Yan Lin1, Zhihui Liu1, Yufen Qiu2, Jinyan Zhang1, Huini Wu3, Rong Liang1, Guoying Chen4, Gang Qin4, Yongqiang Li5, Donghua Zou6. 1. Department of Medical Oncology of Gastroenterology, Affiliated Tumor Hospital of Guangxi Medical University, No. 71 Hedi Road, Nanning, Guangxi, 530021, People's Republic of China. 2. Maternal and Child Health Hospital and Obstetrics and Gynecology Hospital of Guangxi Zhuang Autonomous Region, Guangxi, People's Republic of China. 3. Department of Biological Sciences, University of Illinois at Chicago, Chicago, IL, 60607, USA. 4. The Fifth Affiliated Hospital of Guangxi Medical University, No. 89 Qixing Road, Nanning, Guangxi, 530022, People's Republic of China. 5. Department of Medical Oncology of Gastroenterology, Affiliated Tumor Hospital of Guangxi Medical University, No. 71 Hedi Road, Nanning, Guangxi, 530021, People's Republic of China. Electronic address: lyq702702@126.com. 6. The Fifth Affiliated Hospital of Guangxi Medical University, No. 89 Qixing Road, Nanning, Guangxi, 530022, People's Republic of China. Electronic address: danvor0922@hotmail.com.
Abstract
BACKGROUND: Abnormalities of coagulation and fibrinolysis are frequently observed in cancer patients. Emerging data suggested that plasma D-dimer and fibrinogen levels correlated with tumor stage and prognosis in several cancer types. The aim of this study is to systematically review the prognostic value of plasma D-dimer and fibrinogen in digestive cancers. MATERIALS AND METHODS: We searched major database for manuscripts reporting the effect of pretreatment plasma d-dimer or fibrinogen on survival of digestive cancer patients. Revman5.3 and R were the software used for analysis. Pooled multivariable-adjusted hazard ratios (HR) for overall survival (OS) were calculated in all patients and many different subgroup analyses by stratifying on metastasis stage, tumor type, ethnicity, cutoff points and average age. RESULTS: 37 original studies were included for analysis. Increased levels of plasma D-dimer showed stronger association with worse OS than fibrinogen in digestive cancer (HR = 2.06, 95% CI 1.79-2.38; HR = 1.60, 95% CI 1.44-1.79). The highest adverse impacts of elevated plasma D-dimer and fibrinogen on OS were revealed in colorectal cancer (HR = 2.32, 95% CI 1.89-2.85; HR = 2.20, 95% CI 1.24-3.90). The negative prognostic effects of high plasma D-dimer enhanced in metastatic patients when compared with non-metastatic digestive cancer patients, while high plasma D-dimer was more predictive non-metastatic patients. CONCLUSIONS: Both of pretreatment plasma D-dimer and fibrinogen were robust predictors of poor survival in digestive cancer patients with different traits. Further studies are warranted to verify their roles on cancer prognosis.
BACKGROUND:Abnormalities of coagulation and fibrinolysis are frequently observed in cancerpatients. Emerging data suggested that plasma D-dimer and fibrinogen levels correlated with tumor stage and prognosis in several cancer types. The aim of this study is to systematically review the prognostic value of plasma D-dimer and fibrinogen in digestive cancers. MATERIALS AND METHODS: We searched major database for manuscripts reporting the effect of pretreatment plasma d-dimer or fibrinogen on survival of digestive cancerpatients. Revman5.3 and R were the software used for analysis. Pooled multivariable-adjusted hazard ratios (HR) for overall survival (OS) were calculated in all patients and many different subgroup analyses by stratifying on metastasis stage, tumor type, ethnicity, cutoff points and average age. RESULTS: 37 original studies were included for analysis. Increased levels of plasma D-dimer showed stronger association with worse OS than fibrinogen in digestive cancer (HR = 2.06, 95% CI 1.79-2.38; HR = 1.60, 95% CI 1.44-1.79). The highest adverse impacts of elevated plasma D-dimer and fibrinogen on OS were revealed in colorectal cancer (HR = 2.32, 95% CI 1.89-2.85; HR = 2.20, 95% CI 1.24-3.90). The negative prognostic effects of high plasma D-dimer enhanced in metastatic patients when compared with non-metastatic digestive cancerpatients, while high plasma D-dimer was more predictive non-metastatic patients. CONCLUSIONS: Both of pretreatment plasma D-dimer and fibrinogen were robust predictors of poor survival in digestive cancerpatients with different traits. Further studies are warranted to verify their roles on cancer prognosis.