Prognostic value of plasma fibrinogen in hepatocellular carcinoma: a meta-analysis.
Prognostic value of plasma fibrinogen in hepatocellular carcinoma: a meta-analysis.
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血浆纤维蛋白原在肝细胞癌中的预后价值：荟萃分析
DOI：
10.2147/cmar.s175780
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发表时间：
2018
影响因子：
3.3
通讯作者：
Zhou X
中科院分区：
文献类型：
--
作者：
Huang G;Jiang H;Lin Y;Wu Y;Cai W;Shi B;Luo Y;Jian Z;Zhou X
血浆纤维蛋白原水平升高与几种恶性肿瘤的进展有关。本研究旨在探讨肝细胞癌患者血浆纤维蛋白原水平升高的临床意义。材料与方法在PubMed、Embase和Web of Science等电子数据库中系统检索相关文献。HCC组、HCC组和对照组之间血浆纤维蛋白原水平的汇总差异表示为加权平均差异（WMD）及其相应的95% CI。纤维蛋白原升高与总生存期（OS）和无病生存期（DFS）/无复发生存期（RFS）的关系用HR及其95% CI表示，而纤维蛋白原升高与HCC患者各种临床特征的关系用OR及其95% CI表示。结果肝细胞癌患者血浆纤维蛋白原水平与健康对照组（WMD = 0.50，95%CI = [-0.82，1.82]，P = 0.457）和肝硬化患者（WMD =-0.62，95%CI = [-1.56，0.33]，P = 0.200）比较差异无统计学意义。然而，我们的研究结果显示，与血浆纤维蛋白原水平正常的患者相比，血浆纤维蛋白原水平升高的HCC患者的OS（HR = 2.08，95% CI = [1.67，2.59]，P < 0.0001）和DFS/RFS（HR = 1.90，95% CI = [1.52，2.37]，P < 0.0001）较差。OS的试验序贯分析结果表明，目前可用的研究足以验证HCC患者血浆纤维蛋白原升高的负面预后价值。临床病理学分析表明，高血浆纤维蛋白原水平与肿瘤进展相关，如晚期肿瘤分期，肿瘤大小，肿瘤数量增加，血管浸润的存在。结论血浆纤维蛋白原水平升高与恶性肿瘤预后不良及进展密切相关。血浆纤维蛋白原可能作为HCC患者的阴性预后生物标志物。
Background Elevated plasma fibrinogen levels have been associated with tumor progression in several malignancies. Our study aims to characterize the clinical significance of elevated plasma fibrinogen levels in patients with hepatocellular carcinoma (HCC). Materials and methods Relevant published articles were systematically searched in electronic databases including PubMed, Embase, and Web of Science. The pooled differences in plasma fibrinogen levels among HCC, cirrhotic, and control groups were expressed as weighted mean differences (WMDs) and their corresponding 95% CIs. The associations between elevated fibrinogen and overall survival (OS) and disease-free survival (DFS)/recurrence-free survival (RFS) were expressed as HRs and their 95% CIs, whereas the associations between elevated fibrinogen and various types of clinical characteristic of patients with HCC were expressed as ORs and their corresponding 95% CIs. Results Results showed that the plasma fibrinogen levels in patients with HCC were not significantly different than that in healthy controls (WMD = 0.50, 95% CI = [−0.82, 1.82], P = 0.457) or patients with cirrhosis (WMD = −0.62, 95% CI = [−1.56, 0.33], P = 0.200). However, our results showed that compared to those with normal levels, patients with HCC and elevated plasma fibrinogen levels showed poorer OS (HR = 2.08, 95% CI = [1.67, 2.59], P < 0.0001) and DFS/RFS (HR = 1.90, 95% CI = [1.52, 2.37], P < 0.0001). Results of trial sequential analysis of the OS indicated that currently available studies were sufficient to validate the negative prognostic value of elevated plasma fibrinogen in patients with HCC. Clinicopathological analyses showed that high plasma fibrinogen levels were associated with tumor progression as indicated by advanced tumor stage, larger tumor size, increased tumor number, and the presence of vascular invasion. Conclusion Elevated plasma fibrinogen levels are associated with poor prognosis and advanced tumor progression. Plasma fibrinogen may serve as a negative prognostic biomarker in patients with HCC.