Department of Urology, Huashan Hospital, Fudan University, Shanghai, China; Fudan Institute of Urology, Huashan Hospital, Fudan University, Shanghai, China.
Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, China.
Int J Surg. 2019 May;65:88-93. doi: 10.1016/j.ijsu.2019.03.022. Epub 2019 Apr 2.
To retrospectively evaluate the prognostic value of preoperative plasma fibrinogen to predict oncological outcome and intravesical recurrence in upper urinary tract urothelial carcinoma.
This retrospective study comprised 130 patients with non-metastatic upper urinary tract urothelial carcinoma who underwent surgery between June 2009 and June 2017 at a single center. Patients were categorized base on an optimal value of preoperative plasma fibrinogen. Progression-free and cancer-specific survival were assessed using Kaplan-Meier method. The associations between plasma fibrinogen and clinical outcomes were assessed with univariate and Multivariate analysis.
Elevated plasma fibrinogen was associated with advance tumor stage, high tumor grade and tumor size. No significant association was found between plasma fibrinogen and intravesical recurrence. Multivariate analysis revealed that plasma fibrinogen ≥3.602 g/L was an independent prognostic indicator for progression-free survival (HR = 2.18; 95% CI: 1.17-4.06; p = 0.01) and cancer-specific survival (HR = 2.2; 95% CI: 1.13-4.28; p = 0.02), as well as pathological T stage and tumor grade.
Elevated preoperative plasma fibrinogen is an independent unfavorable prognostic factor for oncological outcomes in patients with upper urinary tract urothelial carcinoma. However, there is no association between preoperative plasma fibrinogen and intravesical recurrence. As an effective and easily accessible biomarker, this parameter can be applied in pre-intervention risk stratification of upper urinary tract urothelial carcinoma.
回顾性评估术前血浆纤维蛋白原预测上尿路上皮癌患者肿瘤预后和膀胱内复发的价值。
本回顾性研究纳入了 2009 年 6 月至 2017 年 6 月在一家单中心接受手术的 130 例非转移性上尿路上皮癌患者。根据术前血浆纤维蛋白原的最佳值对患者进行分类。使用 Kaplan-Meier 法评估无进展生存和癌症特异性生存。使用单因素和多因素分析评估血浆纤维蛋白原与临床结局之间的关系。
升高的血浆纤维蛋白原与晚期肿瘤分期、高级别肿瘤和肿瘤大小有关。血浆纤维蛋白原与膀胱内复发之间无显著相关性。多因素分析显示，血浆纤维蛋白原≥3.602g/L 是无进展生存（HR=2.18；95%CI：1.17-4.06；p=0.01）和癌症特异性生存（HR=2.2；95%CI：1.13-4.28；p=0.02）的独立预后指标，以及病理 T 分期和肿瘤分级。
术前升高的血浆纤维蛋白原是上尿路上皮癌患者肿瘤预后的独立不良预后因素。然而，术前血浆纤维蛋白原与膀胱内复发之间没有关联。作为一种有效且易于获得的生物标志物，该参数可应用于上尿路上皮癌的术前风险分层。
