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Clinical significance of plasma fibrinogen and D-dimer in predicting the chemotherapy efficacy and prognosis for small cell lung cancer patients

Clinical and Translational Oncology volume 18, pages 178–188 (2016)Cite this article

Abstract

Purpose

Elevated plasma fibrinogen and D-dimer levels indicate activation of hemostasis and fibrinolysis, and this activation is required for tumor angiogenesis, metastasis, and invasion. Previous studies demonstrated that the plasma fibrinogen and D-dimer levels correlate with patient’s prognosis in several solid tumors. The aim of this study is to examine the relationship between plasma fibrinogen and D-dimer levels before and during chemotherapy and treatment response and survival in patients with small cell lung cancer (SCLC).

Methods

Plasma fibrinogen and D-dimer levels before and during chemotherapy were prospectively measured in 74 SCLC patients who received first-line therapy. The results were analyzed for correlation between fibrinogen and D-dimer levels and treatment response, as well as progressive-free survival (PFS) and overall survival (OS).

Results

The levels of fibrinogen and D-dimer in SCLC patients before (C0) and after two cycles (C2) of chemotherapy were significantly higher than those in controls. Fibrinogen and D-dimer levels decreased during chemotherapy, and changes in fibrinogen and D-dimer levels between at C0 and at C2 were associated with treatment response. No matter which disease stage, patients with fibrinogen or D-dimer positivities at C0 and C2 time points had worse PFS and OS than those with fibrinogen or D-dimer negativities. Multivariate analyses revealed that fibrinogen and D-dimer positivities after two chemotherapy cycles were independently unfavorable factors for PFS and OS.

Conclusion

Fibrinogen and D-dimer levels after two cycles of chemotherapy are predictors for response on chemotherapy and prognosis in SCLC patients.

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Affiliations

  1. Department of Pulmonary Medicine, Affiliated Hospital of Jiangsu University, 438 North Jiefang Street, Zhenjiang, 212001, China

    L.-R. Zhu, J. Li, P. Chen & X.-P. Tang

  2. Center of Experimental Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, China

    Q. Jiang

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  1. L.-R. Zhu
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  2. J. Li
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Correspondence to J. Li.

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Zhu, LR., Li, J., Chen, P. et al. Clinical significance of plasma fibrinogen and D-dimer in predicting the chemotherapy efficacy and prognosis for small cell lung cancer patients. Clin Transl Oncol 18, 178–188 (2016). https://doi.org/10.1007/s12094-015-1350-7

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  • DOI: https://doi.org/10.1007/s12094-015-1350-7

Keywords

  • Small cell lung cancer
  • Chemotherapy
  • D-dimer
  • Fibrinogen
  • Response
  • Prognosis