| Guangjing Wang,Chengcheng Shi,Xiaofeng Xu,Yuan Zhang,Zhanfa Sun. High level of preoperative serum fibrinogen is a predictor of poor prognosis in patients with esophageal squamous cell carcinoma. Oncol Transl Med, 2020, 6: 228-232. |
| 术前血清纤维蛋白原水平升高是食管鳞癌患者不良预后的预测指标 |
| High level of preoperative serum fibrinogen is a predictor of poor prognosis in patients with esophageal squamous cell carcinoma |
| Received:May 24, 2020 Revised:October 16, 2020 |
| DOI：10.1007/s10330-020-0433-3 |
| 中文关键词: 食管鳞癌；生物标志生物；预后；血清纤维蛋白原 |
| 英文关键词: esophageal squamous cell carcinoma; biomarker; prognosis; serum fibrinogen |
| 基金项目: |
| Author Name | Affiliation | E-mail | | Guangjing Wang* | Department of Cardiothoracic Surgery, Qingdao Municipal Hospital | gjwang123@aliyun.com | | Chengcheng Shi | Department of Cardiothoracic Surgery, Qingdao Municipal Hospital | | | Xiaofeng Xu | Department of Cardiothoracic Surgery, Qingdao Municipal Hospital | | | Yuan Zhang | Department of Cardiothoracic Surgery, Qingdao Municipal Hospital | | | Zhanfa Sun | Department of Cardiothoracic Surgery, Qingdao Municipal Hospital | |
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| 中文摘要: |
| 目的：本研究的目的是探讨术前血清纤维蛋白原水平与可手术的食管鳞癌的病理特征之间的关系，并进一步探讨其对食管鳞癌患者预后的影响。
方法：回顾性分析从2010年1月到2016年12月所有在青岛市市立医院就诊的食管鳞癌患者，所有患者术前均进行了血清纤维蛋白原测定，按照诊断标准，血清纤维蛋白原≥4.0g/l定义为高纤维蛋白原血症。血清纤维蛋白原对食管鳞癌患者无病生存期（disease-free survival, DFS）和总生存期（overall survival, OS）的影响通过Log-rank法和Cox风险回归进行分析。P 值＜0.05可认为具有统计学差异。
结果：最终有336例食管鳞癌患者被纳入本研究进行分析，其中102例患者术前诊断为高纤维蛋白原血症，占比为30.36%。进一步分析得出，高纤维蛋白原血症在年龄大于70岁（P=0.012），病理T分期较晚（P=0.003）以及病理确诊淋巴结转移（P=0.024）的患者中多见。单因素生存分析得出，相较于纤维蛋白原正常的患者，高纤维蛋白原血症的患者无病生存期（1.96年 对比3.64 年, P=0.001）和总生存期（2.27 年 对比 4.15 年, P＜0.001）都较短。多因素分析进一步证实了术前血清纤维蛋白原水平是影响食管鳞癌患者无病生存期(风险比:1.35, 95% 置信区间: 1.02-1.79, P=0.038)和总生存期(风险比:1.37, 95% 置信区间: 1.03-1.83, P=0.034)的独立影响因素。
结论：对于可手术的食管鳞癌患者，术前高纤维蛋白原血症的患者预后较差，血清纤维蛋白原水平是影响食管鳞癌患者术后预后的独立影响因子。 |
| 英文摘要: |
| Objective This study aimed to elucidate the association between the level of preoperative serum
fibrinogen (PSF) and the prognosis of patients with esophageal squamous cell carcinoma (ESCC).
Methods From January 2010 to December 2016, all patients diagnosed with ESCC who underwent
surgery in Qingdao Municipal Hospital were analyzed retrospectively. Moreover, the fibrinogen levels of all
patients were assessed before surgery, and hyperfibrinogenemia was diagnosed when the fibrinogen level
was ≥4.0 g/L. The impact of PSF on disease-free survival (DFS) and overall survival (OS) was analyzed
using the log-rank method and Cox proportional hazards regression model. P value less than 0.05 was
considered statistically significant.
Results A total of 336 patients were finally analyzed, and approximately 102 patients (30.36%) were
diagnosed with hyperfibrinogenemia before surgery. Hyperfibrinogenemia was associated with older age (≥
70 years) (P = 0.012), advanced pathological T stage (P = 0.003), and lymph node involvement (P = 0.024).
Univariate analysis showed that patients with hyperfibrinogenemia had shorter DFS (1.96 years vs. 3.64
years, P = 0.001) and OS (2.27 years vs. 4.15 years, P < 0.001) than patients without hyperfibrinogenemia.
Multivariate analysis confirmed that PSF was an independent factor affecting DFS (risk ratio [RR]: 1.35,
95% confidence interval [CI]: 1.02–1.79, P = 0.038) and OS (RR: 1.37, 95% CI: 1.03–1.83, P = 0.034) in
patients with ESCC.
Conclusion For patients with operable ESCC, hyperfibrinogenemia had poor prognosis. Moreover, PSF
is an independent prognostic factor for operable ESCC. |
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