Higher Plasma Fibrinogen Levels are Associated with Malignant Phenotype and Worse Survival in Patients with Glioblastomas

Abstract

Preoperative plasma fibrinogen levels were associated with poor clinical outcomes in malignancies. There were few data about the prognostic value of plasma fibrinogen in glioblastomas (GBMs). The objective of our study was to investigate the association between fibrinogen and patients' clinicopathological factors and overall survival (OS). From 2008 to 2016, 315 patients with GBMs who had a surgical treatment at our institute, were retrospectively involved in this study. IDH (isocitrate dehydrogenase) mutations and ATRX (alpha thalassemia/mental retardation syndrome X-linked) loss were detected with IHC (Immunohistochemistry). The preoperative plasma fibrinogen levels ranged from 1.00 to 5.22 g/L, with a mean of were 2.57 g/L. There were increased levels of plasma fibrinogen in patients aged ≥ 65 years, secondary GBMs, IDH mutation (p = 0.033) and ATRX loss (p = 0.040). Moreover, the plasma fibrinogen level was the highest in the subtype of IDH-1R132H wildtype - ATRX expression, which showed a shorter OS compared to the group of IDH-1R132H mut and IDH-1R132H wildtype - ATRX loss (p = 0.001, log-rank test). ROC curves for fibrinogen and IDH-1R132H wildtype - ATRX expression was also plotted, and indicated a potential diagnostic value of fibrinogen in molecular pathology. Univariate analysis found that younger age, higher KPS (Karnofsky Performance Score), gross total resection, complete chemoradiotherapy, IDH-1R132H mutations and lower levels of fibrinogen were associated with favorable outcomes. Multivariate analysis proved that chemoradiotherapy, IDH-1R132H and fibrinogen were independent prognostic factors. In conclusion, plasma fibrinogen could predict clinical outcome and molecular subtype in GBMs.

Baseline Serum C-Reactive Protein and Plasma Fibrinogen-Based Score in the Prediction of Survival in Glioblastoma

“…A retrospective study evaluating the plasma fibrinogen levels in 315 patients with GBM found that the plasma fibrinogen levels were significantly higher in IDH-1 wild-type GBMs with ATRX expression. Additionally, these patients had a significantly shorter OS compared to other patients (48). However, it has to be reminded that plasma fibrinogen levels can be influenced by the intake of drugs or the nutritional status (49,50).…”

Blood Coagulation Factor Fibrinogen in Tumor Pathogenesis of Central Nervous System B-Cell Lymphoma

“…Most CNS lymphoma specimens exhibited moderate to high levels of fibrinogen deposits, whereas lymph node and colon tissues had no observable immunoreactivity (Figure 1B). Given the reported correlation between BBB leakage and poor prognosis for CNS lymphoma patients, 7,8 presence of accumulated fibrinogen was examined in the brain of primary CNS lymphoma patients. To further characterize the localization of the fibrinogen deposits, immunostaining with an anti-pan laminin antibody was performed to detect the inner (endothelial) and outer (parenchymal) basement membrane.…”

“…4,5 Loss of integrity in the BBB closely correlates with how fast individual metastases grow, 6 and meta-analyses indicate a significant association between BBB leakage and degree of malignancy. 7,8 However, the relationship between BBB leakage and CNS lymphoma onset or progression has not been demonstrated.…”

Prognostic value of preoperative inflammation-based predictors in patients with bladder carcinoma after radical cystectomy

“…As a marker of systemic inflammation, PF is often associated with haemostasis and plays a key role in tumour research [ 21 , 22 ]. The pretreatment PF level has been shown to predict oncologic outcomes for digestive system tumours, lung carcinoma, gynaecologic carcinoma, and glioblastomas, but studies of its prognostic value in BC are lacking [ 18 , 23 , 24 , 25 ]. Additionally, at this stage, the potential molecular mechanism of PF affecting tumorigenesis remains controversial.…”