Wang Xue-Ping, Mao Min-Jie, He Zhong-Lian, Zhang Lin, Chi Pei-Dong, Su Jia-Rui, Dai Shu-Qin, Liu Wan-Li
Department of Laboratory Medicine, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.
Department of Information section, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.
J Cancer. 2017 Jul 5;8(11):2079-2087. doi: 10.7150/jca.19181. eCollection 2017.
The levels of coagulation system tests have been studied in various cancers. In this study, our aim is to evaluate the prognostic value of pretreatment plasma coagulation tests in hepatocellular carcinoma (HCC) patients. A retrospective study was performed in 539 patients with HCC, and follow-up period was at least 60 months until recurrence or death. The prognostic significance of coagulation system tests (prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen) were determined by univariate and multivariate Cox hazard models. Then, according to the results of the multivariate analyses, we proposed the coagulation-Based Stage, which combined the independent risk factors (prothrombin time and fibrinogen). Coagulation system tests including prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fbg) were analyzed. Patients with prolonged PT (≥12.1 sec) levels had significantly poor overall survival (OS) and disease-free survival (DFS), not only in the entire cohort (HR: 1.661, 95%CI: 1.125-2.451, 0.011 vs. HR: 1.660, 95%CI: 1.125-2.451, 0.011), but also in the subgroups stratified by pathological stage (stage I-II and stage III-IV). Additionally, high Fbg (≥2.83 g/L) levels experienced significantly decreased OS and DFS (HR: 2.158, 95%CI: 1.427-3.263, 0.001 vs. HR: 2.161, 95%CI: 1.429-3.267, 0.001), not only in the entire cohort but also in the subgroups stratified by pathological stage (stage I-II and stage III-IV). All the patients were then stratified (based on combined PT and Fbg) into three groups, The OS for HCC patients were (41.37±17.76), (31.83±19.84) and (18.68±18.41) months, and the DFS for HCC patients were (41.15±17.88), (31.65±19.81) and (18.66±18.39) months. Our findings suggest that the combination of plasma PT and Fbg levels should be evaluated as the valuable predictor of survival in patients with HCC.
凝血系统检测水平已在多种癌症中进行了研究。在本研究中，我们的目的是评估肝细胞癌（HCC）患者治疗前血浆凝血检测的预后价值。对539例HCC患者进行了一项回顾性研究，随访期至少60个月，直至复发或死亡。通过单因素和多因素Cox风险模型确定凝血系统检测（凝血酶原时间、活化部分凝血活酶时间、凝血酶时间、纤维蛋白原）的预后意义。然后，根据多因素分析结果，我们提出了基于凝血的分期，该分期结合了独立危险因素（凝血酶原时间和纤维蛋白原）。分析了包括凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（Fbg）在内的凝血系统检测。PT水平延长（≥12.1秒）的患者不仅在整个队列中总体生存率（OS）和无病生存率（DFS）显著较差（HR：1.661，95%CI：1.125 - 2.451，P = 0.011 vs. HR：1.660，95%CI：1.125 - 2.451，P = 0.011），而且在按病理分期分层的亚组中（I - II期和III - IV期）也是如此。此外，高Fbg（≥2.83 g/L）水平的患者OS和DFS显著降低（HR：2.158，95%CI：1.427 - 3.26
