Fibrinogen在术前肾癌患者血清中水平变化及临床意义

  目的  探讨肾癌患者术前血浆Fibrinogen水平与临床病理特征及患者预后的关系。  方法  选取2000年1月至2003年12月天津医科大学附属肿瘤医院泌尿肿瘤科患者286例为研究对象。术前常规测定所有患者血浆Fibrinogen水平, t检验或ANOVA分析术前血浆Fibrinogen水平与多个临床病理特征相关性, 并进一步通过单因素分析及Cox回归模型对预后影响因子进行分析。  结果  术前血浆Fibrinogen水平与Fuhrman分级、肿瘤大小、T分期及术后远处转移密切相关(均P < 0.001)。单因素结果显示, Fuhrman分级、肿瘤大小、T分期及术前血浆Fibrinogen水平与患者总生存时间显著相关(P < 0.001, P=0.001, P < 0.001, P < 0.001)。进一步通过Cox回归模型分析发现, 术前血浆Fibrinogen水平是肾癌术后患者的一个独立预后因子(P=0.001)。  结论  术前血浆Fibrinogen水平与肾癌术后患者远处转移及预后显著相关, 是肾癌术后患者的一个独立预后因子。 

Changes in the Pre-operative Plasma Fibrinogen Level in Renal Cell Carcinoma and Its Clinical Significance

  Objective  This paper aimed to determine the association of pre-operative plasma fibrinogen levels with the clinicopathological parameters and overall survival in patients with renal cell carcinoma.  Methods  We retrospectively studied 286 patients with renal cell carcinoma who underwent radical nephrectomy from January 2000 to December 2003 in one facility.The plasma fibrinogen level was routinely determined before surgery in all patients.The pre-operative plasma fibrinogen levels were correlated with clinicopathological findings by the t-test or ANOVA methods.Univariate and multivariate analyses were used to determine the association of pre-operative levels of plasma fibrinogen with survival duration.  Results  Elevated plasma fibrinogen level was positively correlated with the Fuhrman grade(P < 0.001), tumor size(P < 0.001), T stage(P < 0.001), and risk of distant metastasis after operation(P < 0.001). However, the elevated plasma fibrinogen level was negatively correlated with the histologic type(P=0.266).Univariate analysis showed that the Fuhrman grade, tumor size, T stage, and plasma fibrinogen level were significantly correlated with overall survival(P < 0.001.P=0.001, P < 0.001, and P < 0.001).Multivariate analysis showed that the plasma fibrinogen level remained as an independent prognostic factor for overall survival(P=0.001).  Conclusion  The pre-operative plasma fibrinogen level is significantly associated with postoperative distant metastasis and overall survival, and is an independent predictor of survival prognosis after radical nephrectomy for patients with renal cell carcinoma.