J Cancer 2018; 9(21):3904-3911. doi:10.7150/jca.26360
Prognostic Value of Plasma Fibrinogen in Lung Cancer Patients: A Meta-Analysis
Department of Respiration, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China.
Zhong H, Qian Y, Fang S, Wang Y, Tang Y, Gu W. Prognostic Value of Plasma Fibrinogen in Lung Cancer Patients: A Meta-Analysis. J Cancer 2018; 9(21):3904-3911. doi:10.7150/jca.26360. Available from https://www.jcancer.org/v09p3904.htm
Background: The prognostic role of plasma fibrinogen in lung cancer remains controversial. The aim of this meta-analysis was to assess the prognostic value of plasma fibrinogen in lung cancer.
Methods: We performed a systematic literature search to identify eligible studies in PubMed, Embase and the Cochrane Library database. The hazard ratios (HR) and their 95% confidence intervals (CI) were collected from these eligible studies and were used to assess the relationship between plasma fibrinogen and lung cancer.
Results: A total of 16 studies including 6,881 patients were selected in this meta-analysis. The results showed that elevated plasma fibrinogen in lung cancer patients was correlated with poor overall survival (OS) (HR = 1.38, 95% CI: 1.22-1.55, P < 0.001) and disease-free survival (DFS) / progress-free survival (PFS). (HR = 1.29, 95% CI: 1.01-1.65, P = 0.042). When stratified by cut-off value for OS and DFS/PFS, there was no significant heterogeneity. And the results of “cut-off value ≥ 400mg/dl” group showed that the high level of fibrinogen in serum was associated with worse OS and DFS/PFS of lung cancer. In further subgroup analysis by tumor histology, high plasma fibrinogen was also associated with worse OS in non-small cell lung cancer (NSCLC) (HR = 1.32, 95% CI: 1.14-1.53, P < 0.001). However, there was no significant association between high plasma fibrinogen and poor DFS in NSCLC patients (HR = 1.24, 95% CI: 0.97-1.57, P = 0.08). The Egger's regression test indicated evidence of publication bias for DFS/PFS.
Conclusions: Elevated plasma fibrinogen, particularly defined as a plasma fibrinogen concentration of ≥ 400mg/dl, could be a promising indicator for worse OS in lung cancer patients, including NSCLC.
Keywords: Fibrinogen, Lung cancer, Non-small cell lung cancer, Prognosis, Meta-analysis