期刊
EJSO
卷 44, 期 10, 页码 1494-1503出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.ejso.2018.07.052
关键词
Cancer; Prognosis; D-dimer; Fibrinogen
资金
- National Natural Science Foundation of China from China [81660498]
- Guangxi Natural Science Foundation from China [2016GXNSFBA380090, 2015GXNSFAA139128]
- Basic Ability Enhancement Program for Young and Middle-age Teachers of Guangxi from China [2017KY0120]
- Guangxi Medical and Health Appropriate Technology Development and Application Project from China [52017101, S2016 34]
- Key Research and Development project of Guangxi from China [Guike AB16380215]
- Project of Nanning Scientific Research and Technology Development Plan from China [20183040-2]
- China Scholarship Council from China [201608455001, 201708455059]
- Guangxi Medical University Training Program for Distinguished Young Scholars from China
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. (C) 2018 The Author(s). Published by Elsevier Ltd.
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