术前外周血纤维蛋白原水平对喉癌预后的影响

目的探讨术前外周血纤维蛋白原(FIB)水平对喉鳞状细胞癌患者预后的影响。方法回顾性分析南京医科大学第一附属医院458例行初次手术治疗的喉鳞状细胞癌患者的临床资料。根据患者术前的FIB,绘制诊断总体生存期(OS)的受试者工作特征曲线(ROC),确定最佳截断值,从而分为低危组和高危组;并采用卡方检验、Kaplan-Meier单因素分析、Cox风险比例模型多因素分析FIB以及其他临床病理参数与喉癌患者总体生存期的关系。结果 FIB诊断喉癌患者OS的ROC曲线下面积(AUC)为0.67。较高纤维蛋白原水平(>3.12 g/L)与肿瘤分期、甲状软骨板侵袭有明显统计学意义(P<0.001)。单因素分析显示FIB、分型、分期、病理分化程度、甲状软骨板累及、淋巴结转移、年龄与喉鳞状细胞癌患者的OS有关;多因素分析显示FIB、分期与年龄是影响喉鳞状细胞癌患者死亡的独立危险因素。结论术前外周血高FIB水平的喉鳞状细胞癌患者术后OS较短,该指标可作为评估喉癌患者预后的重要指标。

Prognostic role of preoperative fibrinogen levels in patients with laryngeal squamous cell carcinoma

Objective This study aimed to evaluate the impact of preoperative fibrinogen(FIB)on the prognosis of patients with laryngeal squamous cell carcinoma. Methods The clinical data of 458 patients with laryngeal squamous cell carcinoma who underwent primary surgery in the First Affiliated Hospital of Nanjing Medical University were analyzed retrospectively. On observation of preoperative FIB levels, a receiver operating characteristic curve(ROC)was drawn to determine the FIB threshold, and then the patients were divided into lower and higher groups. Chi-square test, Kaplan-Meier analysis and Cox risk model were used to analyze the relationship between FIB, other clinicopathological parameters and overall survival. Results The area under the ROC curve(AUC)of FIB for overall survival(OS)of patients with laryngeal squamous cell carcinoma was 0.67. Univariate analysis showed that FIB, tumor classification, TNM stages, pathological differentiation, invasion of thyroid cartilage plate, lymph nodes metastasis and age were associated with OS of patients with laryngeal squamous cell carcinoma. Cox regression model identified high FIB level, TNM stages III and IV, and age as independent risk factors for the OS of patients with laryngeal squamous cell carcinoma (P<0.001; P=0.014; P=0.003). Conclusion Patients with laryngeal squamous cell carcinoma and high preoperative FIB levels are more likely to have lower OS. It could be a clinical biomarker for the prognosis of laryngeal squamous cell carcinoma.