Three hematological indexes that may serve as prognostic indicators in patients with primary, high-grade, appendicular osteosarcoma
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Keqi Hu1,*, Zhan Wang1,*, Peng Lin1,*, Zuojun Wen1, Haiyong Ren2, Lingling Sun1, Hengyuan Li1, Binghao Li1, Shengdong Wang1, Xingzhi Zhou1, Siyuan Tengwang1, Langhai Xu1 and Zhaoming Ye1
1Center for Orthopedic Research, Orthopedics Research Institute of Zhejiang University, Department of Orthopedics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310000, China
2Department of Orthopedics, Tongde Hospital of Zhejiang Province, Hangzhou, 310000, China
*These authors have contributed equally to this work
Zhaoming Ye, email: email@example.com
Keywords: osteosarcoma, prognosis, alkaline phosphatase, lactate dehydrogenase, fibrinogen
Received: December 28, 2016 Accepted: April 19, 2017 Published: May 11, 2017
Background: Although alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) are considered effective prognostic factors of osteosarcoma, useful prognostic biomarkers for patients with osteosarcoma are still lacking.
Methods: A retrospective study of 106 patients with primary, high-grade, appendicular osteosarcoma obtained between 2006 and 2011 was performed to assess the prognostic value of serum ALP, LDH and fibrinogen (FBG) levels, as well as their decrease rates in osteosarcoma. The Kaplan-Meier method was employed to analyze overall survival. The Cox proportional hazard model was used to determine the significance of these prognostic biomarkers on survival distribution.
Results: Patients with pre-ct (before neoadjuvant chemotherapy) LDH>210U/L, post-ct (after neoadjuvant chemotherapy, but before surgery) LDH>215U/L, post-ct FBG>2.8g/L, FBG DR (Decrease Rate)≤10% tended to have a poorer prognosis.
Conclusions: High pre-ct and post-ct peripheral serum LDH level, high serum post-ct FBG level and low decrease rate of serum FBG were related to poor survival in patients with osteosarcoma. Fibrinogen was found to be a new valuable predictor of 5-year survival in patients with osteosarcoma for the first time.
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