Prognostic significance of preoperative fibrinogen in patients with colon cancer

Table 1 Correlations between preoperative fibrinogen and clinicopathological parameters

Parameters	n	Fibrinogen (g/L, mean ± SD)	P value
Age (yr)
< 60	119	3.29 ± 1.01	0.047
≥ 60	136	3.07 ± 0.73
Nationality
Han	216	3.16 ± 0.87	0.892
Uygur	30	3.24 ± 0.92
Others	9	3.12 ± 0.94
BMI (kg/m2)
< 18.5	8	3.54 ± 0.82	0.638
18.5-23.99	115	3.15 ± 0.94
24-27.99	102	3.14 ± 0.83
≥ 28	30	3.23 ± 0.79
Smoking
Never	173	3.06 ± 0.82	0.018
Light	18	3.43 ± 0.74
Heavy	64	3.39 ± 0.99
Grade (tumor differentiation)
Low	203	3.12 ± 0.86	0.080
High	52	3.36 ± 0.92
TNM
I	29	2.70 ± 0.58	0.002
II	139	3.24 ± 0.95
III	87	3.21 ± 0.78
Tumor size (cm)
< 4	51	2.81 ± 0.72	0.000
4-6	114	3.01 ± 0.73
≥ 6	90	3.57 ± 0.98
Type
Mess type	104	3.13 ± 0.87	0.390
Ulceration	148	3.21 ± 0.89
Infiltrative	3	2.58 ± 0.13
Tumor location
Left	155	3.06 ± 0.82	0.020
Right	89	3.38 ± 0.97
Transverse	11	2.99 ± 0.55
Perineural invasion
Yes	7	3.40 ± 0.59	0.488
No	248	3.16 ± 0.88
Vascular invasion
Yes	13	3.29 ± 0.94	0.619
No	242	3.16 ± 0.87
CEA (ng/mL)
< 5	161	3.08 ± 0.89	0.038
≥ 5	94	3.32 ± 0.84
AFP (ng/mL)
< 5	231	3.17 ± 0.88	0.747
≥ 5	24	3.11 ± 0.82
mGPS
0	163	3.00 ± 0.77	0.000
1	71	3.37 ± 0.94
2	21	3.80 ± 1.00
WBC count
< 5 × 109/L	61	2.68 ± 0.56	0.000
≥ 5 × 109/L	194	3.32 ± 0.90
NLR
< 5	238	3.13 ± 0.86	0.013
≥ 5	17	3.69 ± 1.02
PLR
< 150	134	2.96 ± 0.75	0.000
150-300	105	3.41 ± 0.96
> 300	15	3.40 ± 0.83

AFP: Alpha-fetoprotein; BMI: Body mass index; CEA: Carcinoembryonic antigen; mGPS: Modified Glasgow prognostic score; NLR: Neutrophil-lymphocyte ratio; PLR: Platelet-lymphocyte ratio; TNM: Tumor-node-metastasis; WBC: White blood cell.

Table 2 Univariate survival analyses of clinicopathological parameters

Parameters	n	5-yr DFS	χ2	Pvalue	5-yr OS	χ2	Pvalue
Age (yr)
< 60	119	49.3%	0.301	0.583	64.90%	0.616	0.432
≥ 60	136	47.7%			61.80%
Nationality
Han	216	51.3%	3.185	0.203	64.60%	3.477	0.176
Uygur	30	34.4%			48.80%
Others	9	33.3%			76.20%
BMI (kg/m2)
< 18.5	8	37.5%	3.905	0.272	50%	9.296	0.026
18.5-23.99	115	46.5%			55.60%
24-27.99	102	54.4%			74.00%
≥ 28	30	39.7%			59.30%
Smoking
Never	173	49.1%	0.079	0.961	65.00%	0.153	0.927
Light	18	50.0%			60.20%
Heavy	64	47.7%			61.40%
Grade
Low	203	52.7%	5.948	0.015	67.10%	4.482	0.034
High	52	32.7%			49.30%
TNM
I	29	78.7%	38.724	0.000	86.20%	28.420	0.000
II	139	57.3%			70.60%
III	87	25.2%			43.90%
Type
Mess type	104	54.3%	2.523	0.283	68%	3.088	0.213
Ulceration	148	44.1%			59.30%
Infiltrative	3	27.2%			0
Tumor location
Left	155	51.8%	2.992	0.224	67.20%	5.563	0.062
Right	89	42.0%			54.30%
Transverse	11	54.5%			81.80%
Perineural invasion
Yes	7	42.9%	0.551	0.458	42.90%	2.108	0.147
No	248	48.6%			63.90%
Vascular invasion
Yes	13	15.4%	8.432	0.004	30.80%	7.747	0.005
No	242	50.3%			65.10%
CEA (ng/mL)
< 5	161	56.6%	18.630	0.000	71.20%	15.269	0.000
≥ 5	94	33.6%			49.10%
AFP (ng/mL)
< 5	231	49.7%	3.568	0.059	65.20%	5.117	0.024
≥ 5	24	35.0%			43.20%
mGPS
0	163	58.9%	79.236	0.000	77.80%	90.552	0.000
1	71	60.2%			49.80%
2	21	0.0%			4.80%
WBC count
< 5 × 109/L	61	60.9%	4.032	0.045	76.70%	4.870	0.027
≥ 5 × 109/L	194	44.8%			59.30%
NLR
< 5	238	50.1%	6.060	0.014	64.70%	4.754	0.029
≥ 5	17	25.0%			43.80%
PLR
< 150	134	55.6%	11.095	0.004	71.20%	11.772	0.003
150-300	105	43.0%			57.20%
> 300	15	20.0%			33.30%
Fibrinogen (g/L)
< 2.61	74	77.0%	26.717	0.000	87.20%	20.255	0.000
≥ 2.61	181	36.9%			53.60%

DFS: Disease-free survival; OS: Overall survival; BMI: Body mass index; TNM: Tumor-node-metastasis; CEA: Carcinoembryonic antigen; AFP: Alpha-fetoprotein; mGPS: Modified Glasgow prognostic scores; WBC: White blood cell; NLR: Neutrophil-lymphocyte ratio; PLR: Platelet-lymphocyte ratio.

Table 3 Cox proportional hazards model analyses for overall survival and disease-free survival

Parameters	5-yr OS			5-yr DFS
	Pvalue	RR	95%CI	Pvalue	RR	95%CI
PLR	0.330	0.825	0.560-1.215	0.274	0.835	0.604-1.154
NLR	0.262	1.541	0.724-3.282	0.109	1.701	0.889-3.255
WBC count	0.384	1.318	0.708-2.452	0.547	1.161	0.715-1.886
AFP	0.002	2.583	1.406-4.744	0.008	2.111	1.218-3.656
CEA	0.010	1.779	1.146-2.762	0.002	1.762	1.223-2.539
Vascular invasion	0.456	1.359	0.606-3.047	0.528	1.260	0.614-2.585
Fibrinogen	0.001	3.324	1.620-6.821	0.000	2.940	1.707-5.064
BMI	0.401	0.888	0.674-1.171	-	-	-
TNM	0.000	2.583	1.704-3.916	0.000	2.405	1.722-3.360
Grade	0.538	0.851	0.511-1.420	0.892	0.970	0.629-1.497
mGPS	0.000	2.968	2.137-4.122	0.000	2.400	1.799-3.201

RR: Relative risk; CI: Confidence interval; PLR: Platelet-lymphocyte ratio; NLR: Neutrophil-lymphocyte ratio; WBC: White blood cell; AFP: Alpha-fetoprotein; CEA: Carcinoembryonic antigen; BMI: Body mass index; TNM: Tumor-node-metastasis; mGPS: Modified Glasgow prognostic scores.

Table 4 Studies on fibrinogen in different malignancies

Ref.	Country	n	Pre-therapeutic plasma fibrinogen (g/L)	Cancer type	PrognosisDFS/OS
Takeuchi et al[1] (2007)	Japan	105	3.86 ± 1.02	Esophageal cancer	No, neither
Polterauer et al[2] (2009)	Austria	313	4.17 ± 1.30	Cervical cancer	Yes, both
Polterauer et al[3] (2009)	Austria	422	4.50 ± 1.50	Ovarian cancer	Yes, both
Ghezzi et al[4] (2010)	Italy	336	hyper: 40.8%	Endometrial cancer	Yes, both
Zhao et al[5] (2012)	China	160	4.72 ± 1.46	Non-small cell lung cancer	DFS, no; OS, yes
Son et al[6] (2013)	South Korea	624	3.25 ± 0.88	Non-metastatic colon cancer	Yes, both
Zhu et al[7] (2013)	China	275	3.92 (0.68-9.80)	Non-small cell lung cancer	Yes, both

DFS: Disease-free survival; OS: Overall survival.