术前外周血纤维蛋白原水平对喉癌预后的影响

doi:10.6040/j.issn.1673-3770.0.2019.530

摘要/Abstract

摘要： 目的探讨术前外周血纤维蛋白原(FIB)水平对喉鳞状细胞癌患者预后的影响。方法回顾性分析南京医科大学第一附属医院458例行初次手术治疗的喉鳞状细胞癌患者的临床资料。根据患者术前的FIB,绘制诊断总体生存期(OS)的受试者工作特征曲线(ROC),确定最佳截断值,从而分为低危组和高危组;并采用卡方检验、Kaplan-Meier单因素分析、Cox风险比例模型多因素分析FIB以及其他临床病理参数与喉癌患者总体生存期的关系。结果 FIB诊断喉癌患者OS的ROC曲线下面积(AUC)为0.67。较高纤维蛋白原水平(>3.12 g/L)与肿瘤分期、甲状软骨板侵袭有明显统计学意义(P<0.001)。单因素分析显示FIB、分型、分期、病理分化程度、甲状软骨板累及、淋巴结转移、年龄与喉鳞状细胞癌患者的OS有关;多因素分析显示FIB、分期与年龄是影响喉鳞状细胞癌患者死亡的独立危险因素。结论术前外周血高FIB水平的喉鳞状细胞癌患者术后OS较短,该指标可作为评估喉癌患者预后的重要指标。

关键词: 喉鳞状细胞癌, 纤维蛋白原, 总体生存期, 预后

Abstract: Objective This study aimed to evaluate the impact of preoperative fibrinogen(FIB)on the prognosis of patients with laryngeal squamous cell carcinoma. Methods The clinical data of 458 patients with laryngeal squamous cell carcinoma who underwent primary surgery in the First Affiliated Hospital of Nanjing Medical University were analyzed retrospectively. On observation of preoperative FIB levels, a receiver operating characteristic curve(ROC)was drawn to determine the FIB threshold, and then the patients were divided into lower and higher groups. Chi-square test, Kaplan-Meier analysis and Cox risk model were used to analyze the relationship between FIB, other clinicopathological parameters and overall survival. Results The area under the ROC curve(AUC)of FIB for overall survival(OS)of patients with laryngeal squamous cell carcinoma was 0.67. Univariate analysis showed that FIB, tumor classification, TNM stages, pathological differentiation, invasion of thyroid cartilage plate, lymph nodes metastasis and age were associated with OS of patients with laryngeal squamous cell carcinoma. Cox regression model identified high FIB level, TNM stages III and IV, and age as independent risk factors for the OS of patients with laryngeal squamous cell carcinoma (P<0.001; P=0.014; P=0.003). Conclusion Patients with laryngeal squamous cell carcinoma and high preoperative FIB levels are more likely to have lower OS. It could be a clinical biomarker for the prognosis of laryngeal squamous cell carcinoma.

Key words: Laryngeal squamous cell carcinoma, Fibrinogen, Overall survival, Prognosis

中图分类号:

R767

陈慧君,宋圣花,董伟达,周涵. 术前外周血纤维蛋白原水平对喉癌预后的影响[J]. 山东大学耳鼻喉眼学报, 2020, 34(2): 110-114.

CHEN Huijun, SONG Shenghua, DONG Weida, ZHOU Han. Prognostic role of preoperative fibrinogen levels in patients with laryngeal squamous cell carcinoma[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(2): 110-114.

参考文献

[1] 黄选兆, 汪吉宝, 孔维佳. 实用耳鼻咽喉头颈外科学[M]. 北京: 人民卫生出版社,2008:488.
[2] Koodziejczyk J, Ponczek MB. The role of fibrinogen, fibrin and fibrin(ogen)degradation products(FDPs)in tumor progression[J]. Contemp Oncol(Pozn), 2013, 17(2): 113-119. doi:10.5114/wo.2013.34611.
[3] Diao DM, Cheng Y, Song YC, et al. D-dimer is an essential accompaniment of circulating tumor cells in gastric cancer[J]. BMC Cancer, 2017, 17(1): 56. doi:10.1186/s12885-016-3043-1.
[4] Yu XF, Hu FL, Yao Q, et al. Serum fibrinogen levels are positively correlated with advanced tumor stage and poor survival in patients with gastric cancer undergoing gastrectomy: a large cohort retrospective study[J]. BMC Cancer, 2016, 16: 480. doi:10.1186/s12885-016-2510-z.
[5] Otten HM, Prins MH. Venous thromboembolism and occult malignancy[J]. Thromb Res, 2001, 102(6): V187-V194. doi:10.1016/s0049-3848(01)00235-3.
[6] Zhu Y, Zhang LH, Zha HR, et al. Stroma-derived fibrinogen-like protein 2 activates cancer-associated fibroblasts to promote tumor growth in lung cancer[J]. Int J Biol Sci, 2017, 13(6): 804-814. doi:10.7150/ijbs.19398.
[7] Liu YL, Lu Q, Liang JW, et al. High plasma fibrinogen is correlated with poor response to trastuzumab treatment in HER2 positive breast cancer[J]. Medicine(Baltimore), 2015, 94(5): e481. doi:10.1097/MD.0000000000000481.
[8] 张礼, 燕锦. 血浆纤维蛋白原在结直肠癌中的研究进展[J]. 肿瘤预防与治疗, 2016, 29(4): 231-234. doi:10.3969/j.issn.1674-0904.2016.04.009.
[9] 陈慧君, 宋圣花, 周涵, 等. 血小板与淋巴细胞比值对喉癌复发的预测价值[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 106-110. doi:10.6040/j.issn.1673-3770.1.2019.018. CHEN Huijun, SONG Shenghua, ZHOU Han, et al. Preoperative platelet-lymphocyte ratio is an independent prognostic factor for laryngeal squamous cell carcinoma[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(3): 106-110. doi:10.6040/j.issn.1673-3770.1.2019.018.
[10] Kucharczyk J, Sullivan C, Lu J, et al. Prognostic and Predictive Value of Pretreatment Derived Neutrophil-to-Lymphocyte Ratio in Non-Small-Cell Lung Cancer Patients Treated with an Immune Checkpoint Inhibitor[J]. J Cancer Ther, 2018, 9(1): 23-34. doi:10.4236/jct.2018.91004.
[11] Lin Y, Liu Z, Qiu Y, et al. Clinical significance of plasma D-dimer and fibrinogen in digestive cancer: A systematic review and meta-analysis[J]. European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 2018,44(10):1494-1503. doi: 10.1016/j.ejso.2018.07.052.
[12] Grafetstatter M, Husing A, Gonzalez Maldonado S, et al. Plasma Fibrinogen and sP-Selectin are Associated with the Risk of Lung Cancer in a Prospective Study[J]. Cancer epidemiology, biomarkers & prevention. 2019,28(7):1221-1227. doi:10.1158/1055-9965.EPI-18-1285.
[13] Sahni A, Simpson-Haidaris PJ, Sahni SK, et al. Fibrinogen synthesized by cancer cells augments the proliferative effect of fibroblast growth factor-2(FGF-2)[J].J Thromb Haemost, 2008, 6(1): 176-183. doi:10.1111/j.1538-7836.2007.02808.x.

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