J Gastric Cancer.  2012 Jun;12(2):81-87.

Preoperative Plasma Fibrinogen Level Is a Useful Predictor of Adjacent Organ Involvement in Patients with Advanced Gastric Cancer

• Lee SE
• Lee JH
• Ryu KW
• Nam BH
• Cho SJ
• Lee JY
• Kim CG
• Choi IJ
• Kook MC
• Park SR
• Kim YW

Abstract

PURPOSE
The aim of the present study was to assess the association between the pre-operative plasma fibrinogen level and the adjacent organ involvement in advanced gastric cancer.
MATERIALS AND METHODS
A total of 923 pre-operative plasma samples were obtained from 923 patients diagnosed clinically as having advanced gastric cancer, and fibrinogen levels were measured by immunoassay. Associations between fibrinogen levels and clinicopathologic findings (depth of tumor, adjacent organ involvement, and lymph node metastasis), along with survival were examined by univariate and multivariate analyses.
RESULTS
Tumor size, tumor depth, and the presence of lymph node metastasis were found to be positively correlated with the preoperative plasma fibrinogen levels (P<0.001). Fifty (5.4%) patients had adjacent organ involvement. Lymphatic invasion (P<0.001), tumor size (P<0.001), clinical T (depth of invasion) stage (P<0.001), and clinical nodal stage (P=0.018) were found to be associated with adjacent organ involvement. Univariate and multivariate regression analyses showed that a preoperatively elevated plasma fibrinogen level was associated with adjacent organ involvement (P<0.001, 0.028), and Kaplan-Meier analysis showed that it was associated with poorer survival (P<0.001).
CONCLUSIONS
Plasma fibrinogen was found to be a clinically useful marker of adjacent organ involvement and overall survival. When a high fibrinogen level is encountered, preoperatively, adjacent organ involvement should be suspected in clinically advanced gastric cancer.

Keyword

Fibrinogen; Gastrectomy

MeSH Terms

Fibrinogen
Gastrectomy
Humans
Immunoassay
Kaplan-Meier Estimate
Lymph Nodes
Neoplasm Metastasis
Plasma
Stomach Neoplasms
Fibrinogen

Figure

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  Fig. 1 Receiver operating characteristics curve for plasma fibrinogen and adjacent organ involvement.

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  Fig. 2 The relation between overall survival and pre-operative fibrinogen level.

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