A retrospective discussion of the prognostic value of combining prothrombin time(PT) and fibrinogen(Fbg) in patients with Hepatocellular carcinoma.
A retrospective discussion of the prognostic value of combining prothrombin time(PT) and fibrinogen(Fbg) in patients with Hepatocellular carcinoma.
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DOI：
10.7150/jca.19181
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发表时间：
2017
影响因子：
3.9
通讯作者：
Liu WL
中科院分区：
文献类型：
--
作者：
Wang XP;Mao MJ;He ZL;Zhang L;Chi PD;Su JR;Dai SQ;Liu WL
目的：研究了各种癌症中凝血系统试验的水平。在这项研究中，我们的目的是评估肝细胞癌（HCC）患者预处理血浆凝固试验的预后价值。患者和方法：对539例HCC患者进行回顾性研究，随访至少60个月，直至复发或死亡。采用单因素和多因素考克斯风险模型分析凝血系统检测指标（凝血酶原时间、活化部分凝血活酶时间、凝血酶时间、纤维蛋白原）的预后意义。然后，根据多因素分析的结果，我们提出了基于凝血的阶段，它结合了独立的危险因素（凝血酶原时间和纤维蛋白原）。结果如下：分析凝血系统指标：凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、凝血酶时间（TT）、纤维蛋白原（Fbg）。PT延长的患者（≥12.1秒）水平具有显著较差的总生存期（OS）和无病生存期（DFS），不仅在整个队列中（HR：1.661，95%CI：1.125-2.451，p=0.011 vs. HR：1.660，95%CI：1.125-2.451，p=0.011），而且在按病理分期（I-II期和III-IV期）分层的亚组中也是如此。此外，高FBG（≥2.83 g/L）水平显著降低OS和DFS（HR：2.158，95%CI：1.427-3.263，p<0.001 vs. HR：2.161，95%CI：1.429-3.267，p<0.001），不仅在整个队列中，而且在按病理分期（I-II期和III-IV期）分层的亚组中。根据PT和Fbg的联合评分将所有患者分为3组，HCC患者的OS分别为（41.37±17.76）、（31.83±19.84）和（18.68±18.41）个月，DFS分别为（41.15±17.88）、（31.65±19.81）和（18.66±18.39）个月。结论：我们的研究结果表明，血浆PT和Fbg水平的组合应被评估为HCC患者生存的有价值的预测因子。
Aims: The levels of coagulation system tests have been studied in various cancers. In this study, our aim is to evaluate the prognostic value of pretreatment plasma coagulation tests in hepatocellular carcinoma (HCC) patients. Patient and methods: A retrospective study was performed in 539 patients with HCC, and follow-up period was at least 60 months until recurrence or death. The prognostic significance of coagulation system tests (prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen) were determined by univariate and multivariate Cox hazard models. Then, according to the results of the multivariate analyses, we proposed the coagulation-Based Stage, which combined the independent risk factors (prothrombin time and fibrinogen). Results: Coagulation system tests including prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (Fbg) were analyzed. Patients with prolonged PT (≥12.1 sec) levels had significantly poor overall survival (OS) and disease-free survival (DFS), not only in the entire cohort (HR: 1.661, 95%CI: 1.125-2.451, p=0.011 vs. HR: 1.660, 95%CI: 1.125-2.451, p=0.011), but also in the subgroups stratified by pathological stage (stage I-II and stage III-IV). Additionally, high Fbg (≥2.83 g/L) levels experienced significantly decreased OS and DFS (HR: 2.158, 95%CI: 1.427-3.263, p<0.001 vs. HR: 2.161, 95%CI: 1.429-3.267, p<0.001), not only in the entire cohort but also in the subgroups stratified by pathological stage (stage I-II and stage III-IV). All the patients were then stratified (based on combined PT and Fbg) into three groups, The OS for HCC patients were (41.37±17.76), (31.83±19.84) and (18.68±18.41) months, and the DFS for HCC patients were (41.15±17.88), (31.65±19.81) and (18.66±18.39) months. Conclusions: Our findings suggest that the combination of plasma PT and Fbg levels should be evaluated as the valuable predictor of survival in patients with HCC.
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作者：
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