Clinical And Prognostic Significance Of Plasma Fibrinogen In Lung Cancer

Objectives: Hyperfibrinogenemia is a common problem associated withvarious carcinomas. The recent studies have shown that high plasmafibrinogen concentration is associated with invasion, growth andmetastases of cancer. Furthermore, the recent studies focus on theprognostic significance of fibrinogen in the patients with advanced NSCLC(stage IIIB-IV). However, the prognostic significance of the plasmafibrinogen levels in early stage NSCLC patients (stage I-IIIA) stillremains unclear. In addition, it remains unclear whether or notchemotherapy-induced changes in fibrinogen level relate to the prognosis.The aims of this study were to1) further explore the relationship betweenthe plasma fibrinogen concentration and the stage and metastases of lungcancer2) evaluate the prognostic significance of the basal plasmafibrinogen level in patients with lung cancer3) explore the prognosticvalue of the change in fibrinogen levels between pre andpost-chemotherapy.Methods: In this retrospective study, the data from370patients with lungcancer were enrolled into this study. The plasma fibrinogen levels werecompared with the clinical and prognostic significance of lung cancer.The association between the plasma fibrinogen level andclinical-prognostic characteristics were analyzed using SPSS17.0software.Results:1) The median pre-treatment plasma fibrinogen levels were4.20g/L. Pre-treatment plasma fibrinogen levels correlated significantlywith gender (p=0.013). A higher plasma fibrinogen concentration wasassociated with squamous cell carcinoma versus adenocarcinoma (4.83±1.50g/L versus4.15±1.30g/L; P<0.001), there was a significantassociation between plasma fibrinogen level and metastases of lung cancer,pointing a higher plasma fibrinogen level in lymph nodes or distant organ metastases (p<0.001).2) Patients with low plasma fibrinogenconcentration demonstrates higher overall survival compared with thosewith high plasma fibrinogen concentration (median,35months versus19months; P<0.001). In addition, a similar result was observed in194earlystage NSCLC (stage I-IIIA)(P<0.001). Univariate and multivariateanalysis revealed that higher levels of fibrinogen (FIB<4.20g/L), age,distant metastases and pathological types were positively associated withshorter overall survival (OS).3) In addition, there was a significantlink between the elevation by more than15%in the plasma fibrinogen levelafter receiving short-term chemotherapy and shorter overall survival(OS).Furthermore, there was a significant link between the drop by morethan15%in the plasma fibrinogen level after receiving short-termchemotherapy and shorter overall survival (OS).Conclusion:1) This study shows high plasma fibrinogen concentration isassociated with lymph nodes or distant organ metastases in lung cancer.2) Furthermore, our results indicate a significant relevance between highpre-treatment plasma fibrinogen concentration and poor prognosis inpatients with lung cancer.3) In addition, we find that the patients witha low plasma fibrinogen level will have a shorter OS if the plasmafibrinogen level increases significantly after receiving short-termchemotherapy. Interestingly, we also find that the patients with a highplasma fibrinogen level will have a longer OS if the plasma fibrinogenlevel decreases significantly after receiving short-term chemotherapy,which indicates the change of the plasma fibrinogen level after receivingshort-term chemotherapy, may be used as an independent prognostic factor.