Department of Internal Medicine, Eulji Hospital, Eulji University School of Medicine, Seoul, Republic of Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, Republic of Korea.
Pancreatology. 2020 Oct;20(7):1465-1471. doi: 10.1016/j.pan.2020.06.010. Epub 2020 Jul 14.
BACKGROUND/OBJECTIVES: Early diagnosis of pancreatic ductal adenocarcinoma (PDAC) is important as PDAC can lead to mortality; however, no specific biomarker has been identified for its early diagnosis. We previously identified fibrinogen α chain as a promising biomarker for differentiating between patients with and without PDAC using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Here, we aimed to validate the clinical usefulness of serum fibrinogen as a biomarker for PDAC.
From 2009 to 2011, blood samples of 67 PDAC patients and 43 healthy adults (controls) were prospectively collected. Serum fibrinogen levels and their clinical significances were evaluated.
Mean fibrinogen levels were significantly higher in the PDAC group than in the control group (3.08 ± 0.565 vs. 2.54 ± 0.249 log ng/mL, P < 0.001). In the receiver operating characteristic analysis, overall sensitivity, and specificity of serum fibrinogen levels for differentiating PDAC patients from control patients were 67.4% and 83.6%, respectively, with a 427-ng/mL cutoff value. Serum fibrinogen levels were significantly higher in PDAC patients with distant metastasis than in those without distant metastasis (3.38 ± 0.581 vs. 2.93 ± 0.499 log ng/mL, P = 0.002). Median overall survival was significantly longer in PDAC patients with low fibrinogen levels (<1000 ng/mL) than in those with high fibrinogen levels (≥1000 ng/mL) [489 days (95% confidence interval, 248.1-729.9) vs. 172 days (58.4-285.6) (P = 0.008)]. Although serum fibrinogen levels were poorly correlated with carbohydrate antigen 19-9 levels, these two biomarkers together predicted survival better.
Serum fibrinogen levels may be a useful biomarker for diagnosing and predicting PDAC prognosis.
背景/目的：早期诊断胰腺导管腺癌（PDAC）很重要，因为 PDAC 可导致死亡；然而，尚未发现用于其早期诊断的特异性生物标志物。我们之前使用基质辅助激光解吸/电离飞行时间质谱鉴定纤维蛋白原α链作为区分 PDAC 患者和非 PDAC 患者的有前途的生物标志物。在这里，我们旨在验证血清纤维蛋白原作为 PDAC 生物标志物的临床实用性。
从 2009 年到 2011 年，前瞻性收集了 67 例 PDAC 患者和 43 名健康成年人（对照组）的血液样本。评估了血清纤维蛋白原水平及其临床意义。
PDAC 组的平均纤维蛋白原水平明显高于对照组（3.08±0.565 与 2.54±0.249 log ng/mL，P<0.001）。在接受者操作特征分析中，血清纤维蛋白原水平区分 PDAC 患者和对照组患者的总体敏感性和特异性分别为 67.4%和 83.6%，截断值为 427 ng/mL。远处转移的 PDAC 患者的血清纤维蛋白原水平明显高于无远处转移的患者（3.38±0.581 与 2.93±0.499 log ng/mL，P=0.002）。纤维蛋白原水平较低（<1000 ng/mL）的 PDAC 患者的中位总生存期明显长于纤维蛋白原水平较高（≥1000 ng/mL）的患者[489 天（95%置信区间，248.1-729.9）与 172 天（58.4-285.6）（P=0.008）]。尽管血清纤维蛋白原水平与碳水化合物抗原 19-9 水平相关性较差，但这两种生物标志物联合预测生存率更好。
血清纤维蛋白原水平可能是诊断和预测 PDAC 预后的有用生物标志物。
