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Wu X, Yu X, Chen C, Chen C, Wang Y, Su D, Zhu L. Fibrinogen and tumors. Front Oncol 2024; 14:1393599. [PMID: 38779081 PMCID: PMC11109443 DOI: 10.3389/fonc.2024.1393599] [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: 02/29/2024] [Accepted: 04/25/2024] [Indexed: 05/25/2024] Open
Abstract
Elevated plasma fibrinogen (Fg) levels consistently correlate with an unfavorable prognosis in various tumor patient cohorts. Within the tumor microenvironment, aberrant deposition and expression of Fg have been consistently observed, interacting with multiple cellular receptors and thereby accentuating its role as a regulator of inflammatory processes. Specifically, Fg serves to stimulate and recruit immune cells and pro-inflammatory cytokines, thereby contributing to the promotion of tumor progression. Additionally, Fg and its fragments exhibit dichotomous effects on tumor angiogenesis. Notably, Fg also facilitates tumor migration through both platelet-dependent and platelet-independent mechanisms. Recent studies have illuminated several tumor-related signaling pathways influenced by Fg. This review provides a comprehensive summary of the intricate involvement of Fg in tumor biology, elucidating its multifaceted role and the underlying mechanisms.
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Affiliation(s)
- Xinyuan Wu
- School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaomin Yu
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Cheng Chen
- Department of Hematology, Wenzhou Key Laboratory of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chenlu Chen
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yuxin Wang
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Dongyan Su
- Department of Clinical Laboratory, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Liqing Zhu
- Department of Clinical Laboratory, Peking University Cancer Hospital and Institute, Beijing, China
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Zheng D, Yang J, Qian J, Jin L, Huang G. Fibrinogen-to-Neutrophil Ratio as a New Predictor of Central Lymph Node Metastasis in Patients with Papillary Thyroid Cancer and Type 2 Diabetes Mellitus. Cancer Manag Res 2022; 14:3493-3505. [PMID: 36573167 PMCID: PMC9789701 DOI: 10.2147/cmar.s366270] [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: 03/13/2022] [Accepted: 07/23/2022] [Indexed: 12/24/2022] Open
Abstract
Background Many patients have a higher risk of thyroid cancer if they have both papillary thyroid carcinoma (PTC) and Type 2 diabetes mellitus (T2DM). Meanwhile, the primary reason for local PTC recurrence is cervical lymph node metastasis. Therefore, the prognosis of patients affects how cervical lymph nodes are managed during surgery. Due to surgical complications such as laryngeal nerve palsy and hypocalcemia, it is still debatable whether to prevent central lymph node dissection (CLND). Predicting central lymph node metastasis (CLNM) is crucial to direct CLND. It is unclear how important the fibrinogen-to-neutrophil ratio (FNR) is in thyroid cancer, so we looked into how it might help patients with PTC and T2DM predict CLNM. Patients and methods Wenzhou Medical University's First Affiliated Hospital provided us with 413 patients with PTC and T2DM, randomly divided into a training set (N = 292) and a validation set (N = 121). Univariate and multivariate logistic regression analyses were used to identify independent risk factors. After constructing a nomogram, the validity of the model was evaluated. Results The maximum tumor diameter, high-density lipoprotein, thyroxine, triglyceride, lymphocyte, and FNR were all identified as independent risk factors by multivariate logistic regression analysis. The C index of the training set was 0.775, and the validation set was 0.654. Conclusion In patients with PTC and T2DM, preoperative FNR was an independent risk factor for CLNM.
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Affiliation(s)
- Danni Zheng
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Jiawen Yang
- Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Jiali Qian
- Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China
| | - Lingli Jin
- Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China,Correspondence: Lingli Jin, Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village, Nanbaixiang Street, Ouhai District, Wenzhou, Zhejiang, People’s Republic of China, Tel +86 577 5557 8527, Email
| | - Guanli Huang
- Department of Breast and Thyroid Surgery Department, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou, Zhejiang, People’s Republic of China,Department of Thyroid Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People’s Republic of China,Guanli Huang, Department of Breast and Thyroid Surgery Department, The Quzhou Affiliated Hospital of Wenzhou Medical University Quzhou People’s Hospital, Kecheng District, Minjiang Avenue No. 100, Quzhou, Zhejiang, People’s Republic of China, Tel +86 570 8895 120, Email
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Wei C, Li C, Chen X, Chen G, Nie R, Zhao C, Zhou Z, Chen Y. Development and verification of a nomogram for predicting the prognosis of resectable gastric cancer with outlet obstruction. BMC Cancer 2022; 22:1154. [DOI: 10.1186/s12885-022-10260-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/31/2022] [Indexed: 11/11/2022] Open
Abstract
Abstract
Background
The prognosis of patients with gastric cancer (GC) with gastric outlet obstruction (GOO) after gastrectomy is highly variable. In this study, we aimed to develop a nomogram to predict the prognosis of these patients.
Patients and Methods
Data from 218 GC patients with GOO who underwent gastrectomy at Sun Yat-sen University Cancer Center were retrospectively collected as a training cohort. The data of 59 patients with the same diagnosis who underwent gastrectomy at the First Affiliated Hospital of Guangxi Medical University were collected as an external verification cohort. A nomogram for the overall survival (OS) was developed using the Cox regression model in the training cohort, which was validated in a verification cohort.
Results
Multivariate analysis showed that the surgical procedure (P < 0.001), period of chemotherapy (P < 0.001), T stage (P = 0.006), N stage (P = 0.040), systemic immune-inflammatory index (SII) (P < 0.001), and fibrinogen level (P = 0.026) were independent factors affecting OS. The nomogram constructed on the aforementioned factors for predicting the 1- and 3-year OS achieved a Harrell’s concordance index (C-index) of 0.756 and 0.763 for the training and verification cohorts, respectively. Compared with the 8th American Joint Committee on Cancer (AJCC) Tumour-Node-Metastasis (TNM) staging system, the nomogram had higher C-index values and areas under the curve (AUCs) and slightly higher net clinical benefit.
Conclusion
Compared to the 8th AJCC staging system, the newly developed nomogram showed superior performance in predicting the survival of GC patients with GOO after gastrectomy.
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Thrombin Generation and D-Dimer for Prediction of Disease Progression and Mortality in Patients with Metastatic Gastrointestinal Cancer. Cancers (Basel) 2022; 14:cancers14184347. [PMID: 36139507 PMCID: PMC9496981 DOI: 10.3390/cancers14184347] [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: 07/04/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background: the tight and reciprocal interaction between cancer and hemostasis has stimulated investigations on the possible role of hemostatic biomarkers in predicting specific cancer outcomes, such as disease progression (DP) and overall survival (OS). In a prospective cohort of newly diagnosed metastatic gastrointestinal (GI) cancer patients from the HYPERCAN study, we aimed to assess whether the hemostatic biomarker levels measured before starting any anticancer therapy may specifically predict for 6-months DP (6m-DP) and for 1-year OS (1y OS). Methods: plasma samples were collected and tested for thrombin generation (TG) as global hemostatic assay, and for D-dimer, fibrinogen, and prothrombin fragment 1 + 2 as hypercoagulation biomarkers. DP and mortality were monitored during follow-up. Results: A prospective cohort of 462 colorectal and 164 gastric cancer patients was available for analysis. After 6 months, DP occurred in 148 patients, providing a cumulative incidence of 24.8% (21.4−28.4). D-dimer and TG endogenous thrombin potential (ETP) were identified as independent risk factors for 6m-DP by multivariate Fine−Gray proportional hazard regression model corrected for age, cancer site, and >1 metastatic site. After 1 year, we observed an OS of 75.7% (71.9−79.0). Multivariate Cox regression analysis corrected for age, site of cancer, and performance status identified D-dimer and ETP as independent risk factors for 1y OS. Patients with one or both hemostatic parameters above the dichotomizing threshold were at higher risk for both 6m-DP and 1-year mortality. Conclusion.: in newly diagnosed metastatic GI cancer patients, pretreatment ETP and D-dimer appear promising candidate biomarkers for predicting 6m-DP and 1y OS. In this setting, for the first time, the role of TG as a prognostic biomarker emerges in a large prospective cohort.
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Jiang L, Lei G. Albumin/fibrinogen ratio, an independent risk factor for postoperative delirium after total joint arthroplasty. Geriatr Gerontol Int 2022; 22:412-417. [PMID: 35365967 DOI: 10.1111/ggi.14381] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 02/09/2022] [Accepted: 03/08/2022] [Indexed: 12/16/2022]
Abstract
AIM Postoperative delirium (POD) is a very common and serious complication after total joint arthroplasty (TJA), which is closely associated with many adverse consequences and a poor prognosis. This study aimed to establish the potential risk factors for POD. METHODS In total, 336 patients who underwent elective TJA under general anesthesia between 2018 and 2021 were included and deemed eligible for inclusion. POD was diagnosed based on the criteria by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM V). The receiver operating characteristic curve was drawn to evaluate the predictive and cut-off values of continuous variables for POD. Potential risk factors for POD were evaluated by binary univariate and multivariate analysis with the "Enter" method. RESULTS According to the criteria by DSM V, 43 patients were categorized into the POD group, with an incidence of 12.8% (43 of 336). The receiver operating characteristic curve showed that albumin/fibrinogen ratio (AFR) was a good predictor for POD with an area under the curve of 0.754, cut-off value of 9.65, sensitivity of 57.00% and specificity of 83.72% (P <0.001). A low preoperative AFR level (<9.65) was determined as the only independent risk factor for POD by the univariate and multivariate logistic regression analyses (OR: 2.45, 95% CI: 2.01-2.94, P = 0.008). CONCLUSIONS Our results indicate that a low AFR is an independent risk factor for POD in elderly subjects after TJA. Geriatr Gerontol Int 2022; 22: 412-417.
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Affiliation(s)
- Liuying Jiang
- Department of Anesthesiology, Zhongshan Hospital Xiamen University, Xiamen City, China
| | - Gaofeng Lei
- Xiamen Medical Emergency Center, Xiamen City, China
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Baruah P, Paul D, Doshi J, Mitra S. Elevated Fibrinogen Level Reduces Therapeutic Efficiency of AD Drugs: Biophysical Insights into the Interaction of FDA-Approved Cholinesterase Inhibitors with Human Fibrinogen. J Phys Chem B 2021; 126:30-43. [PMID: 34964643 DOI: 10.1021/acs.jpcb.1c07495] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Despite being the second most abundant protein in blood plasma, reports on the interaction of drugs with fibrinogen (FIB) are relatively scarce. The effect of FIB on the therapeutic potency of four FDA-approved Alzheimer's disease drugs, namely, tacrine (TAC), donepezil (DON), eserine (ESE), and huperzine (HUP), was investigated through a combination of different in vitro and in silico experiments. The efficiency of the drugs in inhibiting the activity of acetylcholinesterase (AChE) was significantly reduced in the presence of FIB. This effect was even found to be more substantial than that for the most abundant plasma protein, human serum albumin (HSA). For example, the relative change in IC50 for TAC was found to be 65% in 10 μM FIB as opposed to 43% in the presence of 250 μM HSA. The relative trend of modulation in AChE activity showed consistency with the binding efficiency of the drugs and FIB. The sequestration of drugs in FIB, therefore reducing the availability of free drugs in solution, was identified to be the primary cause for the decrease in the AChE inhibition potency. This study aims to establish FIB as a vital component, while considering the therapeutic effectiveness of different newly developed AChE inhibitors.
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Affiliation(s)
- Prayasee Baruah
- Department of Chemistry, North-Eastern Hill University, Shillong 793022, India
| | - Debojit Paul
- Department of Chemistry, Indian Institute of Technology Guwahati, Guwahati 781039, India
| | - Jitesh Doshi
- BioInsight Solutions (OPC) Pvt. Ltd, Navi Mumbai 410210, India
| | - Sivaprasad Mitra
- Department of Chemistry, North-Eastern Hill University, Shillong 793022, India
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Is Fibrinogen an Effective Marker for Predicting Mortality in Patients with Gastric Cancer? Indian J Surg 2021. [DOI: 10.1007/s12262-021-02915-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Zhang L, Yu G, Wang Z, Li F, Zhao G, Zhao D. The sodium/D-dimer ratio predicts the effect of first-line chemotherapy and prognosis in patients with advanced gastric cancer. Am J Transl Res 2021; 13:792-802. [PMID: 33594327 PMCID: PMC7868830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 11/28/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Gastric cancer (GC) is one of the most common cancers worldwide. The survival time of patients with advanced gastric cancer (AGC) is shortened. We evaluated the role of the sodium/fibrinogen ratio (SFR) and sodium/D-dimer ratio (SDR) in predicting the first-line chemotherapy response, progression-free survival (PFS), and overall survival (OS) of patients with AGC. METHODS A total of 304 patients with AGC were retrospectively reviewed. SDR only was selected as a potential prognostic marker for the subsequent studies in this study. Based on the cut-off value of the SDR, the patients were divided into high-SDR and low-SDR groups and investigated for their clinicopathological features, first-line chemotherapy effects and clinical outcomes. RESULTS The cut-off value based on the SDR was 282.22, and the patients were divided into low-SDR (SDR ≤ 282.22) and high-SDR (SDR > 282.22) groups. The disease control rate was higher in the high-SDR group than in the low-SDR group (91.1% vs. 82.3%; P = 0.036). Patients with a high SDR had a longer median PFS and OS than those with a low SDR (PFS: 206.0 vs. 134.0 days, P < 0.001; OS: 435.0 vs. 295.5 days, P < 0.001). The SDR was an independent prognostic indicator in the multivariable analysis of PFS (P < 0.001) and OS (P = 0.004). In subgroup analyses, among the patients with normal sodium and D-dimer levels, SDR was still a reliable prognostic indicator of PFS and OS in patients with AGC (all P ≤ 0.001). CONCLUSIONS This study suggests that the SDR may serve as a prognostic indicator for chemotherapy outcome, PFS and OS for patients with AGC receiving first-line chemotherapy.
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Affiliation(s)
- Liqun Zhang
- Department of Medical Oncology, Shenyang Fifth People HospitalTiexi District, Shenyang 110020, Liaoning Province, China
| | - Guilin Yu
- Department of General Surgery, Liaoning Cancer Hospital & Institute, Cancer Hospital of China Medical UniversityNo. 44 Xiaoheyan Road, Dadong District, Shenyang 110042, Liaoning Province, China
| | - Zhuo Wang
- Department of Medical Oncology, Liaohua HospitalHongwei District, Liaoyang 111003, Liaoning Province, China
| | - Fang Li
- Department of Hepatobiliary Surgery, Liaoning Cancer Hospital & Institute, Cancer Hospital of China Medical UniversityNo. 44 Xiaoheyan Road, Dadong District, Shenyang 110042, Liaoning Province, China
| | - Guohua Zhao
- Department of General Surgery, Liaoning Cancer Hospital & Institute, Cancer Hospital of China Medical UniversityNo. 44 Xiaoheyan Road, Dadong District, Shenyang 110042, Liaoning Province, China
| | - Dan Zhao
- Department of Medical Imaging, Liaoning Cancer Hospital & Institute, Cancer Hospital of China Medical UniversityNo. 44 Xiaoheyan Road, Dadong District, Shenyang 110042, Liaoning Province, China
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Biomarkers for Malignant Pleural Mesothelioma-A Novel View on Inflammation. Cancers (Basel) 2021; 13:cancers13040658. [PMID: 33562138 PMCID: PMC7916017 DOI: 10.3390/cancers13040658] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 12/14/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive disease with limited treatment response and devastating prognosis. Exposure to asbestos and chronic inflammation are acknowledged as main risk factors. Since immune therapy evolved as a promising novel treatment modality, we want to reevaluate and summarize the role of the inflammatory system in MPM. This review focuses on local tumor associated inflammation on the one hand and systemic inflammatory markers, and their impact on MPM outcome, on the other hand. Identification of new biomarkers helps to select optimal patient tailored therapy, avoid ineffective treatment with its related side effects and consequently improves patient's outcome in this rare disease. Additionally, a better understanding of the tumor promoting and tumor suppressing inflammatory processes, influencing MPM pathogenesis and progression, might also reveal possible new targets for MPM treatment. After reviewing the currently available literature and according to our own research, it is concluded that the suppression of the specific immune system and the activation of its innate counterpart are crucial drivers of MPM aggressiveness translating to poor patient outcome.
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