Hyperfibrinogen Is Associated With the Systemic Inflammatory Response and Predicts Poor Prognosis in Advanced Pancreatic Cancer.
OBJECTIVE
The aim of this study was to examine the prognostic prediction value of plasma fibrinogen level for overall survival (OS) in patients with advanced pancreatic cancer.


METHODS
A total of 321 patients with locally advanced or metastatic pancreatic adenocarcinoma were retrospectively recruited. The association between plasma fibrinogen level and OS was analyzed. We also evaluated the relationship between plasma fibrinogen level and the systemic inflammatory response markers: the neutrophil-lymphocyte ratio, platelets/lymphocyte ratio, and lymphocyte/monocyte ratio.


RESULTS
High plasma fibrinogen levels were significantly correlated with shorter OS in patients with advanced pancreatic cancer (175 days for patients with high fibrinogen levels vs 357 days for patients with low fibrinogen levels; log rank, 22.949; P < 0.001). Multivariate analyses confirmed that plasma fibrinogen level was an independent prognostic predictor for OS (hazard ratio, 2.184; 95% confidence interval, 1.574-3.032; P < 0.001). Receiver operating characteristic analyses showed that including plasma fibrinogen level alongside traditional factors (tumor stage and CA 19-9) significantly improved prognostic prediction capability (traditional model area under the curve of 0.62 versus combined model area under the curve of 0.708; P = 0.016). In addition, plasma fibrinogen level was positively correlated with neutrophil-lymphocyte ratio and platelets/lymphocyte ratio and negatively correlated with lymphocyte/monocyte ratio.


CONCLUSIONS
Hyperfibrinogen is associated with the systemic inflammatory response and predicts poor prognosis for advanced pancreatic cancer.
From the *Department of Integrative Oncology, Shanghai Cancer Center, †Department of Oncology, Shanghai Medical College, and ‡Department of Pathology, Shanghai Cancer Center, Fudan University Shanghai, China.
Qi
Q
Qi
Yawen
Y
Geng
Menghong
M
Sun
Hao
H
Chen
Peng
P
Wang
Zhen
Z
Chen
D000230:Adenocarcinoma / Q000097:blood* / Q000401:mortality / Q000556:secondary; D000368:Aged; D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood*; D001792:Blood Platelets; D018395:CA-19-9 Antigen / Q000097:blood; D016009:Chi-Square Distribution; D003661:Decision Support Techniques; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D053208:Kaplan-Meier Estimate; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009504:Neutrophils; D016017:Odds Ratio; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology; D010976:Platelet Count; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D013997:Time Factors; D015854:Up-Regulation
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D005340:Fibrinogen