Y, Jiang L, Liu S. Plasma fibrinogen acts as a predictive factor for pathological complete response to neoadjuvant chemotherapy in breast cancer: a retrospective study of 1004 Chinese breast cancer patients. BMC Cancer 2021; 21:542. [PMID: 33980202 PMCID: PMC8114717 DOI: 10.1186/s12885-021-08284-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 05/04/2021] [Indexed: 01/04/2023] Open
Abstract
Background The aim of this study was to evaluate the relationship between pre-treatment plasma fibrinogen (Fib) level and pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) in breast cancer patients and to assess the role of plasma Fib as a predictive factor. Methods Data from 1004 consecutive patients with invasive breast cancer who received NAC and subsequent surgery were retrospectively analysed. Both univariate and multivariate analyses based on logistic regression model were performed to identify clinicopathological factors associated with pCR to NAC. Cox regression model was used to determine the correlation between clinical or pathological parameters and recurrence-free survival (RFS). The Kaplan-Meier method and the log-rank test were applied in the survival analysis. Results The median value of Fib, rather than other plasma coagulation parameters, was significantly increased in non-pCR patients compared with pCR patients (P = 0.002). Based on the cut-off value estimated by the receiver operating characteristic (ROC) curve analysis, patients were divided into low or high Fib groups (Fib < 3.435 g/L or ≥ 3.435 g/L). Low Fib levels were significantly associated with premenopausal or perimenopausal status (P < 0.001), tumour size ≤5 cm (P = 0.002), and positive hormone receptor status (P = 0.002). After adjusted for other clinicopathological factors in the multivariate logistic regression model, low Fib status was strongly associated with pCR to NAC (OR = 3.038, 95% CI 1.667–5.537, P < 0.001). Survival analysis showed that patients with low Fib levels exhibited better 3-year RFS compared with patients with high Fib levels in the tumour size>5 cm group (77.5% vs 58.4%, log-rank, P = 0.0168). Conclusions This study demonstrates that low pre-treatment plasma Fib (Fib < 3.435 g/L) is an independent predictive factor for pCR to NAC in breast cancer patients. Moreover, T3-featured breast cancer patients with lower Fib level exhibit better RFS outcomes after NAC compared with high Fib status. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08284-8.
Collapse
Affiliation(s)
- Yihua Wang
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Yu Wang
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Rui Chen
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,Department of Thyroid and Breast Surgery, The Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou Province, China
| | - Zhenrong Tang
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Yang Peng
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Yudi Jin
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Ailin Lan
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Nan Ding
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Yuran Dai
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Linshan Jiang
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Shengchun Liu
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
| |
Collapse
|
12
|
Zhang K, Wang J, Chen J, Li Z, Lou Z. The serum C-reactive protein to prealbumin ratio and fibrinogen to prealbumin ratio are two relevant indicators for evaluating the disease activity of ankylosing spondylitis. EUR J INFLAMM 2021. [DOI: 10.1177/20587392211014092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The C-reactive protein to prealbumin ratio (CPR) and fibrinogen to prealbumin ratio (FPR) in serum are two emerging biomarkers. The purpose of this study is to explore the relationship between these two markers and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Scores (ASDAS). A total of 163 patients with AS and 120 healthy examinees were included in this study. The t-test and Mann-Whitney U ranking test were used to analyze the differences between groups. The spearman-test was used to analyze the correlation between erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), fibrinogen (Fib), prealbumin (PAlb), CPR, FPR, and AS disease activity in the test group. We generated the receiver operating characteristic curves (ROC) of CPR and FPR and determined the discriminating ability by calculating the area under the curve (AUC). Compared with the healthy group, ESR ( p < 0.001), CRP ( p < 0.001), Fib ( p < 0.001), CPR ( p < 0.001), and FPR ( p < 0.001) of AS patients were significantly increased, while PAlb was significantly reduced. CPR and FPR were more correlated to ASDAS-CRP. CPR was positively correlated with CRP, ESR, BASDAI, and ASDAS-CRP in AS patients ( r = 0.959, p < 0.001, r = 0.717, p < 0.001, r = 0.704, p < 0.001, r = 0.763, p < 0.001). FPR was positively correlated with CRP, ESR BASDAI, and ASDAS-CRP in AS patients ( r = 0.779, p < 0.001, r = 0709, p < 0.001, r = 0.551, p < 0.001, r = 0.763, p < 0.001). ROC showed that the AUC levels of CPR and FPR were high (AUC = 0.952 and AUC = 0.893). CPR and FPR are two promising new biological indicators for assessing disease activity in AS patients.
Collapse
Affiliation(s)
- Kai Zhang
- Department of Orthopedic Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Junhao Wang
- Department of Orthopedic Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jinhong Chen
- Department of Orthopedic Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhi Li
- Department of Orthopedic Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhaohui Lou
- Department of Orthopedic Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| |
Collapse
|
13
|
Wach J, Apallas S, Schneider M, Güresir A, Schuss P, Herrlinger U, Vatter H, Güresir E. Baseline Serum C-Reactive Protein and Plasma Fibrinogen-Based Score in the Prediction of Survival in Glioblastoma. Front Oncol 2021; 11:653614. [PMID: 33747971 PMCID: PMC7970301 DOI: 10.3389/fonc.2021.653614] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/12/2021] [Indexed: 01/08/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Johannes Wach
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Stefanos Apallas
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | | | - Agi Güresir
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Patrick Schuss
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Ulrich Herrlinger
- Division of Clinical Neuro-Oncology, Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Hartmut Vatter
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Erdem Güresir
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| |
Collapse
|
14
|
Systemic Coagulation Markers Especially Fibrinogen Are Closely Associated with the Aggressiveness of Prostate Cancer in Patients Who Underwent Transrectal Ultrasound-Guided Prostate Biopsy. DISEASE MARKERS 2021; 2021:8899994. [PMID: 33532007 PMCID: PMC7834837 DOI: 10.1155/2021/8899994] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 11/30/2022]
Abstract
Objective It has been well elucidated that multiple types of cancers are at high risk of thrombosis. Several studies have indicated the prognostic value of fibrinogen (Fib) and D-dimer (DD) in prostate cancer (PCa). However, it remains unclear regarding the association of the comprehensive coagulation markers with the clinicopathological features of PCa. Methods A total of 423 pathologically diagnosed patients with PCa were consecutively collected and stratified as low-intermediate-risk or high-risk groups. The association of coagulation parameters including Fib, DD, prothrombin (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and antithrombin III (AT-III) with clinicopathological features was determined by univariate and multivariate logistic regression analyses. Results The levels of Fib, DD, and PT were significantly higher in the high-risk group (p < 0.001, p < 0.001, and p = 0.043, resp.), while APTT, TT, and AT-III were similar between two groups (p > 0.05, all). Univariate logistic regression analysis demonstrated that Fib, DD, and PT were all positively correlated with high-risk PCa (OR = 2.041, p < 0.001; OR = 1.003, p < 0.001; OR = 1.247, p = 0.044). Nonetheless, after adjusting for PSA, grade, and stage, Fib (T3 vs. T1, OR = 15.202, 95% CI: 1.725-133.959, p = 0.014) but not DD or PT was the unique independent factor associated with high-risk PCa in the multivariate regression analysis. Conclusions Our study firstly revealed that Fib but other coagulation markers was independently associated with the severity of PCa, suggesting Fib might be useful in PCa risk stratification beyond PSA, stage, and grade.
Collapse
|
15
|
He Y, Su Y, Zhou L. Expression of HER2 and BRCA1 Correlates with Prognosis in Patients with Breast Cancer After Radiotherapy: A Case-Control Study. Cancer Biother Radiopharm 2020; 37:603-611. [PMID: 33112672 DOI: 10.1089/cbr.2020.3607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: This study aims to explore the associations of human epidermal growth factor receptor 2 (HER2) and breast cancer susceptibility gene 1 (BRCA1) expression levels with prognosis and radiation sensitivity in patients with breast cancer. Methods: Breast cancer tissues, adjacent normal breast tissues, and benign breast lesions were initially obtained from 256 breast cancer patients as well as an additional 245 patients with breast lesions. Reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) was conducted to assess the expression of HER2 and BRCA1 in the collected tissues. Immunohistochemistry was performed to examine HER2 and BRCA1-positive expression levels in the tissues. The relationship between HER2 and BRCA1 expression levels and radiation sensitivity as well breast cancer prognosis was assessed by the Spearman correlation analysis and Kaplan-Meier survival analysis. Results: Compared with adjacent normal breast tissues and benign breast lesions, the breast cancer tissues exhibited high expression of HER2 mRNA and protein and low expression of BRCA1 mRNA and protein. Patients with positive HER2 expression had a significantly shorter survival time, and survival time of patients with positive BRCA1 expression was markedly longer, which were consistent with RT-qPCR results. After radiotherapy, the local failure rate of HER2-positive patients was higher than that of the negative ones, while that of BRCA1-positive patients was lower than that of the negative ones. Conclusions: This study suggested that breast cancer patients with high HER2 expression and low BRCA1 expression were less sensitive to radiotherapy with poor prognosis in breast cancer.
Collapse
Affiliation(s)
- Ye He
- The First Hospital of China Medical University, Shenyang, People's Republic of China
| | - Yanna Su
- The First Hospital of China Medical University, Shenyang, People's Republic of China
| | - Liping Zhou
- Graduate Faculty, The First Hospital of China Medical University, Shenyang, People's Republic of China
| |
Collapse
|
16
|
Hu W, Zheng C, Quan R, Dai X, Zhang X. The Prognostic Value of Combination of Plasma Fibrinogen and CA19-9 in Non-Distant Metastatic Breast Cancer Patients Undergoing Surgery. Cancer Manag Res 2020; 12:8875-8886. [PMID: 33061583 PMCID: PMC7520160 DOI: 10.2147/cmar.s270385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 08/13/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose This article aimed to study the prognostic value of preoperative plasma fibrinogen and CA19-9 in non-distant metastatic breast cancer (BC). Patients and Methods A total of 343 non-distant metastatic BC patients were included in this study. The optimal cut-off values of plasma fibrinogen and CA19-9 were obtained by receiver operating characteristic (ROC) curve analysis. Univariate and multivariate Cox regression analyses were used to evaluate prognostic factors for overall survival (OS). Survival data were assessed using Kaplan–Meier survival analysis with the Log-rank test. Based on the cut-off values, we classified the fibrinogen-CA19-9 score as follows: 2 (both hyperfibrinogenemia and high CA19-9), 1 (either hyperfibrinogenemia or high CA19-9), and 0 (neither hypefibrinogenemia nor high CA19-9). Results Our follow-up time totaled 10 years, the median follow-up time was 77 months (range=2–119 months), and 82 (23.9%) of 343 patients died during the follow-up period. The optimal cut-off values of plasma fibrinogen and CA19-9 were 2.805 g/L and 11.85 U/mL, respectively. The multivariate Cox analysis results suggested that there was a significant association between worse OS and elevated preoperative plasma fibrinogen and CA19-9 levels (HR=2.016, 95% CI=1.216–3.342, P=0.007; and HR=2.042, 95% CI=1.282–3.253, P=0.003). The area under the ROC curve (AUC) increased from 0.589 (for plasma fibrinogen) and 0.594 (for CA19-9) to 0.640 when these two parameters were combined. When we added this combined factor to the multivariate analysis, it was an independent prognostic factor for BC (P<0.001). According to the above results, we chose four prognostic factors to construct our nomogram. The AUC was 0.724, which indicates that the nomogram performs well. Conclusion The combination of plasma fibrinogen and CA19-9 could be used as a valid independent prognostic factor for non-distant metastatic BC compared with either parameter alone and could easily be applied in clinical practice.
Collapse
Affiliation(s)
- Wenjing Hu
- Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Chen Zheng
- Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Ruida Quan
- Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Xuanxuan Dai
- Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Xiaohua Zhang
- Department of Surgical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| |
Collapse
|
17
|
Chen X, Ji H, Wang J, Zhao G, Zheng B, Niu Z, He W. Prognostic Value of the Preoperative Plasma D-Dimer Levels in Patients with Upper Tract Urothelial Carcinoma in a Retrospective Cohort Study. Onco Targets Ther 2020; 13:5047-5055. [PMID: 32606727 PMCID: PMC7292253 DOI: 10.2147/ott.s254514] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/13/2020] [Indexed: 12/22/2022] Open
Abstract
Purpose Elevated plasma D-dimer levels were thought to be associated with decreasing survival in various cancers. The relationship between plasma D-dimer levels and clinicopathology and the optimal D-dimer cutoff as a prognostic predictor has not been determined in patients with upper tract urothelial carcinoma (UTUC). We aimed to investigate the prognostic value of preoperative plasma D-dimer levels as a predictor of patient outcomes in UTUC following radical nephroureterectomy. Patients and Methods We retrospectively reviewed data for 232 patients. The D-dimer cutoff value was set at 0.36 mg/L, and we used the Kaplan-Meier method and Cox's proportional hazards regression models to analyze the association between D-dimer levels and oncological outcomes. Multivariate Cox regression was used to develop a nomogram, which we evaluated for accuracy using a receiver operating characteristic curve, calibration plot, and decision curve analysis. Results Plasma D-dimer levels ≥0.36 mg/L were significantly associated with advanced tumor status regarding size, location, hydronephrosis, tumor grade, lymph node involvement, grade, and stage (all p < 0.05). The Kaplan-Meier analysis showed that plasma D-dimer levels ≥0.36 mg/L predicted worse oncological outcomes vs levels <0.36 mg/L (all p < 0.001). Univariate and multivariate analyses showed that elevated preoperative plasma D-dimer level was an independent predictor of recurrence-free survival (hazard ratio (HR): 1.67, 95% confidence interval (CI): 1.07-2.63; p = 0.025), cancer-specific survival (HR: 2.34, 95% CI: 1.30-4.19; p = 0.004), and overall survival (HR: 1.98, 95% CI: 1.18-3.34; p = 0.010). We also developed a nomogram predicting 3- and 5-year overall survival probability. Conclusion D-dimer levels may be a useful prognostic predictor of survival and improve risk stratification and precisely individualize treatment for patients with UTUC.
Collapse
Affiliation(s)
- Xiaoxu Chen
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People's Republic of China
| | - Haiyong Ji
- The Third Department of Surgery, Ningjin People's Hospital, Dezhou, Shandong, People's Republic of China
| | - Jianwei Wang
- Department of Urology, Shandong Provincial ENT Hospital Affiliated to Shandong University, Jinan, Shandong, People's Republic of China
| | - Guiting Zhao
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People's Republic of China
| | - Bin Zheng
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People's Republic of China
| | - Zhihong Niu
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People's Republic of China
| | - Wei He
- Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.,Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, People's Republic of China
| |
Collapse
|
18
|
Kalkan S, Caliskan S. High D-dimer levels are associated with prostate cancer. Rev Assoc Med Bras (1992) 2020; 66:649-653. [DOI: 10.1590/1806-9282.66.5.649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 11/12/2019] [Indexed: 11/22/2022] Open
|
19
|
Clinical association between pre-treatment levels of plasma fibrinogen and bone metastatic burden in newly diagnosed prostate cancer patients. Chin Med J (Engl) 2020; 132:2684-2689. [PMID: 31725446 PMCID: PMC6940101 DOI: 10.1097/cm9.0000000000000506] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Due to the different treatments for low-volume metastatic prostate cancer (PCa) as well as high-volume ones, evaluation of bone metastatic status is clinically significant. In this study, we evaluated the correlation between pre-treatment plasma fibrinogen and the burden of bone metastasis in newly diagnosed PCa patients. Methods: A single-center retrospective analysis, focusing on prostate biopsies of newly diagnosed PCa patients, was performed. A total of 261 patients were enrolled in this study in a 4-year period. All subjects were submitted to single-photon emission computerized tomography-computed tomography to confirm the status of bone metastasis and, if present, the number of metastatic lesions would then be calculated. Clinical information such as age, prostate-specific antigen (PSA), fibrinogen, clinical T stage, and Gleason score were collected. Patients were divided into three groups: (i) a non-metastatic group, (ii) a high volume disease (HVD) group (>3 metastases with at least one lesion outside the spine), and (iii) a low volume disease (LVD) group (metastatic patients excluding HVD ones). The main statistical methods included non-parametric Mann-Whitney test, Spearman correlation, receiver operating characteristic (ROC) curves, and logistic regression. Results: Fibrinogen positively correlated with Gleason score (r = 0.180, P = 0.003), PSA levels (r = 0.216, P < 0.001), and number of metastatic lesions (r = 0.296, P < 0.001). Compared with the non-metastatic and LVD groups, the HVD group showed the highest PSA (104.98 ng/mL, median) and fibrinogen levels (3.39 g/L, median), as well as the largest proportion of Gleason score >7 (86.8%). Both univariate (odds ratio [OR] = 2.16, 95% confidential interval [CI]: 1.536–3.038, P < 0.001) and multivariate (OR = 1.726, 95% CI: 1.206–2.472, P = 0.003) logistic regressions showed that fibrinogen was independently associated with HVD. The ROC curve suggested that fibrinogen acts as a predictor of HVD patients, yielding a cut-off of 3.08 g/L, with a sensitivity of 0.684 and a specificity of 0.760 (area under the curve = 0.739, 95% CI: 0.644–0.833, P < 0.001). Conclusions: Pre-treatment plasma fibrinogen is positively associated with bone metastatic burden in PCa patients. Our results indicate that fibrinogen might be a potential predictor of HVD.
Collapse
|
20
|
Wang Y, Zhao B, Chen W, Liu L, Chen W, Zhou L, Kong Z, Dai C, Wang Y, Ma W. Pretreatment Geriatric Assessments of Elderly Patients with Glioma: Development and Implications. Aging Dis 2020; 11:448-461. [PMID: 32257553 PMCID: PMC7069455 DOI: 10.14336/ad.2019.0527] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 05/27/2019] [Indexed: 12/13/2022] Open
Abstract
Glioma is the most frequent primary brain tumor affecting adults, and the most lethal type is glioblastoma (GBM); currently, the available therapies only provide palliation. The treatments for low-grade glioma (LGG) include neurosurgical resection, watchful waiting, radiotherapy and chemotherapy, while the therapeutic strategies for high-grade glioma (HGG), particularly in elderly patients, have evolved to include radiotherapy, chemotherapy, and targeted monotherapy based on the characteristics of the investigated patients. Proper assessments aiming to predict and achieve the most satisfying prognosis among patients prior to surgery, radiotherapy, chemotherapy, targeted therapy or immunotherapy help summarize the pretreatment characteristics of patients, providing doctors comprehensive information to consider while determining whether the patients could benefit from ongoing treatments and deciding the proper treatment strategy for subsequent phases. This article aims to rigorously review the most recent evidence and discuss current mainstream assessments before the initiation of proper treatments for glioma, thus highlighting the potential necessity of pretreatment assessments.
Collapse
Affiliation(s)
- Yaning Wang
- Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Binghao Zhao
- Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wanqi Chen
- Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Liu
- Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenlin Chen
- Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lizhou Zhou
- Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ziren Kong
- Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Congxin Dai
- Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Wang
- Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenbin Ma
- Departments of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
21
|
Giaccherini C, Marchetti M, Masci G, Verzeroli C, Russo L, Celio L, Sarmiento R, Gamba S, Tartari CJ, Diani E, Vignoli A, Malighetti P, Spinelli D, Tondini C, Barni S, Giuliani F, Petrelli F, D'Alessio A, Gasparini G, De Braud F, Santoro A, Labianca R, Falanga A. Thrombotic biomarkers for risk prediction of malignant disease recurrence in patients with early stage breast cancer. Haematologica 2019; 105:1704-1711. [PMID: 31558668 PMCID: PMC7271573 DOI: 10.3324/haematol.2019.228981] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/24/2019] [Indexed: 11/09/2022] Open
Abstract
In cancer patients, hypercoagulability is a common finding. It has been associated with an increased risk of venous thromboembolism, but also to tumor proliferation and progression. In this prospective study of a large cohort of breast cancer patients, we aimed to evaluate whether pre-chemotherapy abnormalities in hemostatic biomarkers levels: (i) are associated with breast cancer-specific clinico-pathological features; and (ii) can predict for disease recurrence. D-dimer, fibrinogen, prothrombin fragment 1+2, and FVIIa/antithrombin levels were measured in 701 early-stage resected breast cancer patients candidate to adjuvant chemotherapy and prospectively enrolled in the HYPERCAN study. Significant prognostic parameters for disease recurrence were identified by Cox regression multivariate analysis and used for generating a risk assessment model. Pre-chemotherapy D-dimer, fibrinogen, and pro-thrombin fragment 1+2 levels were significantly associated with tumor size and lymph node metastasis. After 3.4 years of follow up, 71 patients experienced a recurrence. Cox multivariate analysis identified prothrombin fragment 1+2, tumor size, and Luminal B HER2-negative or triple negative molecular subtypes as independent risk factors for disease recurrence. Based on these variables, we generated a risk assessment model that significantly differentiated patients at low- and high-risk of recurrence (cumulative incidence: 6.2 vs. 20.7%; Hazard Ratio=3.5; P<0.001). Our prospective clinical and laboratory data from the HYPERCAN study were crucial for generating a scoring model for assessing risk of disease recurrence in resected breast cancer patients, candidate to systemic chemotherapy. This finding stimulates future investigations addressing the role of plasma prothrombin fragment 1+2 in the management of breast cancer patients to provide the rationale for new therapeutic strategies. (The HYPERCAN study is registered at clinicaltrials.gov identifier 02622815.)
Collapse
Affiliation(s)
- Cinzia Giaccherini
- Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo
| | - Marina Marchetti
- Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo
| | | | - Cristina Verzeroli
- Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo
| | - Laura Russo
- Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo
| | - Luigi Celio
- Oncology Unit, IRCCS National Cancer Institute, Milan
| | | | - Sara Gamba
- Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo
| | - Carmen J Tartari
- Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo
| | - Erika Diani
- Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo
| | - Alfonso Vignoli
- Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo
| | - Paolo Malighetti
- Department of Management, Information and Production Engineering, University of Bergamo, Bergamo
| | - Daniele Spinelli
- Department of Management, Information and Production Engineering, University of Bergamo, Bergamo
| | - Carlo Tondini
- Oncology Unit, Hospital Papa Giovanni XXIII, Bergamo
| | - Sandro Barni
- Oncology Unit, Hospital Treviglio-Caravaggio, Treviglio
| | | | | | - Andrea D'Alessio
- Medical Oncology and Internal Medicine, Policlinico San Marco, Zingonia-Bergamo
| | | | | | | | - Roberto Labianca
- Department Oncology Bergamo Province, Hospital Papa Giovanni XXIII, Bergamo
| | - Anna Falanga
- Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo .,University of Milan Bicocca, School of Medicine and Surgery, Milan, Italy
| | | |
Collapse
|
22
|
Ding P, Zheng C, Cao G, Gao Z, Lei Y, Deng P, Hou B, Li K. Combination of preoperative plasma fibrinogen and AJCC staging improves the accuracy of survival prediction for patients with stage I-II gastric cancer after curative gastrectomy. Cancer Med 2019; 8:2919-2929. [PMID: 31050218 PMCID: PMC6558503 DOI: 10.1002/cam4.2086] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 01/27/2019] [Accepted: 02/20/2019] [Indexed: 12/11/2022] Open
Abstract
This study aimed to determine the prognostic value of preoperative plasma fibrinogen concentration (PFC) in patients with stage I‐II gastric cancer after curative gastrectomy. The preoperative PFC and clinicopathological data of 793 patients with stage I‐II gastric cancer who underwent curative gastrectomy were analyzed retrospectively. PFC of <4.0 g/L and ≥4.0 g/L were considered as PFC0 and PFC1, respectively. The association between PFC and the clinicopathological features of gastric cancer and the value of PFC in survival prediction were investigated. PFC1 indicated poorer overall survival and cancer‐specific survival among patients with tumor‐node‐metastasis (TNM) stage I‐II, and PFC was identified as an independent indicator of survival via multivariate analysis. Importantly, PFC stage was proven to be an independent prognostic factor for stage I and T1‐4aN0 gastric cancer. PFC stage combined with the American Joint Committee on Cancer (AJCC)‐TNM stage has better accuracy for predicting disease prognosis than AJCC‐TNM stage alone. The prognosis of patients with stage I‐II gastric cancer can be further stratified by PFC level. For patients with stage I gastric cancer, PFC1 can be considered a high‐risk prognostic factor, and adjuvant chemotherapy should be recommended for patients with PFC1.
Collapse
Affiliation(s)
- Peng Ding
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Chen Zheng
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Guohui Cao
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ziming Gao
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yuying Lei
- Department of Oncology, The Hebei Province General Hospital, Shijiazhuang, China
| | - Peng Deng
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Bin Hou
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Kai Li
- Department of Surgical Oncology and General Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China
| |
Collapse
|
23
|
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: 25] [Impact Index Per Article: 4.2] [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.
Collapse
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,
| |
Collapse
|
24
|
Falanga A, Marchetti M. Hemostatic biomarkers in cancer progression. Thromb Res 2018; 164 Suppl 1:S54-S61. [PMID: 29703485 DOI: 10.1016/j.thromres.2018.01.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/08/2018] [Accepted: 01/10/2018] [Indexed: 02/06/2023]
Abstract
Malignant disease is characterized by a hemostatic imbalance, usually shifted towards a procoagulant direction, and a high incidence of thrombotic complications. The mechanisms of hemostasis that are critically involved in thrombosis are also implicated in tumor progression, angiogenesis, and metastatic spread. As there is a close relationship between cancer and the clotting system, circulating biomarkers of activation of various hemostasis compartments (i.e. coagulation, fibrinolysis, platelets, endothelium, and other blood cells) have been extensively studied to predict cancer outcomes along with predicting the thrombotic risk. In this review, we will summarize the results of published studies and will focus on ongoing research and future directions of clotting activation bioproducts as biomarkers of cancer disease and progression.
Collapse
Affiliation(s)
- Anna Falanga
- Division of Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy.
| | - Marina Marchetti
- Division of Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy
| |
Collapse
|
25
|
Lee H, Myung W, Jeong BH, Choi H, Jhun BW, Kim H. Short- and long-term exposure to ambient air pollution and circulating biomarkers of inflammation in non-smokers: A hospital-based cohort study in South Korea. ENVIRONMENT INTERNATIONAL 2018; 119:264-273. [PMID: 29982129 DOI: 10.1016/j.envint.2018.06.041] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 06/02/2018] [Accepted: 06/30/2018] [Indexed: 06/08/2023]
Abstract
Despite increasing epidemiological evidence of an association between air pollution and adverse health outcomes, the detailed mechanisms underlying the adverse effects of air pollution on medical conditions remain unclear. We evaluated the effects of short- and long-term exposure to ambient air pollution on key inflammatory markers in non-smoking subjects. Serum fibrinogen, C-reactive protein, ferritin, and white blood cell counts were repeatedly measured 3 times in 6589 subjects at the Samsung Medical Center (Seoul, South Korea) between 2010 and 2016. Both short- (≤8-day averages) and long-term (annual averages) exposure measures of 6 air pollutants (particles < 2.5 μm, particles < 10 μm, nitrogen dioxide, sulfur dioxide, ozone, and carbon monoxide) were estimated for each subject based on available residential addresses. Linear mixed-effects models were used to relate interquartile range increases in pollutant concentrations to inflammatory marker levels. Short-term exposure to air pollution was associated with increased fibrinogen and ferritin levels. Long-term exposure to air pollution was associated with increased fibrinogen levels and white blood cell counts. The largest short- and long-term associations were observed for ferritin in response to nitrogen dioxide exposure (1.4%, 95% confidence interval [CI] 0.3-2.5) and fibrinogen exposed to particles < 2.5 μm (3.4%, 95% CI 3.0-3.8), respectively. Significantly higher associations were observed among subjects with elevated levels of inflammatory markers (upper 25th percentile), including C-reactive protein, and those with cardiac infarction, chronic obstructive pulmonary disease, cerebral infarction, or diabetes. We found clear associations between short- and long-term exposure to air pollution and inflammatory markers, especially among vulnerable subgroups. Our findings provide evidence in support of the hypothesis that air pollution increases systemic inflammation, particularly among susceptible subgroups.
Collapse
Affiliation(s)
- Hyewon Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do 13619, South Korea; Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, South Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Bundang-gu, Seongnam-si, Gyeonggi-do 13619, South Korea
| | - Byeong-Ho Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul 06351, South Korea
| | - Hong Choi
- Center for Health Promotion, Samsung Medical Center, Gangnam-gu, Seoul 06351, South Korea; Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul 06351, South Korea
| | - Byung Woo Jhun
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul 06351, South Korea.
| | - Ho Kim
- Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, South Korea; Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, South Korea.
| |
Collapse
|
26
|
Shimizu T, Ishizuka M, Shibuya N, Tanaka G, Abe A, Aoki T, Kubota K. Preoperative globulin-to-albumin ratio predicts outcome after curative resection in patients with gastric cancer. Ann Gastroenterol Surg 2018; 2:367-375. [PMID: 30238078 PMCID: PMC6139717 DOI: 10.1002/ags3.12200] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 06/05/2018] [Accepted: 06/21/2018] [Indexed: 12/26/2022] Open
Abstract
AIM The globulin-to-albumin ratio (GAR) is useful for prognostication of patients with various cancers. However, the significance of GAR in gastric cancer (GC) remains unclear. Our purpose was to investigate the relationship between the GAR and outcome after curative resection in GC patients. METHODS Three-hundred and seventy-six patients who had undergone curative resection for GC were retrospectively reviewed. Univariate and multivariate analyses using the Cox proportional hazard model were performed to detect clinical characteristics that correlated with overall survival (OS), and their cut-off values were identified using receiver operating characteristic (ROC) curve analyses. Kaplan-Meier analysis and log-rank test were used for comparison of OS and relapse-free survival (RFS). RESULTS Multivariate analysis using 17 clinical characteristics selected by univariate analyses revealed that GAR (>0.80/≤0.80) was significantly associated with OS (hazard ratio [HR], 2.305; 95% CI, 1.122-4.735; P = 0.023), as well as lymph node metastasis (presence/absence) (HR, 2.417; 95% CI, 1.077-5.426; P = 0.032), neutrophil-to-lymphocyte ratio (>2.7/≤2.7) (HR, 2.368; 95% CI, 1.138-4.930; P = 0.002), and serosal invasion (presence/absence) (HR, 3.443; 95% CI, 1.048-11.31; P = 0.042). Kaplan-Meier analysis and log-rank test demonstrated that the OS and RFS of patients with a high GAR (>0.80) were significantly poorer than those with low GAR (≤0.80). CONCLUSIONS The GAR is a useful predictor of postoperative outcome among GC patients undergoing curative resection.
Collapse
Affiliation(s)
- Takayuki Shimizu
- Second Department of SurgeryDokkyo Medical UniversityTochigiJapan
| | - Mitsuru Ishizuka
- Second Department of SurgeryDokkyo Medical UniversityTochigiJapan
| | - Norisuke Shibuya
- Second Department of SurgeryDokkyo Medical UniversityTochigiJapan
| | - Genki Tanaka
- Second Department of SurgeryDokkyo Medical UniversityTochigiJapan
| | - Akihito Abe
- Second Department of SurgeryDokkyo Medical UniversityTochigiJapan
| | - Taku Aoki
- Second Department of SurgeryDokkyo Medical UniversityTochigiJapan
| | - Keiichi Kubota
- Second Department of SurgeryDokkyo Medical UniversityTochigiJapan
| |
Collapse
|
27
|
Xu WY, Zhang HH, Xiong JP, Yang XB, Bai Y, Lin JZ, Long JY, Zheng YC, Zhao HT, Sang XT. Prognostic significance of the fibrinogen-to-albumin ratio in gallbladder cancer patients. World J Gastroenterol 2018; 24:3281-3292. [PMID: 30090008 PMCID: PMC6079291 DOI: 10.3748/wjg.v24.i29.3281] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 06/16/2018] [Accepted: 06/27/2018] [Indexed: 02/06/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Wei-Yu Xu
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Hao-Hai Zhang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jian-Ping Xiong
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiao-Bo Yang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yi Bai
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jian-Zhen Lin
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jun-Yu Long
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yong-Chang Zheng
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Hai-Tao Zhao
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xin-Ting Sang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| |
Collapse
|
28
|
Sun F, Tan YA, Gao QF, Li SQ, Zhang J, Chen QG, Jiang YH, Zhang L, Ying HQ, Wang XZ. Circulating fibrinogen to pre-albumin ratio is a promising biomarker for diagnosis of colorectal cancer. J Clin Lab Anal 2018; 33:e22635. [PMID: 30047185 DOI: 10.1002/jcla.22635] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 06/15/2018] [Accepted: 07/09/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Inflammation and nutrition are closely associated with initiation and progression of colorectal cancer (CRC). This study aimed to investigate the diagnostic value of the FAR (FAR = 100*Fibrinogen/Albumin) and FPR (FPR = Fibrinogen/pre-Albumin) in CRC. METHODS Neutrophil-to-lymphocyte ratio (NLR), FPR, and FAR were calculated in 455 newly diagnosed CRC patients, 455 healthy individuals, and 455 benign controls with colorectal polyp. The diagnostic value of biomarker for CRC was evaluated by receiver operating characteristic curve (ROC). Logistic regression analysis was adopted to assess the risk factors for telling CRC apart from benign disease. Moreover, the combined biomarkers were used for discriminating between CRC and benign disease. RESULTS Neutrophil-to-lymphocyte ratio, FAR, and FPR were significantly higher in CRC patients compared with the benign or healthy controls (P < 0.05). ROC analysis showed that the diagnostic efficacy of FAR and FPR were better than NLR for CRC. Besides, FPR, NLR, carcinoembryonic antigen (CEA), and carbohydrate antigen 19-9 (CA199) were markedly associated with differentiation of benign disease and CRC in the logistic regression analysis. And the combination of FPR, CEA, and CA199 had the maximum area under the ROC curve (AUC) in separating CRC from benign disease (AUC = 0.845, Sensitivity = 67.9%, Specificity = 85.3%, Positive Predictive Value = 83.5%, Negative Predictive Value = 70.9%). CONCLUSIONS Fibrinogen/pre-Albumin could be a useful CRC diagnostic biomarker, and the combination of FPR, CEA, and CA199 could significantly improve the diagnostic efficacy in discriminating CRC from the benign colorectal disease.
Collapse
Affiliation(s)
- Fan Sun
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yu-Ao Tan
- Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China
| | - Qiu-Fang Gao
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Shu-Qi Li
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jing Zhang
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Qing-Gen Chen
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yu-Huan Jiang
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Lei Zhang
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Hou-Qun Ying
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xiao-Zhong Wang
- Department of Clinical Laboratory, Jiangxi Province Key Laboratory of Laboratory Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| |
Collapse
|
29
|
Li X, Dai D, Chen B, Tang H, Xie X, Wei W. Determination of the prognostic value of preoperative CA15-3 and CEA in predicting the prognosis of young patients with breast cancer. Oncol Lett 2018; 16:4679-4688. [PMID: 30214602 DOI: 10.3892/ol.2018.9160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 12/07/2017] [Indexed: 01/29/2023] Open
Abstract
To the best of our knowledge, no previous study has investigated the association of carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) with the prognosis for young patients (≤40 years) with breast cancer. In the present study, preoperative CEA and CA15-3 serum levels were evaluated in the prediction of the prognosis for young patients with breast cancer. In total, 699 patients were recruited, for which the CEA and CA15-3 serum levels had been measured prior to surgery via a blood sample. The optimal cut-off high and low values were determined using receiver operating characteristic curve analysis and Youden's index. The value of CEA and CA15-3 in predicting overall survival (OS) and disease-free survival (DFS) were measured using univariate and multivariate Cox's regression analyses. The cut-off values were 3.38 ng/ml and 12.32 U/ml for CEA and CA15-3, respectively. It was identified that CEA, but not CA15-3, was a predictor for the prognosis of the young patients with breast cancer. Multivariate analysis confirmed that CEA, but not CA15-3, was an independent prognostic marker for all young patients with breast cancer. In total, 623 young patients exhibited decreased levels of CEA; in these patients, CA15-3 with a cut-off value of 12.48 U/ml was an independent prognostic factor for OS and DFS. Preoperative serum CEA may thus serve as an independent predictor of poor prognosis for young patients with breast cancer. However, for low-risk patients with decreased CEA levels, serum CA15-3 may supplement the prediction of overall prognosis.
Collapse
Affiliation(s)
- Xuan Li
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| | - Danian Dai
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| | - Bo Chen
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| | - Hailin Tang
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| | - Xiaoming Xie
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| | - Weidong Wei
- Department of Breast Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, P.R. China
| |
Collapse
|
30
|
Ou T, Lilly M, Jiang W. The Pathologic Role of Toll-Like Receptor 4 in Prostate Cancer. Front Immunol 2018; 9:1188. [PMID: 29928275 PMCID: PMC5998742 DOI: 10.3389/fimmu.2018.01188] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 05/14/2018] [Indexed: 01/01/2023] Open
Abstract
Toll-like receptor (TLR) 4 is expressed on normal and malignant prostate epithelial cells. The TLR4 and its downstream signaling pathways mediate innate immune responses in the host against invading pathogens. However, multiple lines of evidence shows that TLR4 expression is increased in prostate tissues from prostate cancer patients, and altered TLR4 signals may promote cancer development, as well as antitumor effects. In this review, we have summarized key features of the TLR4 signaling pathway and its associated immune responses and focused on the pathologic role of TLR4 in prostate carcinogenesis and tumor progression.
Collapse
Affiliation(s)
- Tongwen Ou
- Department of Urology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Michael Lilly
- Division of Hematology and Oncology, Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Wei Jiang
- Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, United States
- Division of Infectious Diseases, Department of Medicine, Medical University of South Carolina, Charleston, SC, United States
| |
Collapse
|
31
|
He ZQ, Duan H, Ke C, Zhang XH, Guo CC, Al-Nahari F, Zhang J, Chen ZH, Chen YS, Liu ZG, Wang J, Chen ZP, Jiang XB, Mou YG. Evaluation of cumulative prognostic score based on pretreatment plasma fibrinogen and serum albumin levels in patients with newly diagnosed high-grade gliomas. Oncotarget 2018; 8:49605-49614. [PMID: 28548947 PMCID: PMC5564791 DOI: 10.18632/oncotarget.17849] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 04/29/2017] [Indexed: 12/31/2022] Open
Abstract
This retrospective study was designed to determine the prognostic value of a cumulative score (FA score) based on pretreatment plasma fibrinogen and serum albumin levels for 326 patients newly diagnosed high-grade glioma (HGG). Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off values. Univariate and multivariate analysis were performed to evaluate the independent prognostic value of the FA scores associated with overall survival (OS) and progression-free survival (PFS). The optimal cut-off values were 2.815 g/L for fibrinogen and 43.65 g/L for albumin. PFS and OS were significantly worse for patients with higher FA scores. Patients with elevated fibrinogen level and decreased albumin levels had 3.00-fold higher risk of tumor progression and had a 3.23-fold higher risk of death compared with those with normal values. Multivariate analysis demonstrated FA score was an independent predictive factor for PFS and OS. Moreover, PFS and OS were better for the patients with lower FA score, either in patients with grade III or IV gliomas. These findings indicated that the pretreatment FA score could serve as a simple and noninvasive marker to predict the prognosis of patients with HGG.
Collapse
Affiliation(s)
- Zhen-Qiang He
- Department of Neurosurgery/Neuro-Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Hao Duan
- Department of Neurosurgery/Neuro-Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Chao Ke
- Department of Neurosurgery/Neuro-Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Xiang-Heng Zhang
- Department of Neurosurgery/Neuro-Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Cheng-Cheng Guo
- Department of Neurosurgery/Neuro-Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Fuad Al-Nahari
- Department of Neurosurgery/Neuro-Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Ji Zhang
- Department of Neurosurgery/Neuro-Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Zheng-He Chen
- Department of Neurosurgery/Neuro-Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Yin-Sheng Chen
- Department of Neurosurgery/Neuro-Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Zhi-Gang Liu
- Key Laboratory of Translational Radiation Oncology, Hunan Province, Department of Radiation Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China
| | - Jian Wang
- Department of Neurosurgery/Neuro-Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Zhong-Ping Chen
- Department of Neurosurgery/Neuro-Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Xiao-Bing Jiang
- Department of Neurosurgery/Neuro-Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| | - Yong-Gao Mou
- Department of Neurosurgery/Neuro-Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China
| |
Collapse
|
32
|
Lan M, Chen C, Huang Y, Mao M, Han F, Liao J, Deng M, Duan Z, Zheng L, Wu S, Lu T, Jian Y. Elevated plasma fibrinogen level shows superior prognostic value than Epstein-Barr virus DNA load for stage IVA/B nasopharyngeal carcinoma patients in the intensity-modulated radiotherapy era. Oncotarget 2018; 7:46242-46252. [PMID: 27323828 PMCID: PMC5216794 DOI: 10.18632/oncotarget.10083] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/29/2016] [Indexed: 11/25/2022] Open
Abstract
Purpose Effective prognostic factors for patients with stage IVA/B nasopharyngeal carcinoma (NPC) who are susceptible to distant metastases are limited. We aim to investigate the prognostic value of pretreatment plasma fibrinogen (FIB) level and Epstein–Barr virus DNA (EBV-DNA) load in these patients in the era of intensity-modulated radiotherapy (IMRT). Results The 5-year DSS, DFS and DMFS rates of the entire cohort were 72.7%, 66.8%, 80.0%, respectively. High FIB level was identified as a negative prognostic factor for survival: the 5-year DSS, DFS and DMFS rates for patients with high FIB (> 4.0 g/L) and normal FIB (≤ 4.0 g/L) were 60.3% vs. 76.0%, 56.0% vs. 69.9%, and 59.4% vs. 85.5%, respectively (all P < 0.001). Subgroup analysis demonstrated that DSS, DFS and DMFS decreased as FIB gradually increased, even within the normal range. The risk of distant metastasis in patients with high FIB was over 3-fold than patients with normal FIB. EBV-DNA was not an independent prognostic factor for any survival outcomes in multivariate analysis. Conclusion High pretreatment FIB level shows superior prognostic value than EBV-DNA load for stage IVA/B NPC patients in the era of IMRT. Materials and Methods A total of 755 patients with newly-diagnosed stage IVA/B NPC treated with definitive IMRT between January 2007 and December 2011 were enrolled. Plasma FIB and EBV-DNA were measured before treatment. Disease-specific survival (DSS), disease-free survival (DFS) and distant metastasis-free survival (DMFS) were calculated using the Kaplan-Meier method; differences were compared using the log-rank test.
Collapse
Affiliation(s)
- Mei Lan
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Chunyan Chen
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ying Huang
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Minjie Mao
- Department of Clinical Laboratory, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Fei Han
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Junfang Liao
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Meiling Deng
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Zhijun Duan
- Department of Radiation Diagnosis and Interventional Center, Chengdu Military General Hospital, Chengdu, China
| | - Lie Zheng
- Department of Imaging Diagnosis and Interventional Center, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Shaoxiong Wu
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Taixiang Lu
- Department of Radiation Oncology, State Key Laboratory of Oncology in Southern China, Sun Yat-sen University Cancer Center, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yutao Jian
- Institute of Stomatological Research, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| |
Collapse
|
33
|
Sun F, Zhu J, Lu S, Zhen Z, Wang J, Huang J, Ding Z, Zeng M, Sun X. An inflammation-based cumulative prognostic score system in patients with diffuse large B cell lymphoma in rituximab era. BMC Cancer 2018; 18:5. [PMID: 29291712 PMCID: PMC5749011 DOI: 10.1186/s12885-017-3931-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 12/18/2017] [Indexed: 12/19/2022] Open
Abstract
Background Systemic inflammatory parameters are associated with poor outcomes in malignant patients. Several inflammation-based cumulative prognostic score systems were established for various solid tumors. However, there is few inflammation based cumulative prognostic score system for patients with diffuse large B cell lymphoma (DLBCL). Methods We retrospectively reviewed 564 adult DLBCL patients who had received rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) therapy between Nov 1 2006 and Dec 30 2013 and assessed the prognostic significance of six systemic inflammatory parameters evaluated in previous studies by univariate and multivariate analysis:C-reactive protein(CRP), albumin levels, the lymphocyte-monocyte ratio (LMR), the neutrophil-lymphocyte ratio(NLR), the platelet-lymphocyte ratio(PLR)and fibrinogen levels. Results Multivariate analysis identified CRP, albumin levels and the LMR are three independent prognostic parameters for overall survival (OS). Based on these three factors, we constructed a novel inflammation-based cumulative prognostic score (ICPS) system. Four risk groups were formed: group ICPS = 0, ICPS = 1, ICPS = 2 and ICPS = 3. Advanced multivariate analysis indicated that the ICPS model is a prognostic score system independent of International Prognostic Index (IPI) for both progression-free survival (PFS) (p < 0.001) and OS (p < 0.001). The 3-year OS for patients with ICPS =0, ICPS =1, ICPS =2 and ICPS =3 were 95.6, 88.2, 76.0 and 62.2%, respectively (p < 0.001). The 3-year PFS for patients with ICPS = 0–1, ICPS = 2 and ICPS = 3 were 84.8, 71.6 and 54.5%, respectively (p < 0.001). Conclusions The prognostic value of the ICPS model indicated that the degree of systemic inflammatory status was associated with clinical outcomes of patients with DLBCL in rituximab era. The ICPS model was shown to classify risk groups more accurately than any single inflammatory prognostic parameters. These findings may be useful for identifying candidates for further inflammation-related mechanism research or novel anti-inflammation target therapies.
Collapse
Affiliation(s)
- Feifei Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China.,Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China
| | - Jia Zhu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China.,Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China
| | - Suying Lu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China.,Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China
| | - Zijun Zhen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China.,Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China
| | - Juan Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China.,Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China
| | - Junting Huang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China.,Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China
| | - Zonghui Ding
- Department of Biochemistry and Molecular Biology, Mayo Clinic Scottsdale, 13400 East Shea Boulevard, Scottsdale, AZ, 85259, USA
| | - Musheng Zeng
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China.
| | - Xiaofei Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China. .,Department of Pediatric Oncology, Sun Yat-sen University Cancer Center, NO.651 of Dongfeng East Road, Guangzhou, 510060, China.
| |
Collapse
|
34
|
Hwang KT, Chung JK, Roh EY, Kim J, Oh S, Kim YA, Rhu J, Kim S. Prognostic Influence of Preoperative Fibrinogen to Albumin Ratio for Breast Cancer. J Breast Cancer 2017; 20:254-263. [PMID: 28970851 PMCID: PMC5620440 DOI: 10.4048/jbc.2017.20.3.254] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 06/14/2017] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Elevated serum concentration of fibrinogen and decreased serum concentration of albumin have been reported to be markers of elevated systemic inflammation. We attempted to investigate the prognostic influence of preoperative fibrinogen to albumin ratio (FAR) for breast cancer. METHODS Data from 793 consecutive primary breast cancer patients were retrospectively analyzed. Serum levels of fibrinogen and albumin were tested before curative surgery. Subjects were grouped into two groups according to the cutoff value determined by performing the receiver operating characteristic curve analysis: the high FAR group (FAR>7.1) and the low FAR group (FAR≤7.1). Overall survival was assessed using the Kaplan-Meier estimator. Independent prognostic significance was analyzed using the Cox proportional hazards model. RESULTS The high FAR group had a worse prognosis compared to the low FAR group (log-rank test, p<0.001). The prognostic effect of FAR was more significant than that of single markers such as fibrinogen (log-rank test, p=0.001) or albumin (log-rank test, p=0.001). The prognostic effect of FAR was prominent in the stage II/III subgroup (log-rank test, p<0.001) and luminal A-like subtype (log-rank test, p<0.001). FAR was identified as a significant independent factor on both univariate (hazard ratio [HR], 2.722; 95% confidence interval [CI], 1.659-4.468; p<0.001) and multivariate analysis (HR, 2.622; 95% CI, 1.455-4.724; p=0.001). CONCLUSION Preoperative FAR was a strong independent prognostic factor in breast cancer. Its prognostic effect was more prominent in the stage II/III subgroup and in the luminal A-like subtype. Therefore, preoperative FAR can be utilized as a useful prognosticator for breast cancer patients. Further studies are needed to validate its applications in clinical settings.
Collapse
Affiliation(s)
- Ki-Tae Hwang
- Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jung Kee Chung
- Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Eun Youn Roh
- Department of Laboratory Medicine, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jongjin Kim
- Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Sohee Oh
- Department of Biostatistics, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Young A Kim
- Department of Pathology, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jiyoung Rhu
- Department of Surgery, Seoul National University Boramae Medical Center, Seoul, Korea
| | - Suzy Kim
- Department of Radiation Oncology, Seoul National University Boramae Medical Center, Seoul, Korea
| |
Collapse
|
35
|
Shimizu T, Ishizuka M, Suzuki T, Tanaka G, Park KH, Matsumoto T, Shiraki T, Sakuraoka Y, Kato M, Aoki T, Kubota K. The preoperative globulin-to-albumin ratio, a novel inflammation-based prognostic system, predicts survival after potentially curative liver resection for patients with hepatocellular carcinoma. J Surg Oncol 2017; 116:1166-1175. [PMID: 28853157 DOI: 10.1002/jso.24772] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 06/24/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVES Although the globulin-to-albumin ratio (GAR) is useful for prognostication of patients with various cancers, its relationship with hepatocellular carcinoma (HCC) remains unclear. The study aims to investigate the relationship between GAR and postoperative survival among patients with HCC undergoing potentially curative liver resection (LR). METHODS We retrospectively reviewed 368 patients with newly diagnosed HCC who underwent initial and potentially curative LR. Univariate and multivariate analyses using the Cox proportional hazard model were performed to detect clinical characteristics that correlated with overall survival (OS). Kaplan-Meier analysis and log-rank test were used to compare OS and disease-free survival (DFS). RESULTS The result of multivariate analysis using 25 clinical characteristics selected by univariate analysis revealed that the GAR (≥0.918/<0.918) was significantly associated with OS (hazard ratio [HR], 2.398; 95% confidence interval [CI], 1.012-5.683; P = 0.047), as well as platelet count (<14/≥14, ×104 /mm3 ) and portal vein invasion (presence/absence). Kaplan-Meier analysis and log-rank test demonstrated that the OS and DFS of patients with a high GAR (>0.918) were significantly worse than that of patients with a low GAR (≤0.918). CONCLUSIONS The GAR is a useful predictor of postoperative survival among patients with HCC undergoing potentially curative LR.
Collapse
Affiliation(s)
- Takayuki Shimizu
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Mitsuru Ishizuka
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Takashi Suzuki
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Genki Tanaka
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Kyung Hwa Park
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | | | - Takayuki Shiraki
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Yuhki Sakuraoka
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Masato Kato
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Taku Aoki
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Keiichi Kubota
- Second Department of Surgery, Dokkyo Medical University, Tochigi, Japan
| |
Collapse
|
36
|
Prognostic value of lymphocyte-to-monocyte ratio among Asian lung cancer patients: a systematic review and meta-analysis. Oncotarget 2017; 8:110606-110613. [PMID: 29299172 PMCID: PMC5746407 DOI: 10.18632/oncotarget.20574] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 08/04/2017] [Indexed: 02/05/2023] Open
Abstract
Purpose Numerous studies have reported the prognostic significance of lymphocyte-to-monocyte ratio (LMR) in malignancies, but its prognostic value among lung cancer remains controversial. This meta-analysis aimed to explore the prognostic significance of LMR in lung cancer patients. Results Eight studies including 3954 patients were included in this meta-analysis. Pooled results indicated that low LMR was significantly associated with poorer progression-free survival (hazard ratio (HR): 1.431, 95% confidence interval (CI): 1.294–1.582, p < 0.001) and overall survival (OS) (HR: 1.651, 95% CI: 1.306–2.086, p < 0.001), compared with high LMR. Similar results were observed in subgroups regardless of treatment, LMR cut-off value, or districts. However, no significant correlation between the LMR and OS was observed in the small cell lung cancer (SCLC) subgroup (HR = 1.262, 95% CI: 0.864–1.841, p = 0.229). Materials and Methods Identified literatures were extracted and retrieved from PubMed, Embase, Web of Science, and the Cochrane Library databases; All eligible studies focused on the association between LMR and the prognosis of lung cancer. Conclusions Low LMR is associated with poor outcomes among lung cancer patients. Further studies are needed to discuss the correlation between LMR and lung cancer prognosis.
Collapse
|
37
|
Çalışkan S, Sungur M. Fibrinogen and D-dimer levels in prostate cancer: Preliminary results. Prostate Int 2017; 5:110-112. [PMID: 28828354 PMCID: PMC5551919 DOI: 10.1016/j.prnil.2017.05.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 04/22/2017] [Accepted: 05/12/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Prostate cancer is one of the most common malignancy in men. The main risk factors for coagulation activation and thrombosis are malignancy and older age. The thrombosis risk may be associated with increased level of coagulation markers such as fibrinogen and D-dimer. The aim of this study is evaluate the relationship between coagulation markers and prostate cancer. METHODS This prospective study includes the patients who underwent transrectal ultrasound guided prostate biopsy and prostate surgery was performed between January 2015 and January 2016. Plasma prostate specific antigen (PSA), free PSA (fPSA), percentage fPSA, D-dimer and fibrinogen levels were measured before the procedures. The patients were divided into two groups according to the pathology results. The patients with benign prostate hyperplasia were in group 1 and the patients with prostate cancer were in group 2. RESULTS There were 76 patients in the current study. There were 53 patients in group 1 and 23 patients in group 2. The mean age of the patients, PSA, fPSA, fibrinogen and D-dimer levels was 65.33 ± 7.47 years, 8.21 ± 4.59, 1.41 ± 0.74 ng/ml, 309.75 ± 80.46 mg/dl, 0.42 ± 0.39 ug/ml in group 1. In group 2; the mean age of the patients, PSA, fPSA, fibrinogen and D-dimer levels was 66.08 ± 6.7 years, 145.69 ± 509.35, 7.32 ± 15 ng/ml, 312.16 ± 69.48 mg/dl, 1.09 ± 2.11 ug/ml. The prostate biopsy and transurethral surgery were performed in 64(%84.21) and 12(%15.79) patients. CONCLUSION The present study demonstrated that plasma D-dimer level was higher in patients with prostate cancer. Further studies that include large number of patients are needed to define the relationship between prostate cancer and coagulation disorder.
Collapse
Affiliation(s)
- Selahattin Çalışkan
- Department of Urology, Hitit University, Çorum Training and Research Hospital, Çorum, Turkey
| | - Mustafa Sungur
- Department of Urology, Hitit University, Çorum Training and Research Hospital, Çorum, Turkey
| |
Collapse
|
38
|
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: 40] [Impact Index Per Article: 5.7] [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.
Collapse
|
39
|
Cui J, Yu M, Zhang N, Wang S, Zhu Y, Chen S, Zhu K, Du J, Zhao H, Liu X, Chen P, Wang W, Zhang D, Shi B. Prognostic scores based on the preoperative plasma fibrinogen and serum albumin level as a prognostic factor in patients with upper urinary tract urothelial carcinoma. Oncotarget 2017; 8:68964-68973. [PMID: 28978171 PMCID: PMC5620311 DOI: 10.18632/oncotarget.16483] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/15/2017] [Indexed: 01/12/2023] Open
Abstract
This study is to clarify the prognostic value of preoperative plasma fibrinogen and serum albumin level, as known as FA score, in a cohort of Chinese patients with upper urinary tract urothelial carcinoma (UTUC). We retrospectively evaluated clinicopathological data on 169 patients who underwent surgery between 2006 and 2013. The FA score was calculated based on cutoff values of 3.53g/L for fibrinogen and 43.56 g/L for albumin. Overall survival and cancer specific survival was assessed using the Kaplan-Meier method and the equivalences of the curves were tested by log-rank tests. The Cox proportional hazards regression model was applied in univariate and multivariate analyses. In univariate analysis, tumor size, tumor grade, pathological T stage and FA score were significantly associated with overall survival and cancer specific survival, and multivariate Cox proportional hazards regression analysis identified FA score (score 1: HR=3.486, 95%CI 1.358-8.948, p=0.009; HR=3.485, 95%CI 1.363-8.913, p=0.009, respectively; score 2: HR=5.509, 95%CI 2.144-14.158, p<0.001; HR=5.521, 95%CI 2.074-14.697, p=0.001, respectively) was an independent predictor for overall survival and cancer specific survival. The evaluation of preoperative FA score can be regarded as an independent prognostic factor for predicting overall survival and cancer specific survival in UTUC. The fibrinogen and albumin levels are low cost and easy accessibility in clinical practice.
Collapse
Affiliation(s)
- Jianfeng Cui
- Department of Urology, Qilu Hospital of Shandong University, Jinan, P.R. China
| | - Meng Yu
- Department of Urology, Qilu Hospital of Shandong University, Jinan, P.R. China
| | - Ning Zhang
- Department of Urology, Qilu Hospital of Shandong University, Jinan, P.R. China
| | - Shiyu Wang
- Department of Urology, Qilu Hospital of Shandong University, Jinan, P.R. China
| | - Yaofeng Zhu
- Department of Urology, Qilu Hospital of Shandong University, Jinan, P.R. China
| | - Shouzhen Chen
- Department of Urology, Qilu Hospital of Shandong University, Jinan, P.R. China
| | - Kejia Zhu
- Department of Urology, Qilu Hospital of Shandong University, Jinan, P.R. China
| | - Jian Du
- Department of Urology, Qilu Hospital of Shandong University, Jinan, P.R. China
| | - Hongda Zhao
- Department of Urology, Qilu Hospital of Shandong University, Jinan, P.R. China
| | - Xigao Liu
- Department of Urology, Qilu Hospital of Shandong University, Jinan, P.R. China
| | - Pengxiang Chen
- Department of Radiation Oncology, Qilu Hospital, Shandong University, Jinan, P.R. China
| | - Wenbo Wang
- School of Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China
| | - Dongqing Zhang
- Department of Urology, Qilu Hospital of Shandong University, Jinan, P.R. China
| | - Benkang Shi
- Department of Urology, Qilu Hospital of Shandong University, Jinan, P.R. China
| |
Collapse
|
40
|
Chen B, Dai D, Tang H, Chen X, Ai X, Huang X, Wei W, Xie X. Pre-treatment serum alkaline phosphatase and lactate dehydrogenase as prognostic factors in triple negative breast cancer. J Cancer 2016; 7:2309-2316. [PMID: 27994669 PMCID: PMC5166542 DOI: 10.7150/jca.16622] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 09/17/2016] [Indexed: 02/07/2023] Open
Abstract
Background: Serum parameters as prognostic parameters are studied widely. We aim to examine the prognostic significance of the serum alkaline phosphatase (ALP) level and lactate dehydrogenase (LDH) level in triple negative breast cancer (TNBC). Methods: Total of 253 TNBC patients from Sun Yat-sen University Cancer Center who underwent treatment between January 2004 and December 2009 was conducted in this retrospective study. Before treatment serum ALP and LDH levels were routinely measured. We use the receiver operating characteristic (ROC) curve analysis to estimate the cutoff value of serum ALP and LDH levels. The Kaplan-Meier method and multivariable Cox regression analysis were used for Disease free survival (DFS) and overall survival (OS) assessed. Results: The ROC curves determined that the optimum cutoff point for ALP and LDH were 66.5u/L and 160.5u/L, respectively. The elevated ALP and LDH were both significantly associated with decreased DFS and OS (both P < 0.001). In addition, the entire cohort was stratified into three subgroups basis of ALP levels and LDH levels. TNBC Patients who with ALP >66.5 u/L and LDH >160.5u/L had the worst DFS and OS (both P < 0.001). In TNBC patients, univariate and multivariate Cox regression analyses conformed ALP and LDH were independent unfavorable prognostic factors for DFS and OS. Conclusions: The serum levels of ALP and LDH before treatment are independent prognostic parameters and may serve as complement to help predict survival in TNBC.
Collapse
Affiliation(s)
- Bo Chen
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Danian Dai
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Hailin Tang
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xi Chen
- Department of Anatomy, Medical College, University of South China, Hengyang, Hunan Province, China
| | - Xiaohong Ai
- Department of Radiotherapy, The First Affiliated Hospital, University of South China, Hengyang, Hunan Province, China
| | - Xiaojia Huang
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Weidong Wei
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xiaoming Xie
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| |
Collapse
|
41
|
Liu J, Li D, Cao L, Wang Z, Li Y, Liu H, Chen G. Elevated preoperative plasma fibrinogen level is an independent predictor of malignancy and advanced stage disease in patients with bladder urothelial tumors. Int J Surg 2016; 36:249-254. [PMID: 27826047 DOI: 10.1016/j.ijsu.2016.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/02/2016] [Accepted: 11/03/2016] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the association between preoperative plasma fibrinogen levels and clinicopathological features in patients with bladder urothelial tumors. METHODS In this retrospective single-center study, we evaluated preoperative plasma fibrinogen levels in 503 patients newly diagnosed with bladder urothelial tumors between January 2009 and October 2014. All patients received surgical intervention as the primary treatment method. Associations between preoperative plasma fibrinogen levels and clinicopathological parameters were analyzed. Univariate and multivariate logistic regression analyses were performed to identify independent associations. RESULTS The mean preoperative fibrinogen level in patients with bladder urothelial carcinoma (BUC) was significantly higher than that in patients with papilloma or papillary urothelial neoplasm of low malignant potential (PUNLMP) (P = 0.004). Additionally, patients with BUC with advanced-stage disease showed elevated plasma fibrinogen levels compared to patients with early-stage disease (high-grade BUC vs. low-grade BUC: P = 0.002; muscle-invasive BUC vs. non-muscle-invasive BUC: P = 0.010). In a multivariate regression model, a plasma fibrinogen level >3.04 g/L was identified to be independently associated with the presence of BUC (hazard ratio [HR] = 1.653, P = 0.047), high-grade BUC (HR = 1.869, P = 0.004), and muscle-invasive BUC (HR = 1.870, P = 0.044). CONCLUSIONS Elevated preoperative plasma fibrinogen level is an independent predictor of malignancy as well as advanced-stage carcinoma in patients with bladder urothelial tumors, suggesting that plasma fibrinogen may be a promising diagnostic and prognostic biomarker for bladder tumors.
Collapse
Affiliation(s)
- Jikai Liu
- Department of Urology, Jinshan Hospital of Fudan University, Shanghai City, 201508, PR China
| | - Dawei Li
- Department of Urology, Qilu Hospital of Shandong University, Jinan City, Shandong Province, 250012, PR China
| | - Li Cao
- Department of Urology, Qilu Hospital of Shandong University, Jinan City, Shandong Province, 250012, PR China
| | - Zhanyu Wang
- Department of Urology, Jinshan Hospital of Fudan University, Shanghai City, 201508, PR China
| | - Yan Li
- Department of Urology, Qilu Hospital of Shandong University, Jinan City, Shandong Province, 250012, PR China
| | - Hainan Liu
- Department of Urology, Qilu Hospital of Shandong University, Jinan City, Shandong Province, 250012, PR China
| | - Gang Chen
- Department of Urology, Jinshan Hospital of Fudan University, Shanghai City, 201508, PR China.
| |
Collapse
|
42
|
Dai D, Chen B, Tang H, Wang B, Zhao Z, Xie X, Wei W. Nomograms for Predicting the Prognostic Value of Pre-Therapeutic CA15-3 and CEA Serum Levels in TNBC Patients. PLoS One 2016; 11:e0161902. [PMID: 27561099 PMCID: PMC4999206 DOI: 10.1371/journal.pone.0161902] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 08/12/2016] [Indexed: 12/27/2022] Open
Abstract
Previous studies have indicated that carcinoembryonic antigen (CEA) and cancer antigen 15–3 (CA15-3) levels are both independent prognostic factors in breast cancer. However, the utility of CEA and CA15-3 levels as conventional cancer biomarkers in patients with triple-negative breast cancer (TNBC) remains controversial. The current study was performed to explore the predictive value of pre-therapeutic serum CEA and CA15-3 levels, and nomograms were developed including these serum cancer biomarkers to improve the prognostic evaluation of TNBC patients. Pre-therapeutic CA15-3 and CEA concentrations were measured in 247 patients with stage I–IV TNBC. Kaplan-Meier analysis showed that TNBC patients with high levels of both CEA and CA15-3 had shorter overall survival (OS) and disease-free survival (DFS) rates than those in the low-level groups (p<0.05). Multivariate analysis suggested that pre-therapeutic CA15-3 and CEA levels are independent predictive elements for OS (p = 0.022 and p = 0.040, respectively) and DFS (p = 0.023 and p = 0.028, respectively). In addition, novel nomograms were established and validated to provide personal forecasts of OS and DFS for patients with TNBC. These novel nomograms may help physicians to select the optimal treatment plans to ensure the best outcomes for TNBC patients.
Collapse
Affiliation(s)
- Danian Dai
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Bo Chen
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Hailin Tang
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Bin Wang
- Institute of Life Science, Chongqing Medical University, Chongqing, China
| | - Zhiping Zhao
- Institute of Hepatopancreatobiliary Surgery, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Xiaoming Xie
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
- * E-mail: (WW); (XX)
| | - Weidong Wei
- Department of Breast Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
- * E-mail: (WW); (XX)
| |
Collapse
|
43
|
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.
Collapse
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.
| |
Collapse
|