Abstract
Purpose : To investigate the prognostic implications of plasma fibrinogen and serum C-reactive protein (CRP) levels in tumour resection and survival following successful tumour resection in patients with nonsmall cell lung cancer (NSCLC). Methods : One hundred and fifty-three NSCLC patients who underwent surgical resection at a tertiary care hospital from January 2006 through December 2010 were enrolled. Pre-operative serum CRP and plasma fibrinogen levels were measured. The levels of these biomarkers correlated with tumour size and pathologic TNM stage. The possibility of complete resection and associated findings are reported. Results : Plasma fibrinogen (r = 0.381, p = 0.002) and serum CRP (r = 0.471, p < 0.001) levels were positively associated with tumour diameter. Increased levels of these biomarkers were significantly associated with sex, smoking status, histological type, tumour stage, and clinical stage. Partial tumour resection occurred in 28 % (27/95) of patients with an increased plasma fibrinogen level compared to 10 % (6/58) with a normal fibrinogen level (p = 0.008), and in 30 % (29/97) of patients with an increased serum CRP level compared to 11 % (6/56) with a normal CRP level (p = 0.006). Patients with elevated CRP and fibrinogen concentrations demonstrated higher susceptibility to disease advancement and survival compared to patients with normal fibrinogen and CRP levels. Conclusion : Pre-operative functional concentrations of serum CRP and plasma fibrinogen could serve as indicators of tumour resectability wherein a high tumour resection rate is possible in patients with favourable pre-operative levels of these biomarkers. Increased concentrations of serum CRP and plasma fibrinogen are associated with poor overall survival and progression-free survival. Key words : Plasma fibrinogen, serum C-reactive protein, biomarker, non-small cell lung cancer
Highlights
Lung cancer is the most frequently observed human malignancy worldwide [1]
Tumour resection has been the standard treatment for many years; more than 60 % of Non-small cell lung cancer (NSCLC) patients have metastatic or advanced tumours at initial presentation [2], which precludes surgical resection
The present investigation enrolled 153 patients who were suffering from NSCLC
Summary
Lung cancer is the most frequently observed human malignancy worldwide [1]. The World Health Organisation (WHO) reported that lung cancer causes more than 1.6 million deaths annually; the stated overall 5-year survival rate following diagnosis is approximately15 % [1]. Lung cancer is the most frequently observed human malignancy worldwide [1]. The World Health Organisation (WHO) reported that lung cancer causes more than 1.6 million deaths annually; the stated overall 5-year survival rate following diagnosis is approximately. Tumour resection has been the standard treatment for many years; more than 60 % of NSCLC patients have metastatic or advanced tumours at initial presentation [2], which precludes surgical resection. A difficult-tooperate malignant lung tumour with limited metastasis detected before surgery can be made operable using pre-operative chemotherapy and/or radiotherapy [3]. In patients with inoperable tumours with widespread metastasis, palliative care may be given without surgery.
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