title: Clinical and Prognostic Significance of Preoperative Plasma Fibrinogen Levels in Patients with Operable Breast Cancer.
abstract: OBJECTIVE
  Elevated plasma fibrinogen levels are associated with tumor progression and poor outcomes in different cancer patients. The objective of this study was to investigate the clinical and prognostic value of preoperative plasma fibrinogen levels in patients with operable breast cancer.
  
  
  METHODS
  Two hundred and twenty-three patients diagnosed with breast cancer were retrospectively evaluated in this study. Plasma fibrinogen levels were examined before treatment and analyzed along with patient clinicopathological parameters, disease-free survival (DFS) and overall survival (OS). Both univariate and multivariate analyses were performed to identify the clinicopathological parameters associated with DFS and OS.
  
  
  RESULTS
  Elevated preoperative plasma fibrinogen levels were directly associated with age of diagnose (≤47 vs. >47, p<0.001), menopause (yes vs. no, p<0.001), tumor size (T1&T2 vs. T3&T4, p = 0.033), tumor stage (I vs. II vs. III, p = 0.034) and lymph node involvement (N = 0 vs. 1≤N≤3 vs. N≥4, p<0.001), but not with histological grade, molecular type and other Immunohistochemical parameters (ER, PR, HER2 and Ki-67). In a univariate survival analysis, tumor stage, tumor size, lymph node involvement (p<0.001/p<0.001) and plasma fibrinogen (p<0.001/p<0.001) levels were associated with disease-free and overall survival, but just lymph nodes involvement (p<0.001, hazard ratio [HR] = 2.9, 95% confidence interval [CI] = 1.6-5.3/p = 0.006, HR = 3.2, 95% CI = 1.4-7.3) and plasma fibrinogen levels (p = 0.006, HR = 3.4, 95% CI = 1.4-8.3/p = 0.002, HR = 10.1, 95% CI = 2.3-44.6) were associated with disease-free and overall survival in a multivariate survival analysis, respectively.
  
  
  CONCLUSIONS
  This study demonstrates that elevated preoperative plasma fibrinogen levels are associated with breast cancer progression and are independently associated with a poor prognosis in patients with operable breast cancer.
authors.affiliation: Department of Breast Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, PR China.|Department of Breast Surgery, Jinan Maternity and Child Care Hospital, Jinan, Shandong, PR China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Mei
authors.affiliation: Department of Breast Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, PR China.
authors.forename: Song
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of General Surgery, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, PR China.
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Lu
authors.affiliation: Department of Pathology, Jinan Maternity and Child Care Hospital, Jinan, Shandong, PR China.
authors.forename: Haixia
authors.initials: H
authors.lastname: Liu
authors.affiliation: School of Public Health, Shandong University, Jinan, Shandong, PR China.
authors.forename: Xiangyi
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Breast Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, PR China.
authors.forename: Rong
authors.initials: R
authors.lastname: Ma
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001943:Breast Neoplasms / Q000097:blood / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D008875:Middle Aged; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D014408:Biomarkers, Tumor; D005340:Fibrinogen