Division of Thoracic Surgery, Department of Surgery, Kindai University Faculty of Medicine, 377-2, Ohno-Higashi, Osaka-Sayama, 589-8511, Japan.
Surg Today. 2020 Nov;50(11):1427-1433. doi: 10.1007/s00595-020-02019-1. Epub 2020 May 14.
A high plasma level of either fibrinogen or D-dimer has been shown to correlate with a poor prognosis in patients with surgically resected non-small-cell lung cancer (NSCLC). The present study aimed to identify whether or not both markers combined had a superior prognostic value to either alone.
Of the 1344 patients who underwent surgical resection for NSCLC at our institution between January 2007 and December 2016, 1065 had preoperative plasma fibrinogen and D-dimer data available and were included in the analysis.
The recurrence-free survival (RFS) and overall survival (OS) rates were similar for patients with high plasma levels of either or both fibrinogen (> 4.0 g/L) or D-dimer (> 1.0 μg/mL); therefore, these three groups were combined for a further analysis into a single group with high plasma levels of either or both proteins. The high-level group had significantly lower 5-year RFS (53% vs. 68%, p < 0.001) and 5-year OS (65% vs. 80%, p < 0.001) rates than patients with normal plasma levels of fibrinogen and D-dimer (control group).
Our results suggest that preoperative tests for both plasma fibrinogen and D-dimer are necessary to identify patients with surgically resected NSCLC likely to have a poor RFS and OS.
研究表明,手术切除的非小细胞肺癌(NSCLC)患者血浆中纤维蛋白原或 D-二聚体水平升高与预后不良相关。本研究旨在确定这两种标志物联合检测是否比单独检测具有更好的预后价值。
本研究回顾性分析了 2007 年 1 月至 2016 年 12 月在我院行手术切除的 1344 例 NSCLC 患者,其中 1065 例患者术前有血浆纤维蛋白原和 D-二聚体数据,并纳入分析。
纤维蛋白原(>4.0 g/L)或 D-二聚体(>1.0μg/mL)水平升高的患者,其无复发生存率(RFS)和总生存率(OS)相似;因此,将这三组患者合并为一个单独的高纤维蛋白原和/或 D-二聚体水平组。高水平组患者的 5 年 RFS(53%比 68%,p<0.001)和 5 年 OS(65%比 80%,p<0.001)率显著低于纤维蛋白原和 D-二聚体水平正常的患者(对照组)。
我们的研究结果表明,术前检测血浆纤维蛋白原和 D-二聚体对于识别手术切除的 NSCLC 患者的 RFS 和 OS 可能较差是必要的。