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The Combination of Inflammatory Biomarkers as Prognostic Indicator in Salivary Gland Malignancy. Cancers (Basel) 2022; 14:cancers14235934. [PMID: 36497416 PMCID: PMC9740974 DOI: 10.3390/cancers14235934] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 12/02/2022] Open
Abstract
Background: The aim of this study was to investigate how the systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), taken individually and combined, are associated with overall survival (OS) in patients surgically treated for malignant salivary gland tumors (MSGTs). Methods: A retrospective analysis of 74 cases following surgery at our department between January 2011 and June 2018 was performed. The Receiver Operating Characteristic (ROC) curve was used to calculate the optimal cutoff values for SII, SIRI, PLR, and NLR. Survival curves of different groups at 1−3−5 years were estimated using the Kaplan−Meier method. Results: The optimal thresholds with the highest sensitivity and specificity were 3.95 for NLR, 187.6 for PLR, 917.585 for SII, and 2.045 for SIRI. The ROC curves revealed that the best combination with AUC = 0.884 was SII + SIRI. The estimated 5-year OS probability in patients with SII+ SIRI scores of 0, 1, and 2 was 96%, 87.5% and 12.5%, respectively (p < 0.001). Conclusion: SII+ SIRI can independently predict the OS of patients after MSGT surgery. The prognostic score system based on SII+ SIRI may be good clinical practice as a reference for clinical decision-making.
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Li J, Yan S, Zhang X, Xiang M, Zhang C, Gu L, Wei X, You C, Chen S, Zeng D, Jiang J. Circulating D-Dimers Increase the Risk of Mortality and Venous Thromboembolism in Patients With Lung Cancer: A Systematic Analysis Combined With External Validation. Front Med (Lausanne) 2022; 9:853941. [PMID: 35308559 PMCID: PMC8924589 DOI: 10.3389/fmed.2022.853941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/04/2022] [Indexed: 12/14/2022] Open
Abstract
Background D-dimer is a fibrin-degrading substance that is soluble and whose degradation is produced by plasma protein-mediated degradation of cross-linked fibrin. Previous investigations have shown a link between D-dimer and the mortality in lung cancer patients. However, different investigations varied whether D-dimer could predict prognosis in these patients. Methods A meta-analysis and systematic review of all available cohort studies were performed on the link between circulating D-dimer levels and survival of lung cancer patients. Relevant studies were searched in Embase, Cochrane Library, and PubMed databases. Data from 540 lung cancer patients from the First Hospital of Soochow University and Sichuan Cancer Hospital were used for external validation. Results We finally obtained 19 eligible cohort studies with pooled HR showing that high D-dimer levels contribute to death in tumor group (HR 1.62, 95% CI: 1.39-1.88, I2 = 75.0%). Further stratified analysis showed that higher circulating D-dimer in the advanced lung cancer group was linked to a 1.91-fold risk (HR = 2.91, 95% CI: 2.24-3.78, I2 = 6.0%). Incorporation of other variables, including days of follow-up, country, design, public year, population, disease status, and quality score, into the meta-regression model, indicated that disease status was an additional source of heterogeneity (p < 0.001). External validation of 540 patients also showed that high levels of D-dimer showed a higher risk of overall mortality (HR 1.39, 95% CI: 1.13-1.72, p = 0.002) and VTE events (HR 3.98, 95% CI: 1.99-8.70, p = 0.002) in lung cancer patients. Conclusions High circulating plasma D-dimer levels independently predict long-term prognosis and the risk of venous thromboembolism in lung cancer.
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Affiliation(s)
- Jing Li
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The Affiliated Dushu Lake Hospital of Soochow University, Suzhou, China
| | - Shanle Yan
- Department of Rheumatology and Immunology, The Affiliated Dushu Lake Hospital of Soochow University, Suzhou, China
| | - Xiaohui Zhang
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Mengqi Xiang
- Department of Medical Oncology, Sichuan Cancer Hospital, Medical School, University of Electronic Science and Technology of China, Chengdu, China
| | - Chuanhua Zhang
- Department of Thoracic Surgery, Sichuan Cancer Hospital, Medical School, University of Electronic Science and Technology of China, Chengdu, China
| | - Ling Gu
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoying Wei
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The Affiliated Dushu Lake Hospital of Soochow University, Suzhou, China
| | - Chuanyun You
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shenhua Chen
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Daxiong Zeng
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The Affiliated Dushu Lake Hospital of Soochow University, Suzhou, China
| | - Junhong Jiang
- Department of Medicine, Respiratory, Emergency and Intensive Care Medicine, The Affiliated Dushu Lake Hospital of Soochow University, Suzhou, China
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Yin W, Lv J, Yao Y, Zhao Y, He Z, Wang Q, Cui L, Dai H. Elevations of monocyte and neutrophils, and higher levels of granulocyte colony-stimulating factor in peripheral blood in lung cancer patients. Thorac Cancer 2021; 12:2680-2690. [PMID: 34498383 PMCID: PMC8520797 DOI: 10.1111/1759-7714.14103] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 12/18/2022] Open
Abstract
Introduction Immune cells and molecules are considered as clinical biomarkers and potential targets for immunotherapy. Analyses of the composition of peripheral blood cells hold promise for providing a basis for diagnosing and prognosis lung cancer. In this study, we assessed correlations between immune cell subset profiles in peripheral blood and disease prognosis in patients with lung cancer. Methods One hundred and thirteen patients with lung cancer and 99 age‐matched healthy people were enrolled in this study. The percentage and cell count of monocytes, neutrophils, T cells, B cells, natural killer (NK), and NKT cells in peripheral blood were analyzed by flow cytometry or peripheral blood analyzer. Serum cytokines and colony‐stimulating factors were detected by enzyme‐linked immunosorbent assay (ELISA). Results A reduction in antitumor NK cells (p < 0.0001) and an increase in the protumor MDSCs (p < 0.0001) were observed in the lung cancer patients compared with the controls. Monocyte counts were significantly higher in lung cancer patients with histories of smoking (p < 0.05) or drinking (p < 0.01) than in patients with no relevant history or healthy controls. The number of neutrophils and the neutrophil‐to‐lymphocyte ratio (NLR) were particularly higher in patients with liver metastasis (p < 0.01) compared with no metastasis patients or healthy controls. Levels of the monocyte‐derived cytokine interleukin‐6 (p < 0.05), granulocyte colony‐stimulating factor (G‐CSF) (p < 0.0001), and granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) (p < 0.0001) were higher in patients than in controls. G‐CSF levels decreased during the remission phase (p < 0.05), and positively correlated with carbohydrate antigen 19–9 (p < 0.05) and gene mutation (p < 0.05). Conclusion Monocyte and neutrophil counts were higher in peripheral blood in lung cancer patients than in controls, especially when patients had histories of smoking, drinking, and liver metastasis. Serum levels of G‐CSF and GM‐CSF were higher in lung cancer patients, and G‐CSF levels positively correlated with disease severity.
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Affiliation(s)
- Wencheng Yin
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing, China
| | - Jiaoyun Lv
- Department of Immunology, School of Basic Medical Sciences, NHC Key Laboratory of Medical Immunology, Peking University, Beijing, China
| | - Yanhong Yao
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing, China
| | - Yang Zhao
- Department of Laboratory Medicine, Peking University Third Hospital, Beijing, China
| | - Ziyi He
- Department of Immunology, School of Basic Medical Sciences, NHC Key Laboratory of Medical Immunology, Peking University, Beijing, China
| | - Qiqi Wang
- Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing, China
| | - Liyan Cui
- Department of Laboratory Medicine, Peking University Third Hospital, Beijing, China
| | - Hui Dai
- Department of Immunology, School of Basic Medical Sciences, NHC Key Laboratory of Medical Immunology, Peking University, Beijing, China
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Ma M, Cao R, Wang W, Wang B, Yang Y, Huang Y, Zhao G, Ye L. The D-dimer level predicts the prognosis in patients with lung cancer: a systematic review and meta-analysis. J Cardiothorac Surg 2021; 16:243. [PMID: 34454552 PMCID: PMC8399789 DOI: 10.1186/s13019-021-01618-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/11/2021] [Indexed: 03/21/2023] Open
Abstract
OBJECTIVE Although the significance of increased plasma D-dimer levels in activating coagulation and fibrinolysis has been reported, it is still controversial whether it can be used to predict the prognosis of lung cancer patients. This meta-analysis was performed to explore the beneficial role of plasma D-dimer as a prognostic factor in lung cancer patients according to a larger sample capacity. MATERIALS AND METHODS MEDLINE, EMBASE, and Cochrane Central databases were searched from inception to January 2021. The data are mainly hazard ratio(HR) with 95% confidence interval (CI) and Kaplan-Meier survival curves. The publication bias was examined by Egger's test. RESULTS Finally, a total of 28 studies, enrolling 8452 patients were included in the current meta-analysis. Our results showed that the OS (HR = 1.742, 95%CI:1.542-1.969, P < 0.001) and PFS (HR = 1.385, 95%CI:1.169-1.641, P = 0.003) in the high D-dimer group were significantly lower than those in the low D-dimer group. Subgroup analysis suggested that localization, detection methods and disease stage had an important effect on the prognosis. CONCLUSION This meta-analysis revealed that the high plasma D-dimer level leads to lower survival than in the low D-dimer level, which might provide an important clue for high plasma D-dimer level as an independent factor of poor prognosis in patients with lung cancer.
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Affiliation(s)
- Mingsheng Ma
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University, No. 519 Kunzhou Road, Xishan District, Kunming City, Yunnan Province, China
- Department of Cardiothoracic Surgery, The Sixth Affiliated Hospital of Kunming Medical University, Yuxi, China
| | - Run Cao
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University, No. 519 Kunzhou Road, Xishan District, Kunming City, Yunnan Province, China
| | - Wei Wang
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University, No. 519 Kunzhou Road, Xishan District, Kunming City, Yunnan Province, China
| | - Biying Wang
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University, No. 519 Kunzhou Road, Xishan District, Kunming City, Yunnan Province, China
| | - Yichen Yang
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University, No. 519 Kunzhou Road, Xishan District, Kunming City, Yunnan Province, China
| | - Yunchao Huang
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University, No. 519 Kunzhou Road, Xishan District, Kunming City, Yunnan Province, China
| | - Guangqiang Zhao
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University, No. 519 Kunzhou Road, Xishan District, Kunming City, Yunnan Province, China
| | - Lianhua Ye
- Department of Thoracic Surgery, The Third Affiliated Hospital of Kunming Medical University, No. 519 Kunzhou Road, Xishan District, Kunming City, Yunnan Province, China.
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He Q, Li Y, Zhou X, Zhou W, Xia C, Zhang R, Zhang Z, Hu A, Peng S, Li J. The combination of fibrinogen concentrations and the platelet-to-lymphocyte ratio predicts survival in patients with advanced lung adenocarcinoma treated with EGFR-TKIs. J Int Med Res 2021; 49:3000605211004021. [PMID: 33794676 PMCID: PMC8020225 DOI: 10.1177/03000605211004021] [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] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE This study aimed to identify a predictive marker of response to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in patients with EGFR-mutant advanced lung adenocarcinoma. METHODS A cohort of 190 patients with EGFR-mutant advanced lung adenocarcinoma was analyzed. Receiver operating characteristic curve analysis was used to evaluate the optimal cutoffs for fibrinogen levels, the neutrophil-to-lymphocyte ratio (NLR), and the platelet-to-lymphocyte ratio (PLR) for predicting progression-free survival (PFS). Univariate and multivariate survival analyses were performed to identify factors correlated with PFS and overall survival (OS). RESULTS High NLR was associated with worse performance status. In univariate analysis, fibrinogen levels, NLR, and PLR were correlated with OS and PFS. In multivariate analysis, all three variables remained predictive of OS, whereas only fibrinogen levels and PLR were independent prognostic factors for PFS. Furthermore, the combination of fibrinogen levels and PLR (F-PLR score) could stratify patients into three groups with significantly different prognoses, and the score was independently predictive of survival. CONCLUSION The F-PLR score predicted the prognosis of patients with EGFR-mutant advanced lung adenocarcinoma who received EGFR-TKIs, and this score may serve as a convenient blood-based marker for identifying high-risk patients.
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Affiliation(s)
- Qiong He
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.,Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Xihong Zhou
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Wen Zhou
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Chunfang Xia
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.,Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Ruzhe Zhang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.,Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Zhengjie Zhang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.,Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Aiyang Hu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.,Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Siyin Peng
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.,Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Jing Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.,Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
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The Prognostic Significance of Combined Pretreatment Fibrinogen and Neutrophil-Lymphocyte Ratio in Various Cancers: A Systematic Review and Meta-Analysis. DISEASE MARKERS 2020; 2020:4565379. [PMID: 33376559 PMCID: PMC7746466 DOI: 10.1155/2020/4565379] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 04/18/2020] [Accepted: 10/07/2020] [Indexed: 12/11/2022]
Abstract
Purpose The prognostic value of a new scoring system, termed F-NLR, that combines pretreatment fibrinogen level with neutrophil-lymphocyte ratio has been evaluated in various cancers. However, the results are controversial. The purpose of this study was to comprehensively analyze the prognostic value of F-NLR score in patients with cancers. Methods An integrated search of relevant studies was conducted by screening the PubMed and Embase databases. Pooled hazard ratios, with 95% confidence intervals (CIs), for overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS) were calculated to estimate the prognostic significance of F-NLR score in patients with various tumors. A random effects model was used for comprehensive analysis, and subgroup and meta-regression analyses were used to explore sources of heterogeneity. Results Thirteen articles reporting data from of 4747 patients were included in the study. Pooled analysis revealed that high F-NLR score was significantly associated with poor OS (HR = 1.77; 95% CI, 1.51–2.08) and poor DFS/PFS (HR = 1.63; 95% CI, 1.30–2.05). Subgroup and meta-regression analyses did not alter the prognostic role of F-NLR score in OS and DFS/PFS. Conclusions Increased F-NLR score is significantly associated with poor prognosis in patients with cancers and can serve as an effective prognostic indicator.
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Liu X, Shi B. Progress in research on the role of fibrinogen in lung cancer. Open Life Sci 2020; 15:326-330. [PMID: 33817221 PMCID: PMC7874584 DOI: 10.1515/biol-2020-0035] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 03/11/2020] [Accepted: 03/17/2020] [Indexed: 12/16/2022] Open
Abstract
Lung cancer is one of the most prevalent malignancies worldwide. Local recurrence and distant metastasis remain the major causes of treatment failure. It has been recognized that the process of tumor growth and metastasis involves multiple interactions between tumor and host. Various biomarkers have been used for predicting tumor recurrence, metastasis, and prognosis in patients with lung cancer. However, these biomarkers are still controversial and require further validation. The relationship between malignancy and coagulation system disorders has been explored for more than a century. Fibrinogen is the most abundant plasma coagulation factor synthesized mainly by hepatic cells. Increased plasma fibrinogen levels were observed in various carcinomas such as gastric cancer, colon cancer, and pancreatic cancer. Recent studies have also investigated the role of fibrinogen in patients with lung cancer. This review aimed to address the role of fibrinogen in lung cancer.
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Affiliation(s)
- Xing Liu
- Department of Respiratory Medicine, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, Jiangsu, China
| | - Bin Shi
- Department of Respiratory Medicine, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian 223800, Jiangsu, China
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Wang Z, Fan H, Wang W, Zheng G, Xiao Y, Guo H, Zhang Y. High Preoperative Plasma Fibrinogen Independently Predicts a Poor Prognosis in Patients with Nonmetastatic RCC. J Cancer 2020; 11:2401-2407. [PMID: 32201511 PMCID: PMC7065994 DOI: 10.7150/jca.40961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 01/24/2020] [Indexed: 02/04/2023] Open
Abstract
Background: This study aims to determine the relationship between preoperative plasma fibrinogen levels and the prognosis of patients with nonmetastatic renal cell carcinoma (RCC), including overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS). Methods: We retrospectively analysed the clinical data and prognostic information of 1194 nonmetastatic RCC patients who received radical nephrectomy or nephron-sparing surgery between 2005 and 2015 at our institution. Serum was collected for fibrinogen detection in the week prior to curative operation, and prognostic information was regularly collected by specially trained personnel. The cut-off value of the preoperative plasma fibrinogen level was defined by receiver operating characteristic (ROC) analysis. The chi-square test was used to analyse the association between preoperative fibrinogen level and clinical characteristics. Kaplan-Meier analysis was used to calculate survival curves, and significant differences were determined by the log-rank test. Other significant prognostic factors were evaluated by the Cox multivariate proportional hazard model. Results: The median follow-up period after radical or partial nephrectomy was 42.4 months (ranging from 0.433 to 146.37 months). The optimal preoperative plasma fibrinogen concentration was 3.975 g/L. The preoperative fibrinogen level was significantly associated with age, pathological T stage, sarcomatoid differentiation, necrosis and vein tumour thrombus (all p<0.05). High plasma fibrinogen levels were related to poor prognosis in terms of OS (p<0.001), CSS (p<0.001) and PFS (p<0.001). Multivariate analysis showed that the preoperative fibrinogen level remained an independent prognostic factor for OS (HR: 3.22, 95%CI: 1.87-5.55, p<0.001), CSS (HR: 4.12, 95%: 2.15-7.89, p<0.001) and PFS (HR: 3.137, 95%CI: 2.17-4.53, p<0.001). Conclusions: High preoperative plasma fibrinogen level is an independent negative prognostic factor for OS, CSS and PFS in patients with non-metastatic RCC. Preoperative plasma fibrinogen could be an ideal indicator for evaluating the outcomes of postoperative patients with nonmetastatic RCC.
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Affiliation(s)
- Zhan Wang
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Hua Fan
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Wenda Wang
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Guoyang Zheng
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Yu Xiao
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
| | - Hao Guo
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Yushi Zhang
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
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Deng HY, Zheng X, Jiang R, Wang RL, Zhou J, Qiu XM. Preoperative D-dimer level is an independent prognostic factor for non-small cell lung cancer after surgical resection: a systematic review and meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:366. [PMID: 31555680 DOI: 10.21037/atm.2019.05.35] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Whether high preoperative D-dimer level has any impact on long-term survival of patients with surgically treated non-small cell lung cancer (NSCLC) remains unclear. Therefore, we conducted the first meta-analysis focusing specifically on prognostic value of high preoperative D-dimer level in NSCLC patients after surgical resection comprehensively. Methods We conducted a systematic search for relevant studies in PubMed, Embase, and Web of Science on January 28, 2019. Data for analysis consisted of hazard ratio (HR) with 95% confidence interval (CI) of overall survival (OS) and disease-free survival (DFS) from multivariate analysis and were analyzed by using the STATA 12.0 package. Results Finally, we included a total of 6 cohort studies consisting of 1,817 patients with surgically treated NSCLC for analysis. Our meta-analysis found that NSCLC patients with high preoperative D-dimer level had a significantly worse OS (random effects: HR =2.04; 95% CI: 1.30-3.20; P=0.002; I2=67.4%) and DFS (fixed effects: HR =1.98; 95% CI: 1.41-2.78; P<0.001; I2=0.0%) than these with normal preoperative D-dimer level after surgery. However, potential heterogeneity and publication bias was observed during analysis. Conclusions High pretreatment level of D-dimer remains to be an independent predictor of poor prognosis in NSCLC patients after surgery. Further well-conducted studies with appropriate adjustments are needed to confirm and update our conclusions.
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Affiliation(s)
- Han-Yu Deng
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xi Zheng
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Rui Jiang
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Rui-Lan Wang
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jie Zhou
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiao-Ming Qiu
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, China
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