title: Pretreatment plasma fibrinogen level correlates with tumor progression and metastasis in patients with squamous cell carcinoma of the esophagus.
abstract: BACKGROUND
  Hypercoagulation has been reported to be associated with tumor progression and a poor prognosis in various carcinomas. In this study, we examined fibrinogen levels in pretreated patients with esophageal squamous cell carcinoma (ESCC) and assessed its correlation with clinicopathological factors and prognosis in patients with ESCC.
  
  
  METHODS
  Pretreatment fibrinogen levels were examined prior to surgery or other treatments (e.g. endoscopic mucosal resection and chemoradiotherapy [CRT]) in 105 patients with primary ESCC. We investigated the association of fibrinogen levels with clinicopathological background factors and the survival of ESCC patients.
  
  
  RESULTS
  The plasma fibrinogen concentration (PFC) ranged from 209.4 to 781.6 mg/dL. Pretreatment PFC correlated significantly with the depth of invasion (T factor). There also existed a significant correlation between higher fibrinogen levels and lymph node metastasis (N factor) and distant organ metastasis. Patients with a higher fibrinogen level experienced a significantly worse overall survival (P = 0.006). Fibrinogen levels strongly correlated with platelet counts, white blood cell counts and tumor length. Pretreatment PFC were observed to have a significant correlation with CRT responsiveness in ESCC patients in stages II and III (P = 0.005).
  
  
  CONCLUSIONS
  This study revealed that higher levels of fibrinogen correlated with tumor progression, metastasis and poor responsiveness to CRT in ESCC patients.
authors.affiliation: Department of Surgery, National Tokyo Medical Center, Meguro-ku, Tokyo, Japan. hiroyatakeuchi@aol.com
authors.forename: Hiroya
authors.initials: H
authors.lastname: Takeuchi
authors.forename: Shunji
authors.initials: S
authors.lastname: Ikeuchi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shimada
authors.forename: Takashi
authors.initials: T
authors.lastname: Oishi
authors.forename: Yoh
authors.initials: Y
authors.lastname: Isobe
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kubochi
authors.forename: Masaki
authors.initials: M
authors.lastname: Kitajima
authors.forename: Sumio
authors.initials: S
authors.lastname: Matsumoto
mesh_terms: D000328:Adult; D000368:Aged; D001772:Blood Cell Count; D002294:Carcinoma, Squamous Cell / Q000097:blood* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012044:Regression Analysis; D015996:Survival Rate
chemical_list: D005340:Fibrinogen