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高血浆纤维蛋白原浓度和血小板计数对非小细胞肺癌脑转移患者的生存产生不利影响。

High plasma fibrinogen concentration and platelet count unfavorably impact survival in non-small cell lung cancer patients with brain metastases.

作者信息

Zhu Jian-Fei, Cai Ling, Zhang Xue-Wen, Wen Yin-Sheng, Su Xiao-Dong, Rong Tie-Hua, Zhang Lan-Jun

机构信息

State Key Laboratory of Oncology in South China; Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P. R. China.

出版信息

Chin J Cancer. 2014 Feb;33(2):96-104. doi: 10.5732/cjc.012.10307. Epub 2013 Aug 19.

Abstract

High expression of fibrinogen and platelets are often observed in non-small cell lung cancer (NSCLC) patients with local regional or distant metastasis. However, the role of these factors remains unclear. The aims of this study were to evaluate the prognostic significance of plasma fibrinogen concentration and platelet count, as well as to determine the overall survival of NSCLC patients with brain metastases. A total of 275 NSCLC patients with brain metastasis were enrolled into this study. Univariate analysis showed that high plasma fibrinogen concentration was associated with age≥65 years (P = 0.011), smoking status (P = 0.009), intracranial symptoms (P = 0.022), clinical T category (P = 0.010), clinical N category (P = 0.003), increased partial thromboplastin time (P < 0.001), and platelet count (P < 0.001). Patients with low plasma fibrinogen concentration demonstrated longer overall survival compared with those with high plasma fibrinogen concentration (median, 17.3 months versus 11.1 months; P≤0.001). A similar result was observed for platelet counts (median, 16.3 months versus 11.4 months; P = 0.004). Multivariate analysis showed that both plasma fibrinogen concentration and platelet count were independent prognostic factors for NSCLC with brain metastases (R2 = 1.698, P < 0.001 and R2 = 1.699, P < 0.001, respectively). Our results suggest that high plasma fibrinogen concentration and platelet count indicate poor prognosis for NSCLC patients with brain metastases. Thus, these two biomarkers might be independent prognostic predictors for this subgroup of NSCLC patients.

摘要

在局部区域或远处转移的非小细胞肺癌(NSCLC)患者中,经常观察到纤维蛋白原和血小板的高表达。然而,这些因素的作用仍不清楚。本研究的目的是评估血浆纤维蛋白原浓度和血小板计数的预后意义,以及确定伴有脑转移的NSCLC患者的总生存期。共有275例伴有脑转移的NSCLC患者纳入本研究。单因素分析显示,血浆纤维蛋白原浓度升高与年龄≥65岁(P = 0.011)、吸烟状态(P = 0.009)、颅内症状(P = 0.022)、临床T分期(P = 0.010)、临床N分期(P = 0.003)、活化部分凝血活酶时间延长(P < 0.001)和血小板计数(P < 0.001)相关。血浆纤维蛋白原浓度低的患者与血浆纤维蛋白原浓度高的患者相比,总生存期更长(中位数分别为17.3个月和11.1个月;P≤0.001)。血小板计数也观察到类似结果(中位数分别为16.3个月和11.4个月;P = 0.004)。多因素分析显示,血浆纤维蛋白原浓度和血小板计数均为伴有脑转移的NSCLC的独立预后因素(R2分别为1.698,P < 0.001和R2为1.699,P < 0.001)。我们的结果表明,血浆纤维蛋白原浓度升高和血小板计数高表明伴有脑转移的NSCLC患者预后不良。因此,这两种生物标志物可能是该亚组NSCLC患者的独立预后预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d02b/3935011/e803ab1bc8f4/cjc-33-02-096-g001.jpg

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