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Tian J, Tian H, Yang M, Yang L, Liu D. Prognostic value of pretreatment serum fibrinogen in young patients with small cell lung cancer: A cross-sectional study. Health Sci Rep 2023; 6:e1507. [PMID: 37599658 PMCID: PMC10439336 DOI: 10.1002/hsr2.1507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 08/22/2023] Open
Abstract
Objective To explored the prognostic value of pretreatment serum fibrinogen level in young patients with small cell lung cancer (SCLC). Methods The concentrations of serum fibrinogen of 183 young (<50 years old) SCLC patients were measured. The association of baseline serum fibrinogen level and clinical outcome was analyzed by survival analysis. Results Hyperfibrinogenemia was significantly associated with American Veterans Administration Lung Study Group stage and surgery treatment. The survival analysis indicated that patients with hypefibrinogenemia had worse outcome than patients with normal fibrinogen. Pretreatment serum fibrinogen level was identified as a worse independent survival predictor in young SCLC. The hazard ratio was 1.420 (95% confidence interval: 1.035-1.947). Conclusions Pretreatment serum fibrinogen is independent associated with overall survival in patients with young SCLC.
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Affiliation(s)
- Juncai Tian
- Department of Respiratory and Critical Care MedicineWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Huohuan Tian
- Department of Respiratory and Critical Care MedicineWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Mengzhu Yang
- Department of Respiratory and Critical Care MedicineWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Linhui Yang
- Department of Respiratory and Critical Care MedicineWest China Hospital of Sichuan UniversityChengduSichuanChina
| | - Dan Liu
- Department of Respiratory and Critical Care MedicineWest China Hospital of Sichuan UniversityChengduSichuanChina
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Chen A, Huang R, Wu E, Han R, Wen J, Li Q, Zhang Z, Shen B. The Generation of a Lung Cancer Health Factor Distribution Using Patient Graphs Constructed From Electronic Medical Records: Retrospective Study. J Med Internet Res 2022; 24:e40361. [PMID: 36427233 PMCID: PMC9736747 DOI: 10.2196/40361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/09/2022] [Accepted: 10/25/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Electronic medical records (EMRs) of patients with lung cancer (LC) capture a variety of health factors. Understanding the distribution of these factors will help identify key factors for risk prediction in preventive screening for LC. OBJECTIVE We aimed to generate an integrated biomedical graph from EMR data and Unified Medical Language System (UMLS) ontology for LC, and to generate an LC health factor distribution from a hospital EMR of approximately 1 million patients. METHODS The data were collected from 2 sets of 1397 patients with and those without LC. A patient-centered health factor graph was plotted with 108,000 standardized data, and a graph database was generated to integrate the graphs of patient health factors and the UMLS ontology. With the patient graph, we calculated the connection delta ratio (CDR) for each of the health factors to measure the relative strength of the factor's relationship to LC. RESULTS The patient graph had 93,000 relations between the 2794 patient nodes and 650 factor nodes. An LC graph with 187 related biomedical concepts and 188 horizontal biomedical relations was plotted and linked to the patient graph. Searching the integrated biomedical graph with any number or category of health factors resulted in graphical representations of relationships between patients and factors, while searches using any patient presented the patient's health factors from the EMR and the LC knowledge graph (KG) from the UMLS in the same graph. Sorting the health factors by CDR in descending order generated a distribution of health factors for LC. The top 70 CDR-ranked factors of disease, symptom, medical history, observation, and laboratory test categories were verified to be concordant with those found in the literature. CONCLUSIONS By collecting standardized data of thousands of patients with and those without LC from the EMR, it was possible to generate a hospital-wide patient-centered health factor graph for graph search and presentation. The patient graph could be integrated with the UMLS KG for LC and thus enable hospitals to bring continuously updated international standard biomedical KGs from the UMLS for clinical use in hospitals. CDR analysis of the graph of patients with LC generated a CDR-sorted distribution of health factors, in which the top CDR-ranked health factors were concordant with the literature. The resulting distribution of LC health factors can be used to help personalize risk evaluation and preventive screening recommendations.
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Affiliation(s)
- Anjun Chen
- Institutes for System Genetics, West China Hospital, Chengdu, China
| | - Ran Huang
- Institutes for System Genetics, West China Hospital, Chengdu, China
| | - Erman Wu
- Institutes for System Genetics, West China Hospital, Chengdu, China
| | | | - Jian Wen
- Guilin Medical University Affiliateted Hospital, Guilin, China
| | - Qinghua Li
- Guilin Medical University, Guilin, China
| | | | - Bairong Shen
- Institutes for System Genetics, West China Hospital, Chengdu, China
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Wang J, Huang D, Wang Y, Yuan Q, Chen X, Cheng Y. Pretreatment plasma fibrinogen and serum albumin levels predict therapeutic efficacy of concurrent radiochemotherapy for esophageal squamous cell cancer. Front Oncol 2022; 12:1021214. [PMCID: PMC9610838 DOI: 10.3389/fonc.2022.1021214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeEvidence implies that plasma fibrinogen and serum albumin level (FA score) based on plasma fibrinogen and serum albumin is related to cancer prognosis. However, the association between the FA score and therapeutic efficacy of concurrent radiochemotherapy in esophageal squamous cell carcinoma (ESCC) has not yet been evaluated. This study aimed to assess the role of pretreatment FA score in predicting the therapeutic efficacy of concurrent radiochemotherapy for patients with esophageal squamous cell cancer.MethodsThis retrospective study evaluated 154 patients with ESCC who underwent concurrent radiochemotherapy. Receiver operating characteristic curve (ROC) analysis was used to determine the appropriate cut-off values, and multivariate analysis and Kaplan-Meier curve were used to evaluate prognosis.ResultsFA score was significantly associated with the N stage and M stage (P = 0.015 and 0.042, respectively). Chi-square analysis/Fisher’s exact tests revealed a correlation between the FA score and curative effect (P < 0.001), and higher FA score was associated with poorer treatment effect. Multivariate analysis indicated that FA score (P < 0.001) was predictor of overall survival (OS). Kaplan-Meier curve demonstrated that pretreatment FA score was significantly associated with the OS of ESCC: Patient with higher FA score has lower median OS.ConclusionsThe FA score is a reliable prognostic predictor that could assess the curative effect and OS benefit of concurrent radiochemotherapy in patients with ESCC.
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Affiliation(s)
- Jijin Wang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou, China
| | - Di Huang
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan, China
| | - Yuanyuan Wang
- Department of Oncology, Linyi People’s Hospital, Dezhou, China
| | - Qianqian Yuan
- Department of Oncology, Tengzhou Central People’s Hospital, Zaozhuang, China
| | - Xue Chen
- Department of Minimally Invasion Oncology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- *Correspondence: Yufeng Cheng, ; Xue Chen,
| | - Yufeng Cheng
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan, China
- *Correspondence: Yufeng Cheng, ; Xue Chen,
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Zhang X, Wang X, Li W, Sun T, Dang C, Diao D. D-dimer, a predictor of bad outcome in gastric cancer patients undergoing radical resection. Sci Rep 2022; 12:16432. [PMID: 36180481 PMCID: PMC9525585 DOI: 10.1038/s41598-022-16582-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 07/12/2022] [Indexed: 11/09/2022] Open
Abstract
As a marker of hypercoagulability, plasma D-dimer is associated with progression of many cancers but remains controversial in gastric cancer (GC). We aim to investigate the predictive value of D-dimer for postoperative outcomes after radical gastrectomy of GC patients. We enrolled 903 consecutive patients with GC who underwent radical gastrectomy and the clinicopathological characteristics were compared. Risk factors for overall survival (OS) and disease-free survival (DFS) were determined using multivariate cox regression analysis. We also compared the survival difference based on Kaplan-Meier method after a one-to-one propensity score matching (PSM). Patients with elevated D-dimer had older age (p < 0.001), advanced TNM stage (p < 0.001), larger tumor size (p = 0.005), lower 5-year OS rate (32.8% vs 62.6%, p < 0.001) and DFS (29% vs 59.6%, p < 0.001). In multivariate analysis, elevated D-dimer was independently associated with shorter OS [hazard ratio (HR): 1.633, 95% confidence interval (CI) 1.178-2.264, p = 0.003] and DFS (HR: 1.58, 95% CI 1.151-2.169, P = 0.005). After PSM, the 5-year OS rate of patients with elevated D-dimer was still significantly lower than matched group (32.8% vs 40.6%, p = 0.005), so was DFS (29% vs 36.6%, p = 0.008). Preoperative elevated D-dimer is an independent risk factor for GC patients undergoing curative gastrectomy.
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Affiliation(s)
- Xin Zhang
- Department of Surgical Oncology, First Affiliated Hospital Medical College Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Xuan Wang
- Department of Surgical Oncology, First Affiliated Hospital Medical College Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Wenxing Li
- Department of Surgical Oncology, First Affiliated Hospital Medical College Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Tuanhe Sun
- Department of Surgical Oncology, First Affiliated Hospital Medical College Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China
| | - Chengxue Dang
- Department of Surgical Oncology, First Affiliated Hospital Medical College Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China.
| | - Dongmei Diao
- Department of Surgical Oncology, First Affiliated Hospital Medical College Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, Shaanxi, 710061, People's Republic of China.
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Campello E, Bosh F, Simion C, Spiezia L, Simioni P. Mechanisms of thrombosis in pancreatic ductal adenocarcinoma. Best Pract Res Clin Haematol 2022; 35:101346. [DOI: 10.1016/j.beha.2022.101346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 11/29/2022]
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Soeroso NN, Rizki Ananda F, Samosir G, Hariman H, Chairani Eyanoer P. The correlation between hemostatic parameters and mortality rate in patients with non-small cell lung cancer. Hematol Rep 2021; 13:8361. [PMID: 34650781 PMCID: PMC8447541 DOI: 10.4081/hr.2021.8361] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 07/10/2020] [Indexed: 11/22/2022] Open
Abstract
The increasing level of hemostatic parameters and tumor markers were associated with cancer progression and poor prognosis, particularly in NSCLC. The objective of this study is to determine whether there was a correlation between hemostatic parameters and mortality rate in patients with NSCLC. This was a prospective analytical study with a pretest-posttest design which included 41 patients with diagnosis of NSCLC. Plasma levels of PT, APTT, TT, D-dimer, and fibrinogen were measured before initiation of chemotherapy and remeasured after 4 cycles or 6 cycles of chemotherapy, based on the clinical condition of patients. Then, patients were followed up for 1 year to evaluate the mortality rate. The majority of subjects were male (85.4%) with adenocarcinoma (75.6%). There was no significant difference in mean between adenocarcinoma and squamous cell carcinoma (P>0.05). Most patients died after one month of follow up (61%). The parameters which could predict high mortality rate in NSCLC were prolonged PT and the increased of D-dimer with RR>1, although they had not significant in statistical analysis (P>0.05). There is no correlation between hemostatic parameters and mortality rate in patients with NSCLC.
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Affiliation(s)
- Noni Novisari Soeroso
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Sumatera Utara, Universitas Sumatera Utara Hospital
| | - Fannie Rizki Ananda
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Sumatera Utara, Universitas Sumatera Utara Hospital
| | - Ganda Samosir
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Sumatera Utara, Universitas Sumatera Utara Hospital
| | - Herman Hariman
- Department of Clinical Pathology, Faculty of Medicine Universitas Sumatera Utara, Adam Malik General Hospital
| | - Putri Chairani Eyanoer
- Department of Community Medicine, Faculty of Medicine Universitas Sumatera Utara, Indonesia
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Falanga A, Marchetti M, Russo L. Hemostatic Biomarkers and Cancer Prognosis: Where Do We Stand? Semin Thromb Hemost 2021; 47:962-971. [PMID: 34450680 DOI: 10.1055/s-0041-1733925] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Cancer patients are characterized by hypercoagulable state and an increased rate of thrombotic events, the most common being venous thromboembolism. Several hemostatic pathways that are significantly implicated in mechanisms of thromboembolic disease are also involved in growth, invasion, and metastatic spread of malignant cells as well in tumor-induced neo-angiogenesis. This close connection between cancer and the hemostatic system has prompted numerous studies on the role of alterations in the level plasma biomarkers of the different compartments of hemostasis in predicting cancer prognosis. In this review, we collect the results of several exemplificative studies that have evaluated clotting activation biomarkers in relation to different cancer outcomes with a final emphasis on current research and forthcoming directions in this field.
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Affiliation(s)
- Anna Falanga
- Division of Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy.,Department of Medicine and Surgery, University of Milan Bicocca, Milan, Italy
| | - Marina Marchetti
- Division of Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Laura Russo
- Division of Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy
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Deng HY, Ma XS, Zhou J, Wang RL, Jiang R, Qiu XM. High pretreatment D-dimer level is an independent unfavorable prognostic factor of small cell lung cancer: A systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25447. [PMID: 33847650 PMCID: PMC8052087 DOI: 10.1097/md.0000000000025447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/17/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND High pretreatment level of D-dimer in small cell lung cancer (SCLC) is commonly encountered, but the impact of high pretreatment D-dimer level on the prognosis of SCLC patients remains undetermined. Therefore, we conducted this meta-analysis focusing specifically on the prognostic value of high pretreatment D-dimer level in SCLC patients comprehensively. METHODS We searched systematically in PubMed, Embase, and Web of Science for relevant studies published before January 28, 2019. Outcomes including 1-year overall survival (OS), progression-free survival (PFS) rates, and hazard ratios (HRs) of OS and PFS from multivariate analysis were extracted and analyzed. RESULTS A total of 5 cohort studies consisting of 813 SCLC patients (473 patients with high pretreatment level of D-dimer and 340 with normal level of D-dimer) were finally included for meta-analysis. We found that patients with high pretreatment level of D-dimer had significantly shorter 1-year OS (47.6% vs 79.9%; fixed effects: risk ratio [RR] = 2.506; 95% confidence interval [CI] = [1.948, 3.224]; P < .001) and PFS (15.8% vs 34.0%; random effects: RR = 1.294; 95% CI = [1.060, 1.579]; P = .011) rates than those with normal level of D-dimer. Moreover, high pretreatment D-dimer level was further proved to remain as an unfavorable predictor of OS (fixed effects: HR = 1.865; 95% CI = [1.469, 2.367]; P < .001; I2 = 7.6%) and PFS (fixed effects: HR = 1.513; 95% CI = [1.183, 1.936]; P = .001; I2 = 0.0%) in patients with SCLC. CONCLUSION High pretreatment level of D-dimer was found to be an independent unfavorable prognostic factor in SCLC patients. However, more studies with sufficient adjustment for confounding factors are encouraged to confirm our conclusions.
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Affiliation(s)
- Han-Yu Deng
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu
| | - Xing-Sheng Ma
- Department of Thoracic Surgery, Suining Central Hospital, Suining, PR China
| | - Jie Zhou
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu
| | - Ru-Lan Wang
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu
| | - Rui Jiang
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu
| | - Xiao-Ming Qiu
- Lung Cancer Center, West China Hospital, Sichuan University, Chengdu
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9
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Barlow M, Hamilton W, Ukoumunne OC, Bailey SER. The association between thrombocytosis and subtype of lung cancer: a systematic review and meta-analysis. Transl Cancer Res 2021; 10:1249-1260. [PMID: 35116452 PMCID: PMC8798371 DOI: 10.21037/tcr-20-3287] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/17/2020] [Indexed: 01/24/2023]
Abstract
Background Thrombocytosis is associated with poor lung cancer prognosis and has recently been identified as having a high positive predictive value in lung cancer detection. Lung cancer has multiple histological and genetic subtypes and it is not known whether platelet levels differ across these subtypes, or whether thrombocytosis is predictive of a particular subtype. Methods PubMed and Embase were systematically searched for studies that reported pre-treatment platelet count, as either averages or proportion of patients with thrombocytosis, by subtype of lung cancer using a pre-specified search strategy. The Newcastle-Ottowa scale was used to assess study quality and risk of bias. Suitable studies were synthesised in meta-analyses and subgroup analyses examined for differences across subtypes. Results The prevalence of pre-treatment thrombocytosis across all lung cancer patients was 27% (95% CI: 17% to 37%). By subtype, this was 22% (95% CI: 7% to 41%) for adenocarcinoma, 28% (95% CI: 15% to 43%) for squamous cell carcinoma (SCC), 36% (95% CI: 13% to 62%) for large cell carcinoma (LCC), and 30% (95% CI: 8% to 58%) for small cell lung cancer (SCLC). The pooled mean platelet count for lung cancer patients was 289×109/L (95% CI: 268 to 311). By subtype, this was 282×109/L (95% CI: 259 to 306) for adenocarcinoma, 297×109/L (95% CI: 238 to 356) for SCC, 290×109/L (95% CI: 176 to 404) for LCC, and 293×109/L (95% CI: 244 to 342) for SCLC. There was no difference in thrombocytosis prevalence (P=0.76) or mean platelet count (P=0.96) across the subtypes. Conclusions These findings suggest thrombocytosis is no more indicative of one lung cancer subtype over another. We therefore conclude a high platelet count is likely to be generic across all lung cancer subtypes.
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Affiliation(s)
- Melissa Barlow
- University of Exeter Medical School, St Luke's Campus, Exeter, UK
| | - Willie Hamilton
- University of Exeter Medical School, St Luke's Campus, Exeter, UK
| | - Obioha C Ukoumunne
- NIHR ARC, SW Peninsula, University of Exeter Medical School, St Luke's Campus, Exeter, UK
| | - Sarah E R Bailey
- University of Exeter Medical School, St Luke's Campus, Exeter, UK
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Abbas M, Kassim SA, Wang ZC, Shi M, Hu Y, Zhu HL. Clinical evaluation of plasma coagulation parameters in patients with advanced-stage non-small cell lung cancer treated with palliative chemotherapy in China. Int J Clin Pract 2020; 74:e13619. [PMID: 32726491 DOI: 10.1111/ijcp.13619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/20/2020] [Accepted: 07/15/2020] [Indexed: 01/21/2023] Open
Abstract
AIMS OF THE STUDY Blood coagulation parameters are colossally important for clinical evaluation of palliative chemotherapy; however, this niche was not explored earlier for advanced-stage non-small cell lung cancer (NSCLC). Study focuses to explore the clinical relevancy of Coagulation parameters; prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB), D-dimer and international normalised ratio (INR) and their response to palliative chemotherapy in advanced-stage NSCLC. METHODS A retrospective study was conducted between 2013 and 2019 in Jiangsu Cancer hospital, Nanjing, PR. China. Medical records of 5445 patients were succinctly reviewed and classified accordingly to the inclusion and exclusion criteria. A total of 216 advanced NSCLC patients who used a first-line chemotherapy and antiangiogenic therapy regimen were enrolled in this study under ethical approval (JSCH-2020C-009). Blood samples were collected from these patients to measure the response levels of these coagulation parameters at time of admission to hospital and at the beginning of 4 cycles of Palliative therapy. We find the clinical value of all these coagulation parameters by using SPSS 24. Univariate Cox regression and Multivariate Cox regression models were used to identify the factors that were associated with progression-free survival (PFS) and the response to palliative chemotherapy. RESULTS In the Kaplan-Meier survival analysis for overall median (95% CI) survival of high pre-treatment coagulation parameters showed shorter PFS compared with normal pre-treatment except TT and their overall median (95% CI) follow-up was 3.3 (3.12-3.47). Coagulation parameters have showed clinical relevance as a potential independent prognostic factor of PFS in the Univariate Cox regression. In multivariable model, Age (≥60 years vs < 60 years), cancer differentiation (Unknown vs Poor), PT (High vs Normal) range, FIB (High vs Normal) range and D-dimer (High vs Normal) range, (P = .025, P = .045, P = .029, P = .049 and P = .011, respectively) were associated as a prognostic factor of PFS in NSCLC. Patients on 3-drugs regimen found to have better PFS compared with the ones taking the 2-drugs treatment regimen (P = .043). CONCLUSION The high range of PT, FIB and D-dimers was associated with poor prognosis of advanced-stage NSCLC. Our findings also confirmed that patients on 3-drugs regimen showed longer PFS compared with 2-drugs regimen.
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Affiliation(s)
- Muhammad Abbas
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China
- Department of Medical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Said Abasse Kassim
- Faculté des sciences de l'administration, Université Laval, Québec, QC, Canada
| | - Zhong-Chang Wang
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China
| | - Meiqi Shi
- Department of Medical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Yiqiao Hu
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China
- Institute of Drug R&D, Medical School of Nanjing University, Nanjing, PR China
| | - Hai-Liang Zhu
- State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China
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Yuan Y, Zhong H, Ye L, Li Q, Fang S, Gu W, Qian Y. Prognostic value of pretreatment platelet counts in lung cancer: a systematic review and meta-analysis. BMC Pulm Med 2020; 20:96. [PMID: 32312252 PMCID: PMC7171794 DOI: 10.1186/s12890-020-1139-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 04/07/2020] [Indexed: 01/09/2023] Open
Abstract
Background The prognostic value of elevated pretreatment platelet counts remains controversial in lung cancer patients. We performed the present meta-analysis to determine its precise role in these patients. Methods We employed a multiple search strategy in the PubMed, EMBASE and Cochrane Library databases to identify eligible studies. Disease-free survival (DFS)/progression-free survival (PFS)/time to progression (TTP) and overall survival (OS) were used as outcomes with hazard ratios (HRs) and 95% confidence intervals (CIs). Heterogeneity among the studies and publication bias were also evaluated. Results A total of 40 studies including 16,696 lung cancer patients were eligible for the analysis. Overall, the pooled analysis showed that compared with normal platelet counts, elevated pretreatment platelet counts were associated with poorer OS (HR = 1.54, 95% CI: 1.37–1.72, P < 0.001) and poorer DFS/PFS/TTP (HR = 1.62, 95% CI: 1.33–1.98, P < 0.001) in patients with lung cancer. In subgroup analyses, elevated pretreatment platelet counts were also associated with poorer OS and DFS/PFS/TTP in most subgroups. There was no evidence of publication bias. Conclusions This meta-analysis revealed that elevated pretreatment platelet counts were an independent predictor of OS and DFS/PFS/TTP in lung cancer patients. Large-scale prospective studies and a validation study are warranted.
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Affiliation(s)
- Yuan Yuan
- Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, 68 Changle road, Nanjing, 210006, Jiangsu, China
| | - Hai Zhong
- Department of Pulmonary and Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, 210006, Jiangsu, China
| | - Liang Ye
- Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, 68 Changle road, Nanjing, 210006, Jiangsu, China
| | - Qian Li
- Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, 68 Changle road, Nanjing, 210006, Jiangsu, China
| | - Surong Fang
- Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, 68 Changle road, Nanjing, 210006, Jiangsu, China
| | - Wei Gu
- Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, 68 Changle road, Nanjing, 210006, Jiangsu, China
| | - Yingying Qian
- Department of Respiratory and Critical Care Medicine, Nanjing First Hospital, Nanjing Medical University, 68 Changle road, Nanjing, 210006, Jiangsu, China.
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Zhang K, Xu Y, Tan S, Wang X, Du M, Liu L. The association between plasma fibrinogen levels and lung cancer: a meta-analysis. J Thorac Dis 2019; 11:4492-4500. [PMID: 31903237 DOI: 10.21037/jtd.2019.11.13] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Published studies have presented an inconsistent association between plasma fibrinogen level and poor prognosis or clinicopathological characteristics in lung cancer. Methods In the absence of significant quality difference, combined hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were calculated according to overall survival (OS), progression-free survival (PFS) and disease-free survival (DFS). Risk ratio (RR), odds ratio (OR) and standardized mean difference (SMD) with CIs were pooled to appraise the effect of plasma fibrinogen on clinicopathological characteristics. Furthermore, we directly combined the P values to estimate the association of plasma fibrinogen and tumor size. We adjusted the publication bias using trim-and fill method. Results Twenty studies with 6,494 patients were contained in meta-analysis. The pooled data indicated that elevated fibrinogen level associated with poor prognosis in lung cancer. Typically, the pooled HRs were 1.44 (95% CI, 1.34-1.55), 1.49 (95% CI, 1.24-1.80) and 1.69 (95% CI, 1.31-2.17) for OS, PFS and DFS of lung cancer, respectively. In addition, the combined ORs were 1.50 (95% CI, 1.23-1.84) and 2.01 (95% CI, 1.66-2.44) for lymph node metastasis and III-IV stage; and the combined RR was 2.15 (95% CI, 1.11-4.15) for disease control rate (DCR). Moreover, patients with distant metastasis or III-IV stage had significantly higher plasma fibrinogen level (SMD: 0.20, 95% CI, 0.04-0.36; SMD: 0.31, 95% CI, 0.18-0.44, respectively). Conclusions The summary results indicated that plasma fibrinogen was a marker of prognosis and clinicopathological characteristics in lung cancer.
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Affiliation(s)
- Ke Zhang
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Ye Xu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Shanyue Tan
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xueyan Wang
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Mulong Du
- Department of Genetic Toxicology, The Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China.,Department of Biostatistics, Nanjing Medical University, Nanjing 211166, China
| | - Lingxiang Liu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Wolny-Rokicka EI, Wydmański J, Tukiendorf A, Mróz P, Zembroń-Łacny A. Appraisal of Basic-Hemostatic Markers in Lung Cancer Patients During Follow-Up Care After Radiotherapy Treatment. Med Sci Monit 2018; 24:8577-8582. [PMID: 30479323 PMCID: PMC6278351 DOI: 10.12659/msm.910280] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/23/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of this paper was to investigate the association between clinicopathological factors and the coagulation test in lung cancer patients during follow-up care after treatment. MATERIAL AND METHODS Ninety-five medical patients with histologically proven advanced lung carcinoma (LC) who had undergone radiotherapy were prospectively reviewed between January 2014 and December 2016. The study investigated the relationship between the biochemical results, the disease stage, and the survival rate in lung cancer patients. Post-treatment coagulation-based D-dimer (DD), fibrinogen (Fib), and complete blood count (CBC) were evaluated during the follow-up over a period of 2 years after treatment or until the patient's death. RESULTS An increase of D-dimer generates an increased chance of early death by approximately 0.03% per 1 D-dimer unit. In cases when the difference in the D-dimer concentration equals 1000, the risk of an early death increases by (1.00031000-1)×100%=35%. CONCLUSIONS High levels of D-dimer are associated with an advanced form of disease with metastasis and higher risk of early death in lung cancer patients.
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Affiliation(s)
- Edyta I. Wolny-Rokicka
- Department of Radiotherapy, Provincial Multidisciplinary Hospital, Gorzów Wielkopolski, Poland
- Faculty of Medicine and Health Sciences, University of Zielona Góra, Zielona Góra, Poland
| | - Jerzy Wydmański
- Department of Radiotherapy, Center of Oncology – Maria Skłodowska-Curie Memorial Institute, Branch in Gliwice, Gliwice, Poland
| | - Andrzej Tukiendorf
- Department of Social Medicine, Medical University in Wrocław, Wrocław, Poland
| | - Piotr Mróz
- Faculty of Computer Science, Electrical Engineering and Automation, Institute of Metrology, Electronics and Computer Science, University of Zielona Góra, Zielona Góra, Poland
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14
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Falanga A, Marchetti M. Hemostatic biomarkers in cancer progression. Thromb Res 2018; 164 Suppl 1:S54-S61. [PMID: 29703485 DOI: 10.1016/j.thromres.2018.01.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 01/08/2018] [Accepted: 01/10/2018] [Indexed: 02/06/2023]
Abstract
Malignant disease is characterized by a hemostatic imbalance, usually shifted towards a procoagulant direction, and a high incidence of thrombotic complications. The mechanisms of hemostasis that are critically involved in thrombosis are also implicated in tumor progression, angiogenesis, and metastatic spread. As there is a close relationship between cancer and the clotting system, circulating biomarkers of activation of various hemostasis compartments (i.e. coagulation, fibrinolysis, platelets, endothelium, and other blood cells) have been extensively studied to predict cancer outcomes along with predicting the thrombotic risk. In this review, we will summarize the results of published studies and will focus on ongoing research and future directions of clotting activation bioproducts as biomarkers of cancer disease and progression.
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Affiliation(s)
- Anna Falanga
- Division of Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy.
| | - Marina Marchetti
- Division of Immunohematology and Transfusion Medicine, Hospital Papa Giovanni XXIII, Bergamo, Italy
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15
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Zhong H, Qian Y, Fang S, Wang Y, Tang Y, Gu W. Prognostic Value of Plasma Fibrinogen in Lung Cancer Patients: A Meta-Analysis. J Cancer 2018; 9:3904-3911. [PMID: 30410594 PMCID: PMC6218779 DOI: 10.7150/jca.26360] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/17/2018] [Indexed: 12/12/2022] Open
Abstract
Background: The prognostic role of plasma fibrinogen in lung cancer remains controversial. The aim of this meta-analysis was to assess the prognostic value of plasma fibrinogen in lung cancer. Methods: We performed a systematic literature search to identify eligible studies in PubMed, Embase and the Cochrane Library database. The hazard ratios (HR) and their 95% confidence intervals (CI) were collected from these eligible studies and were used to assess the relationship between plasma fibrinogen and lung cancer. Results: A total of 16 studies including 6,881 patients were selected in this meta-analysis. The results showed that elevated plasma fibrinogen in lung cancer patients was correlated with poor overall survival (OS) (HR = 1.38, 95% CI: 1.22-1.55, P < 0.001) and disease-free survival (DFS) / progress-free survival (PFS). (HR = 1.29, 95% CI: 1.01-1.65, P = 0.042). When stratified by cut-off value for OS and DFS/PFS, there was no significant heterogeneity. And the results of “cut-off value ≥ 400mg/dl” group showed that the high level of fibrinogen in serum was associated with worse OS and DFS/PFS of lung cancer. In further subgroup analysis by tumor histology, high plasma fibrinogen was also associated with worse OS in non-small cell lung cancer (NSCLC) (HR = 1.32, 95% CI: 1.14-1.53, P < 0.001). However, there was no significant association between high plasma fibrinogen and poor DFS in NSCLC patients (HR = 1.24, 95% CI: 0.97-1.57, P = 0.08). The Egger's regression test indicated evidence of publication bias for DFS/PFS. Conclusions: Elevated plasma fibrinogen, particularly defined as a plasma fibrinogen concentration of ≥ 400mg/dl, could be a promising indicator for worse OS in lung cancer patients, including NSCLC.
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Affiliation(s)
- Hai Zhong
- Department of Respiration, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yingying Qian
- Department of Respiration, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Surong Fang
- Department of Respiration, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Ying Wang
- Department of Respiration, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yun Tang
- Department of Respiration, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Wei Gu
- Department of Respiration, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
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16
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Navone SE, Guarnaccia L, Locatelli M, Rampini P, Caroli M, La Verde N, Gaudino C, Bettinardi N, Riboni L, Marfia G, Campanella R. Significance and Prognostic Value of The Coagulation Profile in Patients with Glioblastoma: Implications for Personalized Therapy. World Neurosurg 2018; 121:e621-e629. [PMID: 30292037 DOI: 10.1016/j.wneu.2018.09.177] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/21/2018] [Accepted: 09/24/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Coagulation is an important aspect of the vascular microenvironment in which brain tumors evolve. Patients with tumor often show aberrant coagulation and fibrinolysis activation. In particular, glioblastoma (GBM), the most aggressive primary brain tumor, is associated with a state of hypercoagulability, and venous thromboembolism is a common complication of this cancer and its treatment. Our study aims to investigate the clinical and prognostic significance of routine laboratory tests to assess the coagulative state of patients with brain tumors, to identify potential new prognostic factors and targets for personalized therapy. METHODS Blood samples were collected from patients with GBM (n = 58) and patients with meningioma (MNG, n = 22), before any treatment. The parameters analyzed were prothrombin time (PT), activated partial thromboplastin time (aPTT), D dimer (DD), fibrinogen, von Willebrand factor (VWF), leukocyte count, and hemoglobin levels. RESULTS Plasma levels of PT and aPTT were significantly reduced in GBMs compared with MNGs (P < 0.05), whereas DD, VWF:Ag levels, and leukocyte count were significantly higher in GBMs than in MNGs (P < 0.01). Furthermore, we observed that patients with GBM with reduced PT and aPTT and high levels of DD and VWF, defined as hypercoagulable patients, showed reduced overall survival (P < 0.05) compared with nonhypercoagulable patients. CONCLUSIONS Our data support the assumption that patients with GBM show a plasma hypercoagulable profile and that coagulation profile is related to adverse outcome in patients with GBM. If confirmed, hypercoagulability could play an important role as a prognostic factor of the disease and in the decision of an antithrombotic prophylaxis.
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Affiliation(s)
- Stefania Elena Navone
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, University of Milan, Milan, Italy
| | - Laura Guarnaccia
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, University of Milan, Milan, Italy
| | - Marco Locatelli
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, University of Milan, Milan, Italy
| | - Paolo Rampini
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, University of Milan, Milan, Italy
| | - Manuela Caroli
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, University of Milan, Milan, Italy
| | - Nicla La Verde
- Oncology Unit, Fatebenefratelli and Oftalmico Hospital, Milan, Italy
| | - Chiara Gaudino
- Department of Neuroradiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Nora Bettinardi
- Central Laboratory, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Riboni
- Department of Medical Biotechnology and Translational Medicine, LITA-Segrate, University of Milan, Milan, Italy
| | - Giovanni Marfia
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, University of Milan, Milan, Italy.
| | - Rolando Campanella
- Laboratory of Experimental Neurosurgery and Cell Therapy, Neurosurgery Unit, University of Milan, Milan, Italy
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Xu WY, Zhang HH, Xiong JP, Yang XB, Bai Y, Lin JZ, Long JY, Zheng YC, Zhao HT, Sang XT. Prognostic significance of the fibrinogen-to-albumin ratio in gallbladder cancer patients. World J Gastroenterol 2018; 24:3281-3292. [PMID: 30090008 PMCID: PMC6079291 DOI: 10.3748/wjg.v24.i29.3281] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 06/16/2018] [Accepted: 06/27/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the prognostic role of fibrinogen-to-albumin ratio (FAR) on patients with gallbladder cancer (GBC) in this study.
METHODS One hundred and fifty-four GBC patients were retrospectively analyzed, who received potentially curative cholecystectomy in our institute from March 2005 to December 2017. Receiver operating characteristic curve (ROC curve) was used to determine the optimal cut-offs for these biomarkers. In addition, Kaplan-Meier survival analysis as well as multivariate analysis were applied for prognostic analyses.
RESULTS ROC curve revealed that the optimal cut-off value for FAR was 0.08. FAR was significantly correlated with age (P = 0.045), jaundice (P < 0.001), differentiation (P = 0.002), resection margin status (P < 0.001), T stage (P < 0.001), TNM stage (P < 0.001), and CA199 (P < 0.001) as well as albumin levels (P < 0.001). Multivariate analysis indicated that the resection margin status [hazard ratio (HR): 2.343, 95% confidence interval (CI): 1.532-3.581, P < 0.001], TNM stage (P = 0.035), albumin level (HR = 0.595, 95%CI: 0.385-0.921, P = 0.020) and FAR (HR: 2.813, 95%CI: 1.765-4.484, P < 0.001) were independent prognostic factors in GBC patients.
CONCLUSION An elevated preoperative FAR was significantly correlated with unfavorable overall survival in GBC patients, while an elevated preoperative albumin level was a protective prognostic factor for patients with GBC. The preoperative FAR could be used to predict the prognosis of GBC patients, which was easily accessible, cost-effective and noninvasive.
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Affiliation(s)
- Wei-Yu Xu
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Hao-Hai Zhang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jian-Ping Xiong
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiao-Bo Yang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yi Bai
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jian-Zhen Lin
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Jun-Yu Long
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yong-Chang Zheng
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Hai-Tao Zhao
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xin-Ting Sang
- Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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18
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Minkov P, Gulubova M, Chilingirov P, Ananiev J. The Position of Neutrophils-To-Lymphocytes and Lymphocytes-To-Platelets Ratio as Predictive Markers of Progression and Prognosis in Patients with Non-Small Cell Lung Cancer. Open Access Maced J Med Sci 2018; 6:1382-1386. [PMID: 30159061 PMCID: PMC6108783 DOI: 10.3889/oamjms.2018.210] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/15/2018] [Accepted: 06/18/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Non-small cell lung cancer (NSCLC) is an insidious metastasis condition of the lungs often presenting no symptoms at the onset. Defining markers for quick determination of prognosis is essential for building up a treatment strategy. AIM The aim of this study is to define the role of the Neutrophils-to-Lymphocytes ratio (NLR) and Platelets-to- Lymphocytes ratio (PLR) as biomarkers in patients with NSCLC, according to the stage and prognosis of the disease. METHODS We investigated 20 patients with NSCLC. NLR and PLR are calculated and are evaluated according to the presence or absence of metastasis, stage of the disease, histological type and survival rate. RESULTS We found that thirteen of the patients had low NLR, while the rest 7 had high NLR (mean 3.15). By analysing PLR we found that 11 patients have low and 9 have high level of PLR (mean 1.42). After the correlations have been made we discovered that in 90.1% of the patients with low PLR no lymph metastasises were detected, while in 50% of the patients with high PLR lymph metastasises were observed (χ2 = 3.99; P = 0.046). We also discovered that in 84.6% of the patients with low NLR lymph metastases were absent, while in 42.9% with high NLR lymph metastasises were present (χ 2 = 1.83; P = 0.176). CONCLUSION In conclusion, NLR and PLR were discovered as prominent biomarkers which provide relatively fast determination for prognosis in patients with NSCLC.
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Affiliation(s)
| | - Maya Gulubova
- Department of General and Clinical Pathology, Forensic Medicine and Deontology, Trakia University, Stara Zagora, Bulgaria
| | | | - Julian Ananiev
- Department of General and Clinical Pathology, Forensic Medicine and Deontology, Trakia University, Stara Zagora, Bulgaria
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Relationship between Inflammatory and Biological Markers and Lung Cancer. J Clin Med 2018; 7:jcm7070160. [PMID: 29941786 PMCID: PMC6069225 DOI: 10.3390/jcm7070160] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 06/19/2018] [Accepted: 06/21/2018] [Indexed: 12/20/2022] Open
Abstract
We seek to define inflammatory markers, lipid and protein profiles that may aid in distinguishing lung cancer cases from those who are healthy and to determine the relationships between these levels and cancer stage and cell type. Lung cancer patients (n = 140, Group 1) and healthy cases (n = 50, Group 2) were enrolled. We retrieved platelet, platelet-associated markers (plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW)), neutrophil/lymphocyte ratio-NLR, platelet/lymphocyte ratio-PLR, lipids (total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), triglycerides), proteins (total protein (TP) and albumin), and C-reactive protein (CRP) from electronic records and compared the data from lung cancer patients with those from healthy controls. Platelet, PCT, neutrophil, NLR, PLR, triglycerides, VLDL, and CRP levels were significantly higher in Group 1 compared with Group 2. MPV, lymphocyte, albumin, and HDL levels were significantly lower in Group 1 compared with Group 2. No significant relationship was evident between histopathological types and the level of any marker. Compared to those with early-stage cancer, changes in marker levels in those with advanced-stage cancer were statistically significant. CRP and NLR were significantly higher; albumin and HDL were lower in metastatic patients. We found that platelet, PCT, NLR and PLR, albumin, HDL, and CRP levels aided in lung cancer diagnosis and the detection of late-stage disease. Furthermore, these inflammatory and biological markers are thought to be particularly useful in following the severity of lung cancer.
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20
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Wolny-Rokicka E, Brzeźniakiewicz-Janus K, Wydmański J, Tukiendorf A, Zembroń-Łacny A. Analysis of haemostasis biomarkers in patients with advanced stage lung cancer during hypofractionated radiotherapy treatment. J Int Med Res 2018; 46:1876-1883. [PMID: 29552952 PMCID: PMC5991232 DOI: 10.1177/0300060517750976] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective To investigate the relationship between changes in inflammatory and coagulatory biomarkers before and after short palliative radiotherapy in patients with advanced stage lung cancer. Methods This prospective observational single-centre study enrolled patients with histologically- or cytologically-confirmed lung cancer who were eligible for palliative radiotherapy. Inflammatory and coagulatory biomarkers including complete blood count, D-dimer and fibrinogen levels were evaluated before and after short hypofractionated radiotherapy. Results Seventy-two patients with advanced stage lung carcinoma were enrolled in this study. Metastases were associated with an increase in white blood cells, neutrophils and mean platelet volume. Increased volume of the primary tumour had a borderline level of correlation with white blood cell and neutrophil counts. After radiotherapy, white blood cells, neutrophils, haemoglobin and lymphocyte counts were decreased. After radiotherapy, the change in fibrinogen and mean platelet volume were borderline significant. Conclusion The levels of inflammatory and coagulatory biomarkers can be used to monitor treatment.
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Affiliation(s)
- Edyta Wolny-Rokicka
- 1 Department of Radiotherapy, Provincial Multidisciplinary Hospital, Gorzow Wielkopolski, Poland.,2 Faculty of Medicine and Health Sciences, University of Zielona Gora, Zielona Gora, Poland
| | - Katarzyna Brzeźniakiewicz-Janus
- 2 Faculty of Medicine and Health Sciences, University of Zielona Gora, Zielona Gora, Poland.,3 Department of Haematology, Provincial Multidisciplinary Hospital, Gorzow Wielkopolski, Poland
| | - Jerzy Wydmański
- 4 Department of Radiotherapy, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Gliwice, Poland
| | - Andrzej Tukiendorf
- 5 Department of Biostatistics, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Gliwice, Poland
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21
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Komurcuoglu B, Ulusoy S, Gayaf M, Guler A, Ozden E. Prognostic Value of Plasma D-Dimer Levels in Lung Carcinoma. TUMORI JOURNAL 2018; 97:743-8. [DOI: 10.1177/030089161109700611] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims and Backgrounds Plasma concentrations of several proteases of the coagulation system have been shown to predict prognosis in malignancy. The study was aimed to investigate the prognostic value of plasma D-dimer concentrations and some other coagulation factors in lung cancer. Methods Between 2004 and 2008, 100 newly diagnosed lung cancer patients and 25 healthy individuals serving as the control group were evaluated. The patients had no history of coagulation system disorders or anticoagulant therapy. Plasma D-dimer concentrations, prothrombin time, activated partial thromboplastin time, international normalized ratio and blood counts of the patients were obtained. Patient age, lung cancer stage, tumor histology, therapy modalities (surgery, chemotherapy and radiotherapy), therapy outcomes and survival durations of the patients were determined. Results The median age of the patients (86 males/14 females) was 67 years, and 15% had stage 2, 26% had stage 3A, 24% had stage 3B, and 35% had stage 4 disease. Histologic subtypes were non-small cell carcinoma (87%) and small cell carcinoma (13%). The median D-dimer level of the patients was 1250 ng/dl, which was significantly higher than that of the control group. Survival duration was significantly higher in patients with low D-dimer levels (P <0.05). D-dimer plasma levels predicted survival independently of the clinical stage of disease, histologic tumor type and performance status of the patient (HR = 5.1; 95% confidence interval, 1.015–1.19, P = 0.013). Plasma D-dimer level was significantly higher in metastatic disease (P <0.01). Conclusions The results suggest that D-dimer plasma levels might be useful to predict the clinical outcome and survival of patients with lung cancer.
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Affiliation(s)
- Berna Komurcuoglu
- Izmir Dr Suat Seren Chest Diseases and Thoracic Surgery Research and Training Hospital, Department of Chest Diseases
| | - Sadik Ulusoy
- Izmir Atatürk Training and Research Hospital, Department of Biochemistry, Izmir, Turkey
| | - Mine Gayaf
- Izmir Dr Suat Seren Chest Diseases and Thoracic Surgery Research and Training Hospital, Department of Chest Diseases
| | - Arzu Guler
- Izmir Dr Suat Seren Chest Diseases and Thoracic Surgery Research and Training Hospital, Department of Chest Diseases
| | - Emel Ozden
- Izmir Dr Suat Seren Chest Diseases and Thoracic Surgery Research and Training Hospital, Department of Chest Diseases
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22
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Guo R, Yang J, Liu X, Wu J, Chen Y. Increased von Willebrand factor over decreased ADAMTS-13 activity is associated with poor prognosis in patients with advanced non-small-cell lung cancer. J Clin Lab Anal 2018; 32:e22219. [PMID: 28374895 PMCID: PMC6817161 DOI: 10.1002/jcla.22219] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 02/27/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hypercoagulability induced by the imbalance between von Willebrand factor (VWF) secretion and its cleaving protease (ADAMTS-13) has been correlated with cancer metastasis. The aim of this study was to explore the prognostic significance of the VWF/ADAMTS-13 ratio in advanced non-small-cell lung cancer (NSCLC). METHODS Pre-treatment sera/plasma levels of VWF, ADAMTS-13, VWF/ADAMTS-13 ratio, factor (F) VIII, and other clinical/laboratory parameters were measured in 119 patients with advanced NSCLC and 102 healthy controls. All patients were followed up to determine the predictive value of these parameters for prognosis of advanced NSCLC. RESULTS Elevated VWF, VWF/ADAMTS-13 ratio, and reduced ADAMTS-13 were significantly correlated with the stage and grade of advanced NSCLC and the final status of disease (P<.05). VWF levels and the VWF/ADAMTS-13 ratio were also associated with response to chemotherapy (P<.05). Multivariate analysis identified the VWF/ADAMTS-13 ratio and D-dimer as significant independent predictors of patient mortality. The area under the curve showed that the VWF/ADAMTS-13 ratio was more useful than VWF, ADAMTS-13, and D-dimer to predict mortality. Kaplan-Meier analysis showed that a low VWF/ADAMTS-13 ratio was significantly predictive of improved survival (P=.004). CONCLUSION These results suggest that the imbalance between VWF secretion and ADAMTS-13 may play a critical role in the hypercoagulability state in advanced NSCLC. Moreover, elevation of the plasma VWF/ADAMTS-13 ratio may serve as an independent predictive factor for mortality in patients with advanced NSCLC.
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Affiliation(s)
- Renyong Guo
- Department of Laboratory MedicineFirst Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhouChina
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang ProvinceHangzhouZhejiangChina
| | - Jiezuan Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious DiseasesCollaborative Innovation Center for Diagnosis and Treatment of Infectious DiseasesFirst Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhouChina
| | - Xia Liu
- Department of Intensive Care UnitFirst Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhouZhejiangChina
| | - Jianping Wu
- Department of Laboratory MedicineFirst Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhouChina
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang ProvinceHangzhouZhejiangChina
| | - Yu Chen
- Department of Laboratory MedicineFirst Affiliated HospitalCollege of MedicineZhejiang UniversityHangzhouChina
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang ProvinceHangzhouZhejiangChina
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Liu X, Chen X, Yang J, Guo R. Association of ABO blood groups with von Willebrand factor, factor VIII and ADAMTS-13 in patients with lung cancer. Oncol Lett 2017; 14:3787-3794. [PMID: 28927148 PMCID: PMC5587991 DOI: 10.3892/ol.2017.6619] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 01/31/2017] [Indexed: 02/05/2023] Open
Abstract
Coagulative and fibrinolytic disorders appear to be associated with the development of lung cancer. The aim of the present study was to determine plasma levels of von Willebrand factor (VWF) and a disintegrin and metalloproteinase with a thrombospondin type 1 motif 13 (ADAMTS-13), and factor VIII (FVIII) activity, in association with O and non-O blood groups in patients with lung cancer. Plasma levels of VWF and ADAMTS-13, and FVIII activity were measured in 115 patients with lung cancer and 98 healthy subjects. Phenotyping of the ABO blood groups was also performed for the two groups. Significantly increased VWF levels and FVIII activity, as well as significantly decreased ADAMTS-13 levels, were observed in patients with distant metastasis as compared with those without distant metastasis and the healthy controls. Plasma VWF levels and FVIII activity were significantly increased in subjects with non-O type blood compared with those with type O blood in the two groups. However, a significant decrease in ADAMTS-13 levels was observed only in the control group among those with non-O type blood, compared with those with type O blood. The results of the present study indicate that increased VWF and decreased ADAMTS-13 levels facilitate the invasiveness and metastasis of lung cancer. Non-O blood groups constitute a risk factor for increased VWF and FVIII in plasma. Continued monitoring of VWF and ADAMTS-13 levels, and of FVIII activity in patients with lung cancer with distinct blood groups may help to minimize the incidence of thrombotic events and improve assessment of disease progression.
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Affiliation(s)
- Xia Liu
- Department of Intensive Care Unit, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Xiaogang Chen
- Department of Laboratory Medicine, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Jiezuan Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious Disease, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Renyong Guo
- Department of Laboratory Medicine, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
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Chen P, Wang C, Cheng B, Nesa EU, Liu Y, Jia Y, Qu Y, Jiang Z, Han J, Cheng Y. Plasma fibrinogen and serum albumin levels (FA score) act as a promising prognostic indicator in non-small cell lung cancer. Onco Targets Ther 2017; 10:3107-3118. [PMID: 28790844 PMCID: PMC5488757 DOI: 10.2147/ott.s138854] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Evidence implies that preoperative plasma fibrinogen and serum albumin are associated with cancer prognosis. We aimed to explore the prognostic values of the score based on plasma fibrinogen and serum albumin levels (FA score) in non-small cell lung cancer (NSCLC), and to compare that with prognostic nutritional index (PNI). PATIENTS AND METHODS In all, 182 patients pathologically diagnosed with NSCLC were included in this study. Kaplan-Meier survival analysis and multivariate analysis were used in the prognostic analyses. RESULTS High FA score was related to smoking (P=0.005), poor differential grade (P=0.002), and advanced T stage (P<0.001) and tumor, node, and metastases stage (P=0.011). Low PNI showed association with advanced T stage (P=0.030). Kaplan-Meier survival analysis indicated that high FA score and low PNI were associated with poor progression-free survival (PFS; for the FA score, P<0.001; for PNI, P=0.001) and overall survival (OS; for the FA score, P<0.001; for PNI, P=0.013), respectively. Multivariate analysis revealed that FA score was an independent predictor for PFS (P=0.003) and OS (P=0.001) in NSCLC patients. CONCLUSION The FA score could act as a more promising prognostic predictor than PNI in NSCLC patients who underwent pneumonectomy.
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Affiliation(s)
- Pengxiang Chen
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
| | - Cong Wang
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
| | - Bo Cheng
- Medical College of Qingdao University, Qingdao
| | - Effat Un Nesa
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
| | - Yuan Liu
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
| | - Yibin Jia
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
| | - Yan Qu
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
| | - Ziying Jiang
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
| | - Jie Han
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, People's Republic of China
| | - Yufeng Cheng
- Department of Radiation Oncology, Qilu Hospital of Shandong University, Jinan
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Cukic V. NEUTROPHIL/LYMPHOCYTE RATIO AND PLATELET/LYMPHOCYTE RATIO IN PATIENTS WITH NSCLC. Mater Sociomed 2016; 28:378-381. [PMID: 27999489 PMCID: PMC5149430 DOI: 10.5455/msm.2016.28.378-381] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 10/08/2016] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE to compare neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) in patients with NSCLC (Non- Small- Cell Lung Cancer): with and without metastases at the time of diagnosis to find out if there is the importance of these cell ratios in the assessment of severity NSCLC. MATERIAL AND METHODS this is the retrospective analysis of NRL and PRL in patients with NSCLC at the time of the diagnosis of disease before any anti tumor treatment (chemotherapy, radiotherapy, surgery). 57 of patients with NSCLC treated in the first three months of 2016. year were chosen at random regardless of sex and age. We examined full blood count cells (FBC), calculated NLR and PLR in every patient and compared obtained values in patients with and patients without metastases. RESULTS In 57 patients with NSCLC there were 15 males with metastases, 28 without metastases, and 8 females with metastases, 6 without metastases. Since there was no regularity in the distribution of obtained values of NLR and PLR we made the Mann-Whitney U test. Mean values are presented with a median and interquartile percentiles. There was no significant difference in NLR between patients without and with metastases (p = 0.614; p = NS) as well as in PLR (p=0,068; p=NS). CONCLUSION There must be a link between the immune status of the organism and lung cancer development. Immune cells have become of interest in recent years and much work has been done to study their role in the genesis of cancer but it did not give satisfactory results. Further clinical studies on large number of patients and further laboratory examination of the role of immune cells in cancer development and suppression are required.
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Affiliation(s)
- Vesna Cukic
- Clinic for Pulmonary Diseases and TB "Podhrastovi", Clinical centre of Sarajevo University, Bosnia and Herzegovina
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26
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Fuentes E, Palomo I, Rojas A. Cross-talk between platelet and tumor microenvironment: Role of multiligand/RAGE axis in platelet activation. Blood Rev 2016; 30:213-221. [PMID: 26723842 DOI: 10.1016/j.blre.2015.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 10/02/2015] [Accepted: 11/30/2015] [Indexed: 02/07/2023]
Affiliation(s)
- Eduardo Fuentes
- Department of Clinical Biochemistry and Immunohematology, Faculty of Health Sciences, Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES), Universidad de Talca, Talca, Chile; Centro de Estudios en Alimentos Procesados (CEAP), CONICYT-Regional, Gore Maule R09I2001, Talca, Chile.
| | - Iván Palomo
- Department of Clinical Biochemistry and Immunohematology, Faculty of Health Sciences, Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES), Universidad de Talca, Talca, Chile; Centro de Estudios en Alimentos Procesados (CEAP), CONICYT-Regional, Gore Maule R09I2001, Talca, Chile
| | - Armando Rojas
- Biomedical Research Laboratories, Medicine Faculty, Catholic University of Maule, Talca, Chile.
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Perisanidis C, Psyrri A, Cohen EE, Engelmann J, Heinze G, Perisanidis B, Stift A, Filipits M, Kornek G, Nkenke E. Prognostic role of pretreatment plasma fibrinogen in patients with solid tumors: A systematic review and meta-analysis. Cancer Treat Rev 2016; 41:960-70. [PMID: 26604093 DOI: 10.1016/j.ctrv.2015.10.002] [Citation(s) in RCA: 133] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 10/06/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Plasma fibrinogen may be involved in several stages of cancer progression. Clinical studies have demonstrated that pretreatment plasma fibrinogen is associated with poor survival in various cancers. The aim of this meta-analysis was to examine the prognostic effect of circulating fibrinogen in solid tumors. MATERIALS AND METHODS We searched Medline, EMBASE, Cochrane Database of Systematic Reviews, and meeting proceedings to identify studies assessing the effect of pretreatment plasma fibrinogen on survival of cancer patients. Pooled multivariable-adjusted hazard ratios (HRs) for overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS) were estimated using random-effects models. RESULTS Data from 52 observational studies and 15,371 patients were summarized. An elevated baseline plasma fibrinogen was significantly associated with worse OS (pooled HR = 1.69; 95% CI = 1.48–1.92). The highest negative effect of elevated plasma fibrinogen on OS was demonstrated in renal cell carcinoma (pooled HR = 2.22), followed by head and neck cancer (pooled HR = 2.02), and colorectal cancer (pooled HR = 1.89). The adverse prognostic impact of high plasma fibrinogen remained in both non-metastatic and metastatic disease and patients of different ethnicity. Patients with high baseline fibrinogen had a significantly shorter DFS (pooled HR = 1.52) and CSS (pooled HR = 2.50). CONCLUSIONS An elevated pretreatment plasma fibrinogen significantly correlates with decreased survival in patients with solid tumors. Future clinical trials are warranted to determine whether plasma fibrinogen could be incorporated in cancer staging systems and whether fibrinogen-lowering therapies have a favorable effect on disease recurrence and mortality.
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Clinical and Prognostic Significance of Coagulation Assays in Pancreatic Cancer Patients With Absence of Venous Thromboembolism. Am J Clin Oncol 2016; 38:550-6. [PMID: 24401666 DOI: 10.1097/01.coc.0000436088.69084.22] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Activation of coagulation and fibrinolysis is frequently observed in patients with cancer, even with absence of thrombosis. Furthermore, plasma coagulation parameters were associated with tumor progression, metastasis, and prognosis. Few studies have investigated these associations in pancreatic cancer (PA). This study aimed to investigate the clinical and prognostic significance of various plasma coagulation tests in PA patients with absence of venous thromboembolism (VTE). MATERIALS AND METHODS A total of 139 PA patients with the absence of VTE were included in the analysis. Patients were followed up for at least 12 months until death. Pretreatment coagulation parameters including prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), fibrinogen (F), antithrombin-III (AT-III), protein C (PC), factor-VIII (F-VIII), and D-dimer (DD) were evaluated. A total of 40 age-matched and sex-matched healthy individuals without coagulation disorder were enrolled as the control group. RESULTS Patients were inclined to have higher levels of PT, INR, APTT, F, F-VIII, and DD and lower levels of AT-III and PC than the control group (P<0.01 for all, except P=0.022 for INR and P=0.015 for AT-III). Patients with advanced tumor stages were likely to have higher median DD levels and lower AT-III levels than the control group (P=0.005 and P<0.001, respectively). DD levels were higher in patients with advanced pathology grade (P<0.001). Plasma DD levels (hazards ratio=1.71; 95% confidence interval, 1.07-2.73; P=0.025) were identified as the significantly independent prognostic predictors. CONCLUSIONS PA patients are susceptible to activation of hemostasis system. Pretreatment plasma DD level was a potential predictor of prognosis in PA patients without VTE.
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Li Y, Wei S, Wang J, Hong L, Cui L, Wang C. [Analysis of the factors associated with abnormal coagulation and prognosis
in patients with non-small cell lung cancer]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2015; 17:789-96. [PMID: 25404269 PMCID: PMC6000357 DOI: 10.3779/j.issn.1009-3419.2014.11.04] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
背景与目的 凝血及纤溶系统激活在肺癌患者中较为常见，与肺癌侵袭、转移的高风险和预后差相关。非小细胞肺癌（non-small cell lung cancer, NSCLC）占肺癌的80%-85%，本研究旨在回顾性分析凝血功能指标对NSCLC的预后价值，为目前NSCLC患者高凝状态的预防及治疗提供参考。 方法 回顾性分析2009年1月-2012年12月首次就诊于河北医科大学第四医院的604例经病理学证实的NSCLC患者的临床资料。资料内容包括患者治疗前凝血功能相关指标[血浆凝血酶原时间（prothrombin time, PT）、凝血酶原活动度（prothrombin time activity, PTA）、国际标准化比率（international normalized ratio, INR）、活化部分凝血活酶时间（activated partial thromboplastin time, APTT）、纤维蛋白原（fibrinogen, Fib）、D二聚体（D-dimer, D-D）、血小板计数（platelet count, PLT）]、性别、年龄、病理分型、TNM分期、淋巴结状态等。本研究选择了50例同期就诊于河北医科大学第四医院的非癌症患者作为对照组。采用SPSS 13.0统计软件进行分析。 结果 NSCLC组与对照组之间所有的凝血功能指标（包括PT、PTA、INR、APTT、Fib、D-D、血小板计数）的血浆水平显示均有统计学差异[除了Fib（P=0.001, 5）、Plt（P=0.004, 5），其余指标（P＜0.001）]。纤维蛋白原水平与NSCLC的组织学亚型之间相关，鳞癌比腺癌的Fib水平明显升高（P＜0.001）。Ⅲ期、Ⅳ期期比Ⅰ期-Ⅱ期患者的Fib、PLT水平升高（P＜0.001, P=0.014），APTT缩短（P＜0.001）。与N0患者相比，N1-N3患者的APTT，明显缩短（P＜0.001），Fib、D-D水平升高（P＜0.001, P=0.048）。对生存率的比较研究显示，PT、INR延长（P=0.032, P=0.001），Fib升高（P＜0.001），PTA下降（P=0.005），在统计学上对总生存有明显的不利影响。多因素生存分析显示，在凝血功能指标中INR是唯一的独立预后因素（P=0.017）。 结论 NSCLC患者往往存在凝血纤溶系统的激活，导致凝血纤溶指标的亚临床改变。肺腺癌患者以及分期为晚期、淋巴结存在转移的NSCLC患者更易出现高血凝状态。PT、INR的延长与NSCLC患者生存率的下降密切相关，INR是NSCLC的独立预后因素，PT、INR可能成为NSCLC的预后指标。
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Affiliation(s)
- Yanhua Li
- Department of Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Suju Wei
- Department of Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Junyan Wang
- Department of Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Lei Hong
- Department of Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Lige Cui
- Department of Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Cai Wang
- Department of Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050000, China
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Afshar M, Hamilton P, Seligmann J, Lord S, Baxter P, Marples M, Stark D, Hall PS. Can D-Dimer Measurement Reduce the Frequency of Radiological Assessment in Patients Receiving Palliative Imatinib for Gastrointestinal Stromal Tumor (GIST)? Cancer Invest 2015; 33:347-53. [PMID: 26135352 DOI: 10.3109/07357907.2015.1047504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Imatinib therapy has improved outcomes in advanced GISTs. Current guidelines suggest monitoring with CT scanning every 12 weeks. There are no validated biomarkers to assist disease evaluation. We identified 50 patients treated with imatinib for GIST in a single tertiary center. We assessed the prognostic value of D-dimers by Cox regression, and the utility as a biomarker for radiological progression (rPD) using receiver-operator curve (ROC) analysis. In asymptomatic patients with D-dimer levels <1,000 and falling levels, the negative predictive value for rPD was 92%. D-dimers may reduce the burden of CT scanning in a proportion of patients in this setting.
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Affiliation(s)
- Mehran Afshar
- a Cancer Research Unit, Clinical Trials Unit , University of Warwick , Coventry , UK
| | - Patrick Hamilton
- b Faculty of Medicine & Health , University of Leeds , Leeds , UK
| | - Jenny Seligmann
- b Faculty of Medicine & Health , University of Leeds , Leeds , UK
- c St James's Institute of Oncology , Leeds Teaching Hospitals , Leeds , UK
| | - Simon Lord
- d University Department of Medical Oncology, Churchill Hospital , Oxford , UK
| | - Paul Baxter
- b Faculty of Medicine & Health , University of Leeds , Leeds , UK
| | - Maria Marples
- c St James's Institute of Oncology , Leeds Teaching Hospitals , Leeds , UK
| | - Dan Stark
- b Faculty of Medicine & Health , University of Leeds , Leeds , UK
- c St James's Institute of Oncology , Leeds Teaching Hospitals , Leeds , UK
| | - Peter S Hall
- b Faculty of Medicine & Health , University of Leeds , Leeds , UK
- e Edinburgh Cancer Research Centre , University of Edinburgh , Edinburgh , UK
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31
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Wang Y, Wang Z. Predictive value of plasma D-dimer levels in patients with advanced non-small-cell lung cancer. Onco Targets Ther 2015; 8:805-8. [PMID: 25926741 PMCID: PMC4403698 DOI: 10.2147/ott.s78154] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The relationship between plasma D-dimer level and the prognosis of advanced non-small-cell lung cancer (NSCLC) is not well studied. This study investigated the role of plasma D-dimer as a prognostic factor in advanced NSCLC. Methods The plasma D-dimer was measured in 1,931 newly diagnosed advanced NSCLC patients by enzyme-linked immunosorbent assay. Correlations between plasma D-dimer levels and other clinical parameters were analyzed. Survival curves were plotted using the Kaplan–Meier method. The Cox proportional hazard model was used for multivariate analysis. Results Plasma D-dimer concentrations were within the normal range in 1,393 patients (72.1%) and elevated in 538 patients (27.9%). The median overall survival was 11.5 and 8.8 months in the normal and high plasma D-dimer group, respectively (P<0.001). The progression-free survival of first-line chemotherapy was 5.0 months and 4.4 months in the groups with normal and high levels of plasma D-dimer, respectively, (P<0.001). By multivariate analyses, the elevated plasma D-dimer level was found to be an independent prognostic factor for poor survival (hazard ratio =1.245; P<0.001). Conclusion Plasma D-dimer is an independent determinant of poor prognosis in advanced NSCLC.
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Affiliation(s)
- Yuezhen Wang
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China ; Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, People's Republic of China
| | - Zhun Wang
- Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, People's Republic of China ; Zhejiang Key Laboratory of Radiation Oncology, Hangzhou, People's Republic of China
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So HJ, Hong SI, Lee JK, Chang YH, Kang SJ, Hong YJ. Comparison of the serum fibrin-fibrinogen degradation products with cytokeratin 19 fragment as biomarkers in patients with lung cancer. Biomed Rep 2014; 2:737-742. [PMID: 25054020 DOI: 10.3892/br.2014.315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 06/23/2014] [Indexed: 11/05/2022] Open
Abstract
Lung cancer is one of the main causes of cancer-related mortality. The identification of early diagnostic biomarkers improved outcomes for lung cancer patients. Serum fibrin-fibrinogen degradation products (FDP) levels are elevated in numerous malignancies due to hemostatic alterations. The serum FDP levels were compared to the levels of cytokeratin 19 fragment antigen (CYFRA 21-1), another well-established biomarker. The serum samples from 193 lung cancer patients, 84 healthy controls and 106 patients with benign respiratory diseases were obtained. The serum FDP level was measured using the DR-70 immunoassay and the CYFRA 21-1 level was measured by electrochemiluminescence using the Roche Analytics E170. Receiver operating characteristics curves were used to assess the predictive sensitivity and specificity. The mean serum FDP level in lung cancer patients (35.01±229.02 μg/ml) was significantly higher compared to the 190 non-cancerous subjects (0.60±0.75 μg/ml; P=0.039). The mean serum CYFRA 21-1 level in lung cancer patients (4.50±6.67 ng/ml) was also significantly higher compared to the non-cancerous subjects (1.40±0.83 ng/ml; P<0.05). FDP exhibited clinical sensitivity and specificity of 86 and 75%, respectively, at an optimal cut-off at 0.67 μg/ml. CYFRA 21-1 exhibited clinical sensitivity and specificity of 77 and 74%, respectively, at a cut-off of 1.65 ng/ml. The serum FDP area under the curve (0.87) was slightly higher compared to CYFRA 21-1 (0.83). Therefore, it is apparent that serum FDP is comparable to CYFRA 21-1 as a lung cancer biomarker and can be used for clinical practice.
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Affiliation(s)
- Hee Jin So
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Seoul 139-709, Republic of Korea
| | - Seok-Il Hong
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Seoul 139-709, Republic of Korea ; Radiation Cancer Medicine Program, University of Science and Technology, Daejeon 305-350, Republic of Korea
| | - Jin Kyung Lee
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Seoul 139-709, Republic of Korea ; Radiation Cancer Medicine Program, University of Science and Technology, Daejeon 305-350, Republic of Korea
| | - Yoon Hwan Chang
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Seoul 139-709, Republic of Korea ; Radiation Cancer Medicine Program, University of Science and Technology, Daejeon 305-350, Republic of Korea
| | - Sun Jung Kang
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Seoul 139-709, Republic of Korea
| | - Young Jun Hong
- Department of Laboratory Medicine, Korea Cancer Center Hospital, Seoul 139-709, Republic of Korea ; Radiation Cancer Medicine Program, University of Science and Technology, Daejeon 305-350, Republic of Korea
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İnal T, Anar C, Polat G, Ünsal İ, Halilçolar H. The prognostic value of D-dimer in lung cancer. CLINICAL RESPIRATORY JOURNAL 2014; 9:305-13. [PMID: 24720709 DOI: 10.1111/crj.12144] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 03/10/2014] [Accepted: 04/04/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIM Activation of coagulation and fibrinolysis is frequently encountered among cancer patients. Such tumors are supposed to be associated with higher risk of invasion, metastases and eventually worse outcome. The aim of this study is to explore the prognostic value of blood coagulation tests for lung cancer patients. METHODS Between 2009 and 2012, 72 newly diagnosed patients with lung cancer and 40 healthy subjects as control group were included in this prospective study. Patients were staged according to the seventh edition of the tumor, node, metastasis (TNM) classification. The treatment responses of patients were evaluated according to the World Health Organization (WHO) criteria. We measured plasma D-dimer level, activated partial thromboplastin time (APTT), prothrombin time (PT), international normalized ratio (INR), lactate dehhydrogenase (LDH), hemoglobin (Hb), platelet (Plt), white blood cells (WBC) count before, during and after chemotherapy. We investigated association of the results with stage and histologic type of the disease, as well as with response to therapy and survival in lung cancer patients. RESULTS The median D-dimer, PT and INR levels of the patients with lung cancer were significantly higher than in the control group (P = 0,000). D-dimer, APTT, PT, INR, LDH levels after four cycles of treatment were significantly lower in responders than in nonresponders (P = 0,000). Plasma D-dimer levels were evaluated according to histopathological type and stage of diseases; D-dimer level was found significantly higher in metastatic disease (P < 0,5) and significantly lower in small cell lung cancer (SCLC) (P < 0,05). The mean follow-up was 574,14 ± 463,48 days. The mean survival was 750,866 ± 74,857 days (95% CI: 604,147 - 897,586). After second and fourth cycles of treatment, the plasma D-dimer, APTT, and LDH levels were higher in mortality group than in survival group (P = 0,000). After four cycles of treatment, the mean survival of the patients with serum D-dimer level above and below 1900 ng/mL was found to be significantly different (P = 0,000). CONCLUSION The results suggest that determination of D-dimer plasma levels that is an inexpensive, easy and non invasive method may be useful in predicting clinical outcome, survival and treatment response of patients with lung cancer.
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Affiliation(s)
- Tuba İnal
- Department of Respiratory Diseases, Chest Disease and Surgery Training and Research Hospital, Izmir, Turkey
| | - Ceyda Anar
- Department of Respiratory Diseases, Chest Disease and Surgery Training and Research Hospital, Izmir, Turkey
| | - Gülru Polat
- Department of Respiratory Diseases, Chest Disease and Surgery Training and Research Hospital, Izmir, Turkey
| | - İpek Ünsal
- Department of Respiratory Diseases, Chest Disease and Surgery Training and Research Hospital, Izmir, Turkey
| | - Hüseyin Halilçolar
- Department of Respiratory Diseases, Chest Disease and Surgery Training and Research Hospital, Izmir, Turkey
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Ji Y, Sheng L, Du X, Qiu G, Su D. Elevated platelet count is a strong predictor of poor prognosis in stage I non-small cell lung cancer patients. Platelets 2014; 26:138-42. [PMID: 24679181 DOI: 10.3109/09537104.2014.888547] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Stage I non-small cell lung cancer (NSCLC) show a highly variable biological behavior which cannot be accurately predicted by the current available prognostic markers. Platelet plays a significant role in cancer cell growth, progression and metastasis. This study aimed to investigate whether preoperative platelet count correlate with clinical prognosis in localized NSCLC. A retrospective clinical analysis was designed for a total of 234 stage I NSCLC patients in our hospital between October 2006 and December 2009. Pre-operative platelet count was measured. The association of platelet count with clinical pathological factors and patient outcome was evaluated. A significant correlation was detected between platelet count and tumor cell differentiation and T stage. Patients with elevated platelet count had an elevated risk of disease progression and death compared to patients with normal platelet count. The hazard ratio was 5.314 (95% confidence interval [CI] 2.750-10.269) for disease progression and 3.139 (95% CI 1.227-8.034) for death. The trend linking increasing platelet count with risk was also statistically significant for both the outcomes (p < 0.05). These finding demonstrate that preoperative platelet count is a useful predictor of high risk progression and poor prognosis in stage I NSCLC patients.
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Affiliation(s)
- Yongling Ji
- Department of Radiation Therapy, Zhejiang Cancer Hospital , Hangzhou, Zhejiang , China
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Liu L, Zhang X, Yan B, Gu Q, Zhang X, Jiao J, Sun D, Wang N, Yue X. Elevated plasma D-dimer levels correlate with long term survival of gastric cancer patients. PLoS One 2014; 9:e90547. [PMID: 24618826 PMCID: PMC3949713 DOI: 10.1371/journal.pone.0090547] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 02/03/2014] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Increasing evidence indicated plasma D-dimer could be regarded as a marker in cancers, however, its role in gastric cancer is still largely unknown. METHODS Plasma D-dimer levels were measured by enzyme linked fluorescent immunoassays and evaluated by receiver operating characteristic (ROC) curves for peritoneal dissemination in gastric cancer and healthy subjects. The overall survival (OS) characteristics were determined using Kaplan-Meier and Cox regression analyses. RESULTS The average of the plasma D-dimer levels for gastric cancer patients was significantly higher than the healthy subjects. A Spearman correlation analysis showed that plasma D-dimer levels correlated with the depth of invasion, lymph node metastasis, peritoneal dissemination, distant metastasis, tumor size and TNM stage. The mean plasma D-dimer level was 2.20 ± 1.51 µg/mL in peritoneal dissemination patients and 1.01 ± 0.79 µg/mL in non-peritoneal dissemination patients (P<0.001). Additionally, the mean plasma D-dimer concentration in patients alive at the final follow-up evaluation was 0.79 ± 0.72 µg/mL,which was significantly lower than the amounts determined for the deceased patients (1.36 ± 1.13 µg/mL) (P<0.001). The AUC of D-dimer was 0.833 (95%CI: 0.780-0.885). At a cut-off value of 1.465 µg/mL, the D-dimer measurement had a sensitivity of 78.00%, a specificity of 83.76% and an accuracy of 82.59%. The median OS was 48.10 months (95% CI: 43.88-52.31) in patients with plasma D-dimer levels less than 1.465 µg/mL and 22.39 months (95% CI: 16.95-27.82) in patients with plasma D-dimer levels exceeding 1.465 µg/mL (log-rank test, P<0.001). Importantly, plasma D-dimer levels exceeding 1.465 µg/mL were significantly associated with poor OS, as determined using a multivariate Cox regression analysis (hazard ratio [HR], 2.28; 95%CI: 1.36-3.81; P = 0.002). CONCLUSIONS Plasma D-dimer levels are increased in gastric cancer patients and may be a valuable biomarker for peritoneal dissemination, with high D-dimer levels predicting poor outcomes for gastric cancer patients.
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Affiliation(s)
- Long Liu
- Department of Traditional Chinese Medicine, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Xi Zhang
- Department of Anatomy, Second Military Medical University, Second Military Medical University, Shanghai, China
| | - Bing Yan
- Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Qunhao Gu
- Department of General Surgery, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaodong Zhang
- Department of General Surgery, Yueyang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jianpeng Jiao
- Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Dazhi Sun
- Department of Traditional Chinese Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Ning Wang
- Department of Oncology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Xiaoqiang Yue
- Department of Traditional Chinese Medicine, Changhai Hospital, Second Military Medical University, Shanghai, China
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Coagulation tests show significant differences in patients with breast cancer. Tumour Biol 2014; 35:5985-92. [PMID: 24596033 DOI: 10.1007/s13277-014-1793-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 02/24/2014] [Indexed: 12/13/2022] Open
Abstract
Activated coagulation and fibrinolytic system in cancer patients is associated with tumor stroma formation and metastasis in different cancer types. The aim of this study is to explore the correlation of blood coagulation assays for various clinicopathologic factors in breast cancer patients. A total of 123 female breast cancer patients were enrolled into the study. All the patients were treatment naïve. Pretreatment blood coagulation tests including PT, APTT, PTA, INR, D-dimer, fibrinogen levels, and platelet counts were evaluated. Median age of diagnosis was 51 years old (range 26-82). Twenty-two percent of the group consisted of metastatic breast cancer patients. The plasma level of all coagulation tests revealed statistically significant difference between patient and control group except for PT (p<0.001 for all variables except for PT; p=0.08). Elderly age (>50 years) was associated with higher D-dimer levels (p=0.003). Metastatic patients exhibited significantly higher D-dimer values when compared with early breast cancer patients (p=0.049). Advanced tumor stage (T3 and T4) was associated with higher INR (p=0.05) and lower PTA (p=0.025). In conclusion, coagulation tests show significant differences in patients with breast cancer.
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Prognostic role of D-dimer in patients with lung cancer: a meta-analysis. Tumour Biol 2013; 35:2103-9. [PMID: 24114016 DOI: 10.1007/s13277-013-1279-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 09/27/2013] [Indexed: 02/05/2023] Open
Abstract
D-dimer detection in patients suffering from a variety of different types of cancer has become a hot point as an emerging and promising biomarker. In this study, therefore, we evaluated the prognostic role of D-dimer in lung cancer. Initial literature was identified using the PubMed, EMBASE, and CNKI. The primary data was hazard ratio (HR) with 95% confidence interval (CI) of survival outcomes in candidate articles, including overall survival (OS) and disease-free survival (DFS). Finally, 11 eligible studies were included in this meta-analysis, which were published between 1996 and 2013. The estimated pooled HR and 95% CI for OS of all studies was 2.06 (95% CI 1.64-2.58, p < 0.00001) and the HR and 95% CI for DFS in one study was 3.38 (95% CI 1.17-9.75, p = 0.002). The HRs and 95% CIs for OS in Asian and non-Asian patients were 2.48 (95% CI 1.60-3.84, p < 0.0001) and 1.89 (95% CI 1.44-2.47, p < 0.00001), respectively. When we further analyzed the data by various detecting methods, the pooled HR and 95% CI for OS were 3.22 (95% CI 1.99-5.21, p < 0.00001) for ELISA, 1.52 (95% CI 1.25-1.86, p < 0.0001) for Latex assay, and 1.79 (95% CI 1.19-2.69, p = 0.005) for immunoturbidimetry assay. We also did subgroup analysis according to the ratio of histological type and clinical stage. All the above analysis had positive results. This meta-analysis showed that D-dimer had a fine predictive role in lung cancer patients, especially in Asian group. Also, it demonstrated that D-dimer had a stronger predictive value by using the method ELISA.
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Zhang PP, Sun JW, Wang XY, Liu XM, Li K. Preoperative plasma D-dimer levels predict survival in patients with operable non-small cell lung cancer independently of venous thromboembolism. Eur J Surg Oncol 2013; 39:951-6. [DOI: 10.1016/j.ejso.2013.06.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 03/26/2013] [Accepted: 06/06/2013] [Indexed: 01/20/2023] Open
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High plasma D-dimer level is associated with decreased survival in patients with lung cancer: a meta-analysis. Tumour Biol 2013; 34:3701-4. [PMID: 23873105 DOI: 10.1007/s13277-013-0953-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 06/17/2013] [Indexed: 01/24/2023] Open
Abstract
An elevated plasma D-dimer level indicates the activation of coagulation and fibrinolysis. Several studies suggested that high level of plasma D-dimer was associated with the prognosis of lung cancer. In the present study, we performed a meta-analysis to evaluate the relationship between plasma D-dimer level and the prognosis of lung cancer based on larger sample size. We retrieved the literature, assessed and selected the data, and performed the statistical analysis according to the RevMan 5.0 guidelines. Literature-based searching was guided to gather data, and fixed-effects model was used to pool the hazard ratio according to the test of heterogeneity. A total of seven eligible studies including 1,377 lung cancer patients were analyzed. Survival time was significantly better in patients in the low D-dimer group than those in the high D-dimer group (hazard ratio for high D-dimer group = 1.12; 95% confidence interval 1.02 to 1.23). Patients with high levels of D-dimer have a poorer overall survival compared with those patients with low levels of D-dimer.
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Sheng L, Luo M, Sun X, Lin N, Mao W, Su D. Serum fibrinogen is an independent prognostic factor in operable nonsmall cell lung cancer. Int J Cancer 2013; 133:2720-5. [PMID: 23716344 DOI: 10.1002/ijc.28284] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 05/06/2013] [Indexed: 12/15/2022]
Abstract
Serum fibrinogen converted to insoluble fibrin by activated thrombin, plays an important role in the coagulation system. Increased fibrinogen considerably influences cancer cell growth, progression and metastasis. In nonsmall cell lung cancer (NSCLC), however, the association between serum fibrinogen concentration and prognosis has not been fully examined. We enlisted 567 operable NSCLC patients in our study. Preoperative serum fibrinogen was measured by the Clauss method. The association of serum fibrinogen concentration with clinical pathological factors and patient outcome was evaluated. Survival analysis indicated that serum fibrinogen was an independent prognostic factor in operable NSCLC. Patients with hyperfibrinogenemia had an elevated risk of disease progression and death compared to patients with normal fibrinogen levels. The hazard ratio was 1.49 (95% confidence interval [CI] 1.07-2.05) for disease progression and 1.64 (95% CI 1.06-2.53) for death. The trend linking increasing fibrinogen levels with risk was also statistically significant for both outcomes (p < 0.05). These analyses were adjusted for patient age, sex, smoking behavior, disease stage, tumor grade and histology. Kaplan-Meier survival curves showed similar results. Preoperative serum fibrinogen is a novel independent prognostic biomarker in operable NSCLC.
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Affiliation(s)
- Liming Sheng
- Department of Radiation Therapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China; Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang, China
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Yu D, Liu B, Zhang L, DU K. Platelet count predicts prognosis in operable non-small cell lung cancer. Exp Ther Med 2013; 5:1351-1354. [PMID: 23737877 PMCID: PMC3671769 DOI: 10.3892/etm.2013.1003] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Accepted: 02/08/2013] [Indexed: 12/16/2022] Open
Abstract
Platelets play a significant role in cancer cell growth, progression and metastasis. However, in non-small cell lung cancer (NSCLC), the association between a patient's platelet count and prognosis has not previously been fully elucidated. The aim of the present study was to investigate the correlation between platelet count, patients' characteristics and prognosis in patients with NSCLC. A total of 510 NSCLC patients were enrolled in the present study. The median platelet count in the NSCLC patients was 203×109/l (95% CI, 115-358×109/l). The median platelet count in T3 and T4 patients was significantly higher than that of T1 and T2 patients (median, 263×109/l and 253.5×109/l vs. 199.5×109/l and 196.5×109/l, respectively; P<0.001). The 3-year cumulative overall survival (OS) probability was 75.3% for patients with normal platelet counts and 59.2% for patients with elevated platelet counts. When compared with the patients with normal platelet counts, the patients with elevated platelet counts had an increased risk of disease progression (HR, 1.568; 95% CI, 1.015-2.453). Pre-operative platelet counts are a novel independent prognostic biomarker in operable NSCLC.
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Affiliation(s)
- Dangfan Yu
- Departments of Radiology, Zhejiang Provincial Corps Hospital, Chinese People's Armed Police Force, Jiaxing, Zhejiang 314000, P.R. China
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[Importance of early detection of lung cancers with initial paraneoplastic manifestations]. SRP ARK CELOK LEK 2010; 138:595-9. [PMID: 21180089 DOI: 10.2298/sarh1010595v] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Lung cancers are mostly detected in the developed clinical stages, with clearly manifested pulmonary, extrapulmonary or metastatic manifestations. In the early disease stages, radiographic and clinical manifestations may be absent or mimicked. OBJECTIVE The aim of this study was the timely detection of early pulmonary, extrapulmonary and paraneoplastic manifestations of lung cancers in order to apply the most appropriate treatment protocols. METHODS We examined 230 patients with lung cancer, among them 125 of the working study group with minimal pulmonary and/or initial paraneoplastic symptoms, and 105 patients in the control group with clear tumour manifestations. RESULTS The symptom analysis revealed a statistically significantly lesser presence of the respiratory symptoms in the working study group (68%) in comparison with the control group of patients (97%) (chi2 = 29.996; p < 0.001). The analysis of radiographic presentations of lung cancer showed that there were significantly more patients with normal findings in the working group (6.4%) than in the control group--1.9% (p > 0.05), and a positive bronchoscopic finding of the centrally localized tumour (mainly right upper lobe) was confirmed in patients of both groups with normal radiographic findings. The number of diagnosed patients in earlier clinical disease stages (I, II, IIIa) with better prognosis in non-small cell lung cancer was significantly higher (chi2 = 19.149; p < 0.001) in the working group (71.1%) in comparison with the control group (38.1%). Small cell lung cancer was more frequently diagnosed in the stage of limited disease in the working (80%) than in the control group (38.1%) (chi2 = 10.039; p < 0.05). With regard to treatment administration, there is a statistically significant difference (chi2 = 4.013; p = 0.0452) in the frequency between the use of chemotherapy and highly significant difference (chi2 = 22.044; p < 0.001) in the frequency of use of surgical treatment in the working group in comparison with the control group--both chemotherapy and surgery treatment were more frequent in the patients of the working group. CONCLUSION Recognizing the initial pulmonary, extrapulmonary or paraneoplastic manifestations as well as performing diagnostic procedures in due time represent the most important guidelines in early detection and the most efficacious therapeutic choice in lung cancer.
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Small-Howard AL, Harris H. Advantages of the AMDL-ELISA DR-70 (FDP) assay over carcinoembryonic antigen (CEA) for monitoring colorectal cancer patients. J Immunoassay Immunochem 2010; 31:131-47. [PMID: 20391025 PMCID: PMC2872273 DOI: 10.1080/15321811003617438] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The DR-70® (FDP) test was the first cancer test cleared by USFDA for monitoring colorectal cancer (CRC) since Carcinoembryonic Antigen (CEA) in 1982. Conservatively, 50% of biopsy-positive CRC patients have negative CEA values. DR-70 and CEA values were compared for 113 CRC monitoring patients. Total concordance rates for DR-70 and CEA were 0.665 and 0.686, respectively. CRC patient pairs were grouped based on their CEA value to deduce DR-70's effectiveness at monitoring patients with low CEA values. DR-70 had 12% to 100% greater positive concordance rates than CEA in this group. DR-70 is a welcome new option for CRC patients.
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Ursavaş A, Karadağ M, Uzaslan E, Yesilkaya S, Coşkun F, Eğe E. Prognostic Significance of Plasma D-Dimer Levels in Patients with Lung Cancer. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2010. [DOI: 10.29333/ejgm/82843] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Clinical significance of the ratio between the alpha 2 plasmin inhibitor-plasmin complex and the thrombin-antithrombin complex in advanced non-small cell lung cancer. Med Oncol 2010; 28:351-6. [PMID: 20300980 DOI: 10.1007/s12032-010-9454-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2010] [Accepted: 02/15/2010] [Indexed: 10/19/2022]
Abstract
The aims of this study are to: (a) confirm the prognostic significance of the procoagulant molecules D dimer, thrombin-antithrombin complex (TAT), and plasmin-α2-plasmin inhibitor complex (PIC); (b) to evaluate hemostatic activation in patients with advanced non-small cell lung cancer (NSCLC); and (c) to delineate the relationships between markers of hemostasis and other clinical characteristics. In this study, a low PIC/TAT ratio and poor PS were significant independent negative prognostic factors for survival in patients with advanced NSCLC. The PIC/TAT ratio may become a surrogate marker for treatment with anticoagulants in the future.
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Cherfils-Vicini J, Platonova S, Gillard M, Laurans L, Validire P, Caliandro R, Magdeleinat P, Mami-Chouaib F, Dieu-Nosjean MC, Fridman WH, Damotte D, Sautès-Fridman C, Cremer I. Triggering of TLR7 and TLR8 expressed by human lung cancer cells induces cell survival and chemoresistance. J Clin Invest 2010; 120:1285-97. [PMID: 20237413 DOI: 10.1172/jci36551] [Citation(s) in RCA: 172] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Accepted: 01/06/2010] [Indexed: 12/26/2022] Open
Abstract
Compelling evidence suggests that inflammation, cell survival, and cancer are linked, with a central role played by NF-kappaB. Recent studies implicate some TLRs in tumor development based on their ability to facilitate tumor growth; however, to our knowledge, involvement of neither TLR7 nor TLR78 has yet been demonstrated. Here we have demonstrated expression of TLR7 and TLR8, the natural receptors for single-stranded RNA, by tumor cells in human lung cancer in situ and in human lung tumor cell lines. Stimulation with TLR7 or TLR8 agonists led to activated NF-kappaB, upregulated expression of the antiapoptotic protein Bcl-2, increased tumor cell survival, and chemoresistance. Transcriptional analysis performed on human primary lung tumor cells and TLR7- or TLR8-stimulated human lung tumor cell lines revealed a gene expression signature suggestive of chronic stimulation of tumor cells by TLR ligands in situ. Together, these data emphasize that TLR signaling can directly favor tumor development and further suggest that researchers developing anticancer immunotherapy using TLR7 or TLR8 agonists as adjuvants should take into account the expression of these TLRs in lung tumor cells.
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Hong SK, Ko DW, Park J, Kim IS, Doo SH, Yoon CY, Park H, Lee WK, Kim DS, Jeong SJ, Byun SS, Lee SE. Alteration of Antithrombin III and D-dimer Levels in Clinically Localized Prostate Cancer. Korean J Urol 2010; 51:25-9. [PMID: 20414406 PMCID: PMC2855465 DOI: 10.4111/kju.2010.51.1.25] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2009] [Accepted: 10/15/2009] [Indexed: 11/18/2022] Open
Abstract
Purpose We performed a comparative analysis of the plasma levels of antithrombin (AT) III, plasminogen, fibrinogen, and D-dimer among patients with and without clinically localized prostate cancer to investigate the clinical significance of the coagulation profile in prostate cancer. Materials and Methods A prospective study was performed in which plasma levels of AT III, plasminogen, fibrinogen, and D-dimer were assessed in patients before they underwent prostate biopsy. According to the results of the biopsy, the patients were categorized into the cancer group or the control group. Levels of the four coagulation factors were then compared between the cancer and control groups. Also, levels of the four coagulation factors were correlated with tumor stage and grade in the cancer group. Results The cancer group had significantly lower levels of AT III activity and higher plasma D-dimer levels than did the control group (p=0.007 and p=0.018, respectively). Within the cancer group, no significant differences were observed in the levels of AT III, plasminogen, fibrinogen, or D-dimer between those with a pathological Gleason score of ≥7 and otherwise. Regarding pathologic stage of prostate cancer, the subjects with organ-confined disease and those with extraprostatic extension of a tumor demonstrated no significant differences in the preoperative levels of the four coagulation factors analyzed. Conclusions Our results suggest that plasma levels of AT III and D-dimer are altered in patients with prostate cancer. Further study is needed to elucidate the underlying mechanism and clinical significances of such a phenomenon among patients with clinically localized prostate cancer.
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Affiliation(s)
- Sung Kyu Hong
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
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Arslan S, Haznedaroglu IC, Öz B, Goker H. Endobronchial application of Ankaferd blood stopper to control profuse lung bleeding leading to hypoxemia and hemodynamic instability. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.rmedc.2008.10.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Yigit E, Gönüllü G, Yücel I, Turgut M, Erdem D, Cakar B. Relation between hemostatic parameters and prognostic/predictive factors in breast cancer. Eur J Intern Med 2008; 19:602-7. [PMID: 19046726 DOI: 10.1016/j.ejim.2007.06.036] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2007] [Revised: 05/25/2007] [Accepted: 06/06/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND In our study, we searched for a relation between various prognostic and predictive factors and hemostatic parameters. METHODS One hundred women with newly diagnosed breast cancer after surgery were included. Patients did not receive systemic therapy or radiotherapy. The control group included 100 healthy, age-matched women. In the patient group, age, menopausal status, tumor size, grade, axillary lymph node status, steroid receptor status, p53, and HER2/neu were evaluated. Plasma levels of factor VIII, factor IX, D-dimer, fibrinogen, protein C, protein S, vWF, and antithrombin III were measured in both groups. RESULTS Plasma levels of factor VIII, factor IX, vWF, and CRP in patients with breast cancer were higher than those in controls. Protein S levels in patients were lower than in controls. There was no significant difference in other hemostatic parameters between the groups. In patients with axillary lymph node metastasis, factor VIII levels were significantly higher than in node-negative patients. There was a strong correlation between axillary lymph node status, number of metastatic nodes, and factor VIII levels. There was no correlation between factor VIII levels and CRP. Factor VIII levels were higher in the group having high HER2/neu (3+) than in the group with negativity for HER2/neu. CONCLUSION There was a strong correlation between axillary lymph node involvement, number of metastatic nodules, overexpression of HER2/neu, hemostatic parameters, and factor VIII levels. Our study showed that factor VIII level measurement can provide additional data for evaluation of breast cancer patients' prognosis.
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Affiliation(s)
- Engin Yigit
- Department of Internal Medicine, Ondokuz Mayis University Medical School, Kurupelit/Samsun, Turkey
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Turna H, Ozguroglu M, Bolayirli M, Orhanoglu T, Balci H. Is There Any Effect of Tumor Burden on Hemostatic Parameters in Cancer Patients? A Case—Control Study of Hemostatic Abnormalities and Anticardiolipin Antibodies in Solid Tumors. Clin Appl Thromb Hemost 2007; 15:454-7. [DOI: 10.1177/1076029607308873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Hemostatic complications are one of the leading causes of mortality in cancer patients. In the present study, we assessed the hemostatic parameters and anticardiolipin antibodies in patients with solid tumors (n = 104) and healthy controls (n = 25) and also find out whether the abnormalities in these hemostatic parameters vary related to tumor burden. Prothrombin time, activated partial thromboplastine time, D-dimer, and fibrinogen as hemostatic parameters were determined by photo-optometric clot detection system, and serum anticardiolipin levels were measured by enzyme-linked immunosorbent assay. The plasma levels of fibrinogen, D-dimer, and serum anticardiolipin IgM levels in cancer patients were significantly higher compared with those in controls ( P < .001, P = .001, and P = .01, respectively). Only fibrinogen levels were significantly higher in metastatic group than nonmetastatic group ( P < .001 ). Hemostatic abnormalities that are detected in asymptomatic cancer patients may not give any clue about tumor burden or stage of the cancer patients.
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Affiliation(s)
- Hande Turna
- Department of Medical Oncology Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Mustafa Ozguroglu
- Department of Medical Oncology Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey,
| | - Murat Bolayirli
- Fikret Biyal Central Research Laboratory, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Timur Orhanoglu
- Department of Medical Oncology Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Huriye Balci
- Department of Medical Oncology Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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