Abstract
PurposeElevated 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.MethodsTwo 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.ResultsElevated 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 (Ⅰvs.Ⅱvs.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.ConclusionsThis 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.
Highlights
Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females worldwide, with an estimated 1.7 million cases and 521,900 deaths in 2012, It alone accounts for 25% of all cancer cases and 15% of all cancer deaths among females[1]
Elevated preoperative plasma fibrinogen levels were directly associated with age of diagnose (47 vs. >47, p
In a univariate survival analysis, tumor stage, tumor size, lymph node involvement (p
Summary
Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females worldwide, with an estimated 1.7 million cases and 521,900 deaths in 2012, It alone accounts for 25% of all cancer cases and 15% of all cancer deaths among females[1]. The lack of better adjuvant therapy is still the main cause of death in patients with recurrence and metastasis of breast cancer. The tumor, node, and metastasis (TNM) staging system of the American Joint Committee on Cancer (AJCC) has been broadly recognized, and the plasma cancer antigen 15–3 level has conventionally become a simple and clinically useful method for routine surveillance, diagnosis, and the evaluation of prognosis, but the worldwide recognized system or marker for preoperatively predicting the prognosis of patients with breast cancer is uncertain. A biological characteristics that can predict recurrence and metastasis is very important for patients with operable breast cancer, maybe it can develop the treatment plans of breast cancer
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