J Korean Med Sci.  2014 Apr;29(4):507-511. 10.3346/jkms.2014.29.4.507.

Prognostic Significance of Initial Platelet Counts and Fibrinogen Level in Advanced Non-Small Cell Lung Cancer

• Kim KH
• Park TY
• Lee JY
• Lee SM
• Yim JJ
• Yoo CG
• Kim YW
• Han SK
• Yang SC

• KMID: 1774455
• DOI: http://doi.org/10.3346/jkms.2014.29.4.507

Abstract

Thrombocytosis and coagulation systems activation are commonly associated with disease progression and are suggested poor prognostic factors in patients with malignancies. This study aimed to investigate the prevalence and prognostic significance of thrombocytosis and elevated fibrinogen levels in patients with advanced non-small cell lung cancer (NSCLC). Initial platelet counts and fibrinogen levels were reviewed in 854 patients with histologically proven NSCLC. Thrombocytosis was defined as platelet counts > 450 x 10(9)/L. A serum fibrinogen level > 4.5 g/L was considered high. At the time of diagnosis, initial platelet counts and serum fibrinogen levels were evaluated before treatment. Clinicopathologic data including histological type, tumor, node, metastasis (TNM) stage, performance status, treatment method, and survival time were evaluated. Initial thrombocytosis was found in 6.9% of patients, and elevated fibrinogen levels were found in 55.1% of patients. Patients with thrombocytosis had a significantly poorer prognosis than patients with normal platelet counts (P < 0.001). In multivariate survival analysis, thrombocytosis was an independent prognostic factor (P < 0.001). An elevated serum fibrinogen level was associated with poor prognosis (P < 0.001). In conclusion, initial thrombocytosis and a high fibrinogen level are independent factors for predicting poor prognosis in patients with advanced NSCLC.

Keyword

Carcinoma Non-Small Cell Lung; Prognosis; Thrombocytosis; Fibrinogen

MeSH Terms

Aged
Blood Platelets/*cytology
Carcinoma, Non-Small-Cell Lung/*diagnosis/mortality/pathology
Female
Fibrinogen/*analysis
Humans
Lung Neoplasms/*diagnosis/mortality/pathology
Male
Middle Aged
Neoplasm Staging
Platelet Count
Prognosis
Retrospective Studies
Survival Rate
Thrombocytosis/complications/diagnosis
Fibrinogen

Figure

• 

  Fig. 1 Survival of lung cancer patients after diagnosis (Kaplan-Meier analysis). (A) Stratified to normal and elevated platelet count. (B) Stratified to normal and elevated fibrinogen level. (C) Stratified to normal and elevated platelet count and fibrinogen level.

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