Ma Chengquan, Yang Bin, Mao Quanzong
Department of Urology, Tianjin Medical University General Hospital, Tianjin, China.
Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Clin Med Insights Oncol. 2025 Jan 7;19:11795549241271657. doi: 10.1177/11795549241271657. eCollection 2025.
The correlation between fibrinogen levels and adrenocortical carcinoma (ACC) remains unclear. This study aimed to explore the value of preoperative plasma fibrinogen as a biomarker for ACC.
We identified 40 patients with ACC and 170 patients with adrenal adenoma (AA) who underwent surgery at our institution between 2015 and 2022. Plasma fibrinogen levels and postoperative tumor recurrence information of the patients were also recorded. For intergroup comparisons, data obtained from the AA and ACC groups were evaluated using a -test. The cutoff value of fibrinogen level was determined using a receiver operating characteristic (ROC) curve.
Mean fibrinogen levels in the AA and ACC groups were 2.81 ± 0.59 g/L and 3.88 ± 1.75 g/L, respectively ( < .001). Fibrinogen level, which can help distinguish between AA and ACC, was evaluated using the ROC curve. The cutoff fibrinogen level was estimated as 3.87 g/L according to the Youden index. With this value, the sensitivity was 62.5%, specificity was 95.7%, and the area under the ROC curve (AUC) was 0.74 ( < .001). Fibrinogen level, which can help distinguish between recurrence and non-recurrence, was evaluated using the ROC curve. The cutoff fibrinogen level was estimated as 3.96 g/L according to the Youden index. The sensitivity, specificity, and AUC were 90%, 71.4%, and 0.85, respectively ( < .001).
According to the data in this study, plasma fibrinogen could be used to distinguish ACC from AA. Most importantly, plasma fibrinogen may be used to identify recurrence of postoperative ACC.
纤维蛋白原水平与肾上腺皮质癌（ACC）之间的相关性尚不清楚。本研究旨在探讨术前血浆纤维蛋白原作为ACC生物标志物的价值。
我们纳入了2015年至2022年期间在本机构接受手术的40例ACC患者和170例肾上腺腺瘤（AA）患者。记录患者的血浆纤维蛋白原水平和术后肿瘤复发信息。对于组间比较，使用t检验评估从AA组和ACC组获得的数据。使用受试者工作特征（ROC）曲线确定纤维蛋白原水平的临界值。
AA组和ACC组的平均纤维蛋白原水平分别为2.81±0.59 g/L和3.88±1.75 g/L（P<0.001）。使用ROC曲线评估有助于区分AA和ACC的纤维蛋白原水平。根据约登指数，纤维蛋白原水平的临界值估计为3.87 g/L。以此值计算，敏感性为62.5%，特异性为95.7%，ROC曲线下面积（AUC）为0.74（P<0.001）。使用ROC曲线评估有助于区分复发和未复发的纤维蛋白原水平。根据约登指数，纤维蛋白原水平的临界值估计为3.96 g/L。敏感性、特异性和AUC分别为90%、71.4%和0.85（P<0.001）。
根据本研究数据，血浆纤维蛋白原可用于区分ACC和AA。最重要的是，血浆纤维蛋白原可用于识别ACC术后复发。
