纤维蛋白原预测晚期非小细胞肺癌化疗的疗效及预后

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。

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

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 fibrinogen levels and different chemotherapy regimens,or fibrinogen and prognosis were analyzed.Results:Pre-chemotherapy plasma fibrinogen levels were correlated with gender（P=0.001) and ECOG（P=0.000).Post-chemotherapy plasma fibrinogen levels were correlated with ECOG（P=0.002).Plasma fibrinogen levels markedly decreased after chemotherapy in 153 patients with pre-chemotherapy hyperfibrinogenemia(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 hyperfibrinogen population increse in progressive disease（PD,P=0.016) group.There's no statistical significance between 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 independent factors influencing PFS and OS.Conclusion:Fibrinogen levels is a predictor for response on chemotherapy and prognosis in advanced NSCLC patients.