Jiang He-Guo, Li Jian, Shi Shun-Bing, Chen Ping, Ge Li-Ping, Jiang Qian, Tang Xin-Ping
Department of Pulmonary Medicine, Affiliated Hospital of Jiangsu University, 438 North Jiefang Street, Zhenjiang, 212001, China.
Med Oncol. 2014 Jul;31(7):22. doi: 10.1007/s12032-014-0022-8. Epub 2014 May 27.
Previous studies have suggested an association between preoperative plasma fibrinogen and D-dimer levels and prognosis in patients with non-small cell lung cancer (NSCLC) who underwent surgery. In this study, we evaluate the value of pre- and post-operative plasma fibrinogen and D-dimer levels and changes in the levels of the two markers between before and after operation in predicting tumor recurrence and metastasis in NSCLC patients who undergoing radical surgery. One hundred and eighty-four patients with I-IIIA NSCLC were enrolled in this study, and plasma fibrinogen and D-dimer levels were measured in these patients before and after surgery, respectively. The results showed that pre- and post-operative plasma fibrinogen and D-dimer levels were significantly higher in NSCLC patients than in control group. Pre- and post-operative plasma fibrinogen and D-dimer positivities were significantly correlated with tumor recurrence (P = 0.020 and P = 0.001 for fibrinogen, and P = 0.027 and P = 0.001 for D-dimer). Moreover, there was a significant link between the decrease in fibrinogen and D-dimer levels after surgery and tumor recurrence (P = 0.014 and P = 0.018). Patients with pre- and post-operative fibrinogen and D-dimer positivities had a shorter disease-free survival (DFS) than those without (P = 0.002 and P < 0.001 for fibrinogen, and P = 0.003 and P = 0.001 for D-dimer). Multivariate Cox regression analyses revealed that pre- and post-operative fibrinogen and D-dimer positivities were independent predictors for unfavorable DFS. Our results indicate that pre- and post-operative plasma fibrinogen and D-dimer levels may be useful biomarkers in predicting tumor recurrence and metastasis for patients who undergo curative surgery.
既往研究表明，术前血浆纤维蛋白原和D - 二聚体水平与接受手术的非小细胞肺癌（NSCLC）患者的预后相关。在本研究中，我们评估术前和术后血浆纤维蛋白原和D - 二聚体水平以及这两种标志物在手术前后的水平变化对接受根治性手术的NSCLC患者肿瘤复发和转移的预测价值。本研究纳入了184例I - IIIA期NSCLC患者，分别在这些患者手术前后检测血浆纤维蛋白原和D - 二聚体水平。结果显示，NSCLC患者术前和术后血浆纤维蛋白原和D - 二聚体水平显著高于对照组。术前和术后血浆纤维蛋白原和D - 二聚体阳性与肿瘤复发显著相关（纤维蛋白原P = 0.020和P = 0.001，D - 二聚体P = 0.027和P = 0.001）。此外，术后纤维蛋白原和D - 二聚体水平的下降与肿瘤复发之间存在显著关联（P = 0.014和P = 0.018）。术前和术后纤维蛋白原和D - 二聚体阳性的患者无病生存期（DFS）短于无阳性的患者（纤维蛋白原P = 0.002和P < 0.001，D - 二聚体P = 0.003和P = 0.001）。多因素Cox回归分析显示，术前和术后纤维蛋白原和D - 二聚体阳性是不良DFS的独立预测因素。我们的结果表明，术前和术后血浆纤维蛋白原和D - 二聚体水平可能是预测接受根治性手术患者肿瘤复发和转移的有用生物标志物。
