术前纤维蛋白原对结肠癌患者的预后意义。
Prognostic significance of preoperative fibrinogen in patients with colon cancer.
作者信息
Sun Zhen-Qiang, Han Xiao-Na, Wang Hai-Jiang, Tang Yong, Zhao Ze-Liang, Qu Yan-Li, Xu Rui-Wei, Liu Yan-Yan, Yu Xian-Bo
机构信息
Zhen-Qiang Sun, Hai-Jiang Wang, Ze-Liang Zhao, Xian-Bo Yu, Department of Gastrointestinal Surgery, Affiliated Tumor Hospital, Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China.
出版信息
World J Gastroenterol. 2014 Jul 14;20(26):8583-91. doi: 10.3748/wjg.v20.i26.8583.
AIM
To investigate the prognostic significance of preoperative fibrinogen levels in colon cancer patients.
METHODS
A total of 255 colon cancer patients treated at the Affiliated Tumor Hospital of Xinjiang Medical University from June 1(st) 2005 to June 1(st) 2008 were enrolled in the study. All patients received radical surgery as their primary treatment method. Preoperative fibrinogen was detected by the Clauss method, and all patients were followed up after surgery. Preoperative fibrinogen measurements were correlated with a number of clinicopathological parameters using the Student t test and analysis of variance. Survival analyses were performed by the Kaplan-Meier method and Cox regression modeling to measure 5-year disease-free survival (DFS) and overall survival (OS).
RESULTS
The mean preoperative fibrinogen concentration of all colon cancer patients was 3.17 ± 0.88 g/L. Statistically significant differences were found between preoperative fibrinogen levels and the clinicopathological parameters of age, smoking status, tumor size, tumor location, tumor-node-metastasis (TNM) stage, modified Glasgow prognostic scores (mGPS), white blood cell (WBC) count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and carcinoembryonic antigen (CEA) levels. Univariate survival analysis showed that TNM stage, tumor cell differentiation grade, vascular invasion, mGPS score, preoperative fibrinogen, WBC, NLR, PLR and CEA all correlated with both OS and DFS. Alpha-fetoprotein (AFP) and body mass index correlated only with OS. Kaplan-Meier analysis revealed that both OS and DFS of the total cohort, as well as of the stage II and III patients, were higher in the hypofibrinogen group compared to the hyperfibrinogen group (all P < 0.05). In contrast, there was no significant difference between OS and DFS in stage I patients with low or high fibrinogen levels. Cox regression analysis indicated preoperative fibrinogen levels, TNM stage, mGPS score, CEA, and AFP levels correlated with both OS and DFS.
CONCLUSION
Preoperative fibrinogen levels can serve as an independent prognostic marker to evaluate patient response to colon cancer treatment.
目的
探讨术前纤维蛋白原水平在结肠癌患者中的预后意义。
方法
选取2005年6月1日至2008年6月1日在新疆医科大学附属肿瘤医院接受治疗的255例结肠癌患者纳入本研究。所有患者均接受根治性手术作为主要治疗方法。采用Clauss法检测术前纤维蛋白原水平，术后对所有患者进行随访。使用Student t检验和方差分析将术前纤维蛋白原测量值与多项临床病理参数进行相关性分析。采用Kaplan-Meier法和Cox回归模型进行生存分析，以评估5年无病生存率（DFS）和总生存率（OS）。
结果
所有结肠癌患者术前纤维蛋白原浓度均值为3.17±0.88 g/L。术前纤维蛋白原水平与年龄、吸烟状况、肿瘤大小、肿瘤位置、肿瘤-淋巴结-转移（TNM）分期、改良格拉斯哥预后评分（mGPS）、白细胞（WBC）计数、中性粒细胞-淋巴细胞比值（NLR）、血小板-淋巴细胞比值（PLR）及癌胚抗原（CEA）水平等临床病理参数之间存在统计学显著差异。单因素生存分析显示，TNM分期、肿瘤细胞分化程度、血管侵犯、mGPS评分、术前纤维蛋白原、WBC、NLR、PLR和CEA均与OS和DFS相关。甲胎蛋白（AFP）和体重指数仅与OS相关。Kaplan-Meier分析显示，与高纤维蛋白原组相比，低纤维蛋白原组的总队列以及II期和III期患者的OS和DFS均更高（所有P<0.05）。相比之下，I期患者纤维蛋白原水平高低组之间的OS和DFS无显著差异。Cox回归分析表明，术前纤维蛋白原水平、TNM分期、mGPS评分、CEA和AFP水平与OS和DFS均相关。
结论
术前纤维蛋白原水平可作为评估结肠癌患者治疗反应的独立预后标志物。
Zotero 插件