Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan South Li, Chaoyang District, Beijing 100021, China.
Dis Markers. 2021 Jan 13;2021:8899994. doi: 10.1155/2021/8899994. eCollection 2021.
It has been well elucidated that multiple types of cancers are at high risk of thrombosis. Several studies have indicated the prognostic value of fibrinogen (Fib) and D-dimer (DD) in prostate cancer (PCa). However, it remains unclear regarding the association of the comprehensive coagulation markers with the clinicopathological features of PCa.
A total of 423 pathologically diagnosed patients with PCa were consecutively collected and stratified as low-intermediate-risk or high-risk groups. The association of coagulation parameters including Fib, DD, prothrombin (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and antithrombin III (AT-III) with clinicopathological features was determined by univariate and multivariate logistic regression analyses.
The levels of Fib, DD, and PT were significantly higher in the high-risk group ( < 0.001, < 0.001, and = 0.043, resp.), while APTT, TT, and AT-III were similar between two groups ( > 0.05, all). Univariate logistic regression analysis demonstrated that Fib, DD, and PT were all positively correlated with high-risk PCa (OR = 2.041, < 0.001; OR = 1.003, < 0.001; OR = 1.247, = 0.044). Nonetheless, after adjusting for PSA, grade, and stage, Fib (T3 vs. T1, OR = 15.202, 95% CI: 1.725-133.959, = 0.014) but not DD or PT was the unique independent factor associated with high-risk PCa in the multivariate regression analysis.
Our study firstly revealed that Fib but other coagulation markers was independently associated with the severity of PCa, suggesting Fib might be useful in PCa risk stratification beyond PSA, stage, and grade.
已有充分的证据表明，多种癌症存在较高的血栓形成风险。多项研究表明纤维蛋白原（Fib）和 D-二聚体（DD）在前列腺癌（PCa）中的预后价值。然而，综合凝血标志物与 PCa 临床病理特征之间的关系仍不清楚。
连续收集了 423 例经病理诊断为 PCa 的患者，并将其分为低中危组和高危组。通过单因素和多因素逻辑回归分析，确定包括纤维蛋白原（Fib）、D-二聚体（DD）、凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）和抗凝血酶 III（AT-III）在内的凝血参数与临床病理特征的相关性。
高危组的 Fib、DD 和 PT 水平明显升高（<0.001、<0.001 和=0.043），而两组之间的 APTT、TT 和 AT-III 无差异（>0.05，均）。单因素逻辑回归分析表明，Fib、DD 和 PT 均与高危 PCa 呈正相关（OR=2.041，<0.001；OR=1.003，<0.001；OR=1.247，=0.044）。然而，在校正 PSA、分级和分期后，Fib（T3 与 T1，OR=15.202，95%CI：1.725-133.959，=0.014）而不是 DD 或 PT 是多因素回归分析中与高危 PCa 相关的唯一独立因素。
本研究首次表明，Fib 而不是其他凝血标志物与 PCa 的严重程度独立相关，这提示 Fib 可能在 PSA、分期和分级之外对 PCa 风险分层有用。
