弥漫性大B细胞淋巴瘤患者血浆纤维蛋白原水平的临床意义。
The clinical significance of fibrinogen plasma levels in patients with diffuse large B cell lymphoma.
作者信息
Troppan Katharina T, Melchardt Thomas, Wenzl Kerstin, Schlick Konstantin, Deutsch Alexander, Bullock Marc D, Reitz Daniel, Beham-Schmid Christine, Weiss Lukas, Neureiter Daniel, Tränkenschuh Wolfgang, Greil Richard, Neumeister Peter, Egle Alexander, Pichler Martin
机构信息
Division of Hematology, Department of Internal Medicine, Medical University of Graz (MUG), Graz, Austria.
3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Laboratory for Immunological and Molecular Cancer Research, Oncologic Center, Paracelsus Medical University Salzburg, Graz, Austria.
出版信息
J Clin Pathol. 2016 Apr;69(4):326-30. doi: 10.1136/jclinpath-2015-203356. Epub 2015 Dec 7.
BACKGROUND
Fibrinogen plays a crucial role in the pathophysiology of tumour cell growth, invasion and metastasis. The aim of this study was to evaluate the prognostic significance of pretreatment plasma fibrinogen levels in patients with diffuse large B cell lymphoma (DLBCL) METHODS: Data from 372 patients with DLBCL, diagnosed and treated between 2004 and 2013 at two Austrian centres, were evaluated retrospectively. The prognostic influences of plasma fibrinogen levels and other factors, including age, tumour stage and the National Comprehensive Cancer Network-International Prognostic Index, on 5-year overall survival (OS) and 5-year disease-free survival (DFS) were studied using Kaplan-Meier curves as well as univariate and multivariate Cox regression models.
RESULTS
Kaplan-Meier analysis revealed that a high fibrinogen plasma level is associated with decreased 5-year OS and 5-year DFS in patients with DLBCL (p<0.001, log-rank test). Furthermore, in multivariate analysis, elevated serum fibrinogen was found to be an independent marker of poor clinical outcome: 5-year OS (HR=1.69, 95% CI 1.06 to 2.72, p=0.029) and 5-year DFS (HR=1.68, 95% CI 1.08 to 2.61, p=0.021).
CONCLUSIONS
In the current study, we demonstrate that high plasma fibrinogen levels at diagnosis predict poor outcome in patients with DLBCL.
TRIAL REGISTRATION NUMBER
25-434 ex 12713 and 415-EP/73/127-2012.
背景
纤维蛋白原在肿瘤细胞生长、侵袭和转移的病理生理学中起关键作用。本研究旨在评估弥漫性大B细胞淋巴瘤（DLBCL）患者治疗前血浆纤维蛋白原水平的预后意义。方法：回顾性评估2004年至2013年在奥地利两个中心诊断和治疗的372例DLBCL患者的数据。使用Kaplan-Meier曲线以及单因素和多因素Cox回归模型研究血浆纤维蛋白原水平和其他因素（包括年龄、肿瘤分期和美国国立综合癌症网络国际预后指数）对5年总生存期（OS）和5年无病生存期（DFS）的预后影响。
结果
Kaplan-Meier分析显示，DLBCL患者血浆纤维蛋白原水平高与5年OS和5年DFS降低相关（p<0.001，对数秩检验）。此外，在多因素分析中，血清纤维蛋白原升高被发现是临床预后不良的独立标志物：5年OS（风险比[HR]=1.69，95%置信区间[CI]1.06至2.72，p=0.029）和5年DFS（HR=1.68，95%CI 1.08至2.61，p=0.021）。
结论
在本研究中，我们证明诊断时血浆纤维蛋白原水平高预示DLBCL患者预后不良。
试验注册号
25-434 ex 12713和415-EP/73/127-2012。
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