Clinical Research Papers:

Plasma fibrinogen levels are correlated with postoperative distant metastasis and prognosis in esophageal squamous cell carcinoma

Danhong Zhang, Xia Zhou, Wuan Bao, Ying Chen, Lei Cheng, Guoqin Qiu, Liming Sheng, Yongling Ji _ and Xianghui Du

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Oncotarget. 2015; 6:38410-38420. https://doi.org/10.18632/oncotarget.4800

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Danhong Zhang1,2, Xia Zhou1,2, Wuan Bao1,2, Ying Chen1,2, Lei Cheng1,2, Guoqin Qiu1,2, Liming Sheng1,2, Yongling Ji1,2, Xianghui Du1,2

1Department of Radiotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China

2Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Zhejiang, China

Correspondence to:

Yongling Ji, e-mail: [email protected]

Xianghui Du, e-mail: [email protected]

Keywords: esophageal squamous cell carcinoma, fibrinogen, metastasis, prognosis

Received: March 21, 2015     Accepted: July 23, 2015     Published: August 04, 2015


This study investigated the correlation of preoperative plasma fibrinogen level with distant metastasis and prognosis in esophageal squamous cell carcinoma (ESCC). A total of 255 patients with ESCC who underwent surgery in Zhejiang cancer hospital (Hangzhou, China), between October 2006 and December 2009, were evaluated in this retrospective study. Population controls were selected from a pool of cancer-free subjects in the same region. Each patient and cancer-free people provided 3-mL pretreatment blood. Plasma fibrinogen level was measured by the Clauss method. The effects of hyperfibrinogenemia on locoregional relapse-free survival (LRFS), distant metastasis-free survival (DMFS), relapse-free survival (RFS), and overall survival (OS) were assessed using Kaplan-Meier analysis. Independent prognostic factors were identified in the multivariate Cox analysis. The proportion of hyperfibrinogenemia was higher in ESCC patients than those in controls (40.4% vs 13.6%). Subjects with hyperfibrinogenemia had a significantly higher risk of ESCC than those with normal plasma fibrinogen level (adjust OR = 4.61; 95% CI = 3.02–7.01, P < 0.001) after adjusted for age, sex and smoking status. The Kaplan-Meier curves showed that patients with hyperfibrinogenemia had worse DMFS, RFS and OS (P < 0.001). Tumor length, lymph node metastasis and plasma fibrinogen level were independent prognostic factors of ESCC (P < 0.05). Increased plasma fibrinogen level was significantly associated with elevated risk of ESCC. Preoperative plasma fibrinogen level was a predictor of distant metastasis and independently associated with prognosis of patients with ESCC.

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