title: Plasma fibrinogen levels in patients with benign and malignant ovarian tumors.
abstract: OBJECTIVE
  Plasma fibrinogen is a key acute phase protein and known to be elevated in ovarian cancer. We aimed to investigate the association between plasma fibrinogen and malignant and benign ovarian tumors.
  
  
  METHODS
  In a retrospective, single-center study, we evaluated preoperative plasma fibrinogen levels in 471 patients with benign and in 224 patients with malignant (borderline ovarian tumor [BOT]: n=36, epithelial ovarian cancer [EOC]: n=188) ovarian tumors. The association between preoperative plasma fibrinogen levels and clinico-pathological parameters was investigated. A multivariate logistic regression model was performed to identify an independent association.
  
  
  RESULTS
  Mean (standard deviation) preoperative plasma fibrinogen levels in patients with benign ovarian tumors, BOT, and invasive ovarian cancers were 346.7 (99.7), 372.8 (114), and 472.6 (148.4) mg/dL, respectively (p<0.001). Within the EOC cohort, patients with advanced stage disease had higher plasma fibrinogen levels (485.5 [151.3] mg/dL) than patients with early stage disease (430.9 [130.3] mg/dL; p=0.03). In a multivariate model plasma fibrinogen was identified to be independently associated with the presence of BOT and EOC. In the subgroup of patients <50 years, plasma fibrinogen levels remained independently associated with malignant ovarian tumors in CA 125 positive and negative patients.
  
  
  CONCLUSIONS
  Plasma fibrinogen levels are independently associated with malignant ovarian tumors. Plasma fibrinogen levels showed an independent association with malignant ovarian tumors in the subgroup of patients <50 years, in whom differential diagnosis of ovarian tumors is particularly challenging.
authors.affiliation: Department of Internal Medicine, Hospital of the Sisters of Mercy Linz, Austria. Electronic address: k_hefler@yahoo.com.
authors.forename: Katrin
authors.initials: K
authors.lastname: Hefler-Frischmuth
authors.affiliation: Department of Gynecology, Hospital of the Sisters of Mercy Linz, Austria.
authors.forename: Judith
authors.initials: J
authors.lastname: Lafleur
authors.affiliation: Department of Gynecology, Hospital of the Sisters of Mercy Linz, Austria; Karl Landsteiner Institute of Gynecologic Surgery and Oncology, Linz, Austria.
authors.forename: Lukas
authors.initials: L
authors.lastname: Hefler
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Austria.
authors.forename: Stephan
authors.initials: S
authors.lastname: Polterauer
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Austria.
authors.forename: Veronika
authors.initials: V
authors.lastname: Seebacher
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Reinthaller
authors.affiliation: Department of General Gynecology and Gynecologic Oncology, Gynecologic Cancer Unit, Comprehensive Cancer Center, Medical University of Vienna, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Grimm
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D000077216:Carcinoma, Ovarian Epithelial; D003937:Diagnosis, Differential; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000097:blood / Q000175:diagnosis / Q000473:pathology; D010051:Ovarian Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D005340:Fibrinogen
keywords: Benign ovarian tumors; Borderline ovarian tumors; Differential diagnosis; Ovarian cancer; Plasma fibrinogen