纤维蛋白原预测晚期非小细胞肺癌化疗的疗效及预后  

Fibrinogen in predicting the chemotherapy efficacy and prognosis for advanced non-small cell lung cancer

作　　者：赵隽[1] 韩宇[2] 金高娃[1] 李全福[1] Zhao Jun;Han Yu;Jin Gaowa;Li Quanfu(Department of Oneology;Respiratory Medicine,Affiliated Erdos Central Hospital of Inner Mongolia Medical University,Inner Mongolia Erdos 017000,China.)

机构地区：[1]内蒙古医科大学附属鄂尔多斯市中心医院肿瘤内科,内蒙古鄂尔多斯017000 [2]内蒙古医科大学附属鄂尔多斯市中心医院呼吸科,内蒙古鄂尔多斯017000

出　　处：《现代肿瘤医学》2018年第20期3228-3231,共4页Journal of Modern Oncology

摘　　要：目的:探讨纤维蛋白原在晚期非小细胞肺癌(NSCLC)患者中对预测化疗疗效及预后的临床意义。方法:我们回顾性分析了251例晚期非小细胞肺癌患者化疗前后纤维蛋白原水平与临床病理特征、化疗前后纤维蛋白原水平的变化与化疗疗效、化疗前后纤维蛋白原水平变化与不同化疗方案、化疗前纤维蛋白原与预后的关系。结果:男性患者化疗前纤维蛋白原水平高于女性(P=0. 001),ECOG 1分的患者化疗前后纤维蛋白原水平均高于ECOG 0分的患者(P=0. 000、P=0. 002)。化疗前有高纤维蛋白原血症的153例患者化疗后纤维蛋白原水平显著降低(P=0. 004),在这部分人群中,疾病部分缓解(PR)组、疾病稳定(SD)组和疾病进展(PD)组纤维蛋白原水平降低差异有统计学意义(P=0. 001、P=0. 003、P=0. 033)。总体人群化疗前高纤维蛋白原血症患者的纤维蛋白原在PD组明显升高(P=0. 016)。不同化疗方案与纤维蛋白原水平变化不相关(P=0. 545)。高纤维蛋白原组、低纤维蛋白原组的中位PFS分别为142天和204天,中位OS分别为317天和427天,差异有统计学意义(P <0. 001)。而且两组患者中位PFS及中位OS在DP、TP和GP方案组差异有统计学意义。Cox风险比例模型显示,ECOG 1分及纤维蛋白原升高是影响PFS和OS的独立因素。结论:晚期非小细胞肺癌患者纤维蛋白原的变化与化疗疗效相关,高纤维蛋白原水平是预后不良因素。Objective：To analyze fibrinogen role in predicting chemotherapy response and prognosis in patients with advanced non-small cell lung cancer（NSCLC）. Methods ： In this retrospective study, the data from 251 patients with advanced NSCLC were collected. The association between the pre- and post-chemotherapy fibrinogen levels and patient clinical characteristics, or fibrinogen changes and chemotherapeutic response, or pre- chemotherapy fi-brinogen levels and different chemotherapy regimens, or fibrinogen and prognosis were analyzed. Results ：Pre-chemo-therapy plasma fibrinogen levels were correlated with gender（ P = 0. 001 ） and ECOG（ P = 0.000）. Post-chemothera-py plasma fibrinogen levels were correlated with ECOG（P = 0. 002）. Plasma fibrinogen levels markedly decreased af-ter chemotherapy in 153 patients with pre-chemotherapy hypeffibrinogenemia（ P = 0. 004 ） , and in this population there was a significant link between the decrease in fibrinogen level, and initial partial response（ PR, P = 0. 001 ） and stable disease（ SD,P = 0.003） and progressive disase （PD, P = 0. 033 ）. The fibrinogen levels of both total and hy-perfibrinogen population inerese in progressive disease（ PD, P = 0. 016） group. There＇s no stalistical significance be-tween different chemotherapy regimens and changes of fibrinogen levels（ P = 0. 545 ）. Median PFS of high fibrinogen group and low fibrinogen group was 142 days and 204 days（P 〈0.001 ） ,and median OS of them were 317 days and 427 days （P 〈 0.001 ）. In DP, TP and GP groups, patients with hyperfibrinogen had a shorter median PFS and median OS than those without hyperfibrinogen. Cox hazard-ratio model found that ECOG 1 score, fibrinogen were the inde-pendent factors ilfflueneing PFS and OS. Conclusion： Fibrinogen levels is a predictor for response on chemotherapy and prognosis in advanced NSCLC patients.

关 键 词：纤维蛋白原 非小细胞肺癌 化疗疗效 预后 

分 类 号：R734.2[医药卫生—肿瘤]