The clinical significance of preoperative plasma fibrinogen levels and platelet counts in resectable colon cancer

Abstract

Background and aim Several aspects of the correlation between colon cancer and hemostatic markers are still unknown to many researchers in the field. In this study, we evaluated the association, if any, of preoperative platelet (PLT) counts and plasma fibrinogen levels with postoperative lymph node involvement and venous invasion in colon cancer patients. Methods This study retrospectively included eighty patients with colon cancer (mean age 58.09 years; 37% female 63% male). Results Patients with negative lymph nodes and venous invasion showed a significantly lower PLT count and higher fibrinogen level than their counterparts, i.e., patients with positive lymph nodes (p<0.001, all of them) and venous invasion (p<0.001, all of them). The results also showed a positive association of PLT counts and fibrinogen levels with lymphatic invasion (r=0.670, p<0.001 and r=0.639, p<0.001, respectively) and a positive association of PLT counts and fibrinogen levels with venous invasion (r=0.3988, p<0.001 and r=0.5268, p<0.001, respectively). According to the results of the ROC curve analysis, when the PLT count cutoff was 290/mm3, the sensitivity and specificity were 82% and 86.67%, respectively (AUC = 0.8840, p<0.0001, 95% CI 0.8084–0.9596). When the fibrinogen level cutoff was 310.0 mg/dL, the sensitivity and specificity were 72% and 96.67%, respectively (AUC 0.8790, p <0.0001, 95% CI 0.8067–0.9513). Conclusion The preoperative PLT count and plasma fibrinogen level may be considered key markers to monitor postoperative lymph node involvement and venous invasion in colon cancer patients.

Prognostic Impact of Platelet-Large Cell Ratio In Myelodysplastic Syndromes

“…Moreover, the baseline platelet count seemingly has a prognostic impact in MDS. While various studies have evaluated the prognostic significance of thrombocytosis in cancers, such as colon cancer, ovarian cancer, and hepatocellular cancer (13)(14)(15), no significance for platelet count in MDS has been reported. Gender seems to influence the prognosis of MDS patients; the same conclusion was also found in previous studies (16,17).…”

Fibrinogen levels in relation to colorectal cancer onset: A nested case-cohort study from the Moli-sani cohort

“…Much is known about the mutual connection among cancer progression and hemostatic system and, several enzymes of the latter have been found to predict poor outcomes in cancer patients ( 15 , 18 , 45 ). Although cancer ( 24 – 30 ) and CVD ( 21 , 22 ) were traditionally considered as distinct disorders, today there is an increasing evidence reporting the shared pathophysiology and an overlapping risk factors profile between these two conditions, supporting the so-called “common soil hypothesis” ( 10 – 15 , 34 ). Two previous studies from our group reported the predictive role of other two hemostatic biomarkers in a general population.…”

“…The role of this coagulation protein has been widely investigated, in cancer clinical settings. Indeed, elevated plasma levels of pre-operative fibrinogen have been associated with a poor prognosis of overall/disease free survival, a worst response to therapy and tumor size and extension of tumor invasion in gastrointestinal and, in particular, colorectal cancer (24)(25)(26)(27)(28)(29)(30). On the other hand, nowadays, the only study investigating the possible relationship of fibrinogen with cancer in the setting of a general population, is represented, by the work of Allin et al showing that a simultaneous elevation of levels of inflammatory markers (fibrinogen, C-reactive protein and leukocyte count) was associated with an increased risk of lung, breast and colorectal cancer, with a stronger effect in the first few years of follow-up (31).…”

Fibrinogen/albumin ratio index is an independent predictor of recurrence-free survival in patients with intrahepatic cholangiocarcinoma following surgical resection

“…Fibrinogen was shown to promote the malignant transformation of tumors by inducing epithelial-tomesenchymal transition via the mammalian target of rapamycin (mTOR)/protein kinase B (AKT) signaling Abbreviations: AAPR albumin-to-alkaline phosphatase ratio, AIC Akaike information criterion, CI confidence interval, FARI fibrinogen/albumin ratio index, GLR γ-glutamyltransferase-to-lymphocyte ratio, NLR neutrophil-to-lymphocyte ratio pathway [42], and inhibited the cytotoxic activities of natural killer cells in tumors [43]. It has been found to be a key marker in progression of colon cancer [44]. Thus, fibrinogen is a useful marker for monitoring cancer progression.…”