Plasma fibrinogen levels in patients with benign and malignant ovarian tumors

Hefler-Frischmuth, Katrin; Lafleur, Judith; Hefler, Lukas; Polterauer, Stephan; Seebacher, Veronika; Reinthaller, Alexander; Grimm, Christoph

doi:10.1016/j.ygyno.2014.12.041

Cited by 16 publications

(21 citation statements)

References 27 publications

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“…Apart from being one of the key proteins within the formation of blood clots and inflammatory processes, plasma fibrinogen levels have been found to be elevated in patients with a poor prognosis in various malignant tumours including OC [20][21][22][23][24][25][26][27]. Moreover, our study group has previously investigated the predictive role of plasma fibrinogen to distinguish between benign and malignant ovarian tumours [25]. The results of the present study confirm the independent predictive value of elevated plasma fibrinogen to be associated with an increased risk for OC in patients with suspected adnexal masses in a very large cohort of patients.…”

Section: Discussionmentioning

confidence: 99%

“…It has been found have prognostic value for various malignant tumours including ovarian cancer [20][21][22][23][24][25][26][27]. We have previously reported that pre-operative plasma fibrinogen is independently associated with ovarian cancer presence in patients with adnexal masses [25]. This study was limited by the failure to adjust for the effects of ultrasound results and its statistical design.…”

Section: Introductionmentioning

confidence: 94%

“…In contrast to our previous logistic regression model [25], where we included patients' age, serum CA-125 (< vs. ! 35 kU/L) and plasma fibrinogen (with the laboratories normal range as cut-off), we used our newly determined cut-off value for fibrinogen, replaced patients' age by menopausal status, and added the presence of M-criteria on ultrasound to the present model.…”

Section: Threshold Probability For Ovarian Cancer % Net Benefit In Tmentioning

confidence: 99%

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Development of a Tool for Prediction of Ovarian Cancer in Patients With Adnexal Masses: Value of Plasma Fibrinogen

Veronika¹

2017

Preprint

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Objective To develop a tool for individualized risk estimation of presence of cancer in women with adnexal masses, and to assess the added value of plasma fibrinogen. Study design We performed a retrospective analysis of a prospectively maintained database of 906 patients with adnexal masses who underwent cystectomy or oophorectomy. Uni-and multivariate logistic regression analyses including pre-operative plasma fibrinogen levels and established predictors were performed. A nomogram was generated to predict the probability of ovarian cancer. Internal validation with split-sample analysis was performed. Decision curve analysis (DCA) was then used to evaluate the clinical net benefit of the prediction model. Results Ovarian cancer including borderline tumours was found in 241 (26.6%) patients. In multivariate analysis, elevated plasma fibrinogen, elevated CA-125, suspicion for malignancy on ultrasound, and postmenopausal status were associated with ovarian cancer and formed the basis for the nomogram. The overall predictive accuracy of the model, as measured by AUC, was 0.91 (95% CI 0.87-0.94). DCA revealed a net benefit for using this model for predicting ovarian cancer presence compared to a strategy of treat all or treat none. Conclusion We confirmed the value of plasma fibrinogen as a strong predictor for ovarian cancer in a large cohort of patients with adnexal masses. We developed a highly accurate multivariable model to help in the clinical decision-making regarding the presence of ovarian cancer. This

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Section: Threshold Probability For Ovarian Cancer % Net Benefit In Tmentioning

confidence: 99%

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Development of a Tool for Prediction of Ovarian Cancer in Patients With Adnexal Masses: Value of Plasma Fibrinogen

Veronika¹

2017

Preprint

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“…Thrombin stimulates inflammation at the tumor site in breast cancer patients [113] and plays a role in tumorigenesis of colitis-associated colon cancer [114]. Fibrinogen levels may provide a prognostic parameter, since a high level of fibrinogen is associated with advanced stage and poor survival in multiple types of cancer including cervical [115], ovarian [116, 117], endometrial, [118] or vulvar cancers [119]. A strong correlation also exists between coagulation and cancer progression and as such, anticoagulants including low molecular weight heparin, constitute a treatment of choice against cancer.…”

Section: 0 the Role Of Coagulation Evasion In Diseasementioning

confidence: 99%

Evasion and interactions of the humoral innate immune response in pathogen invasion, autoimmune disease, and cancer

Rettig

Harbin

Harrington

et al. 2015

Clinical Immunology

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The humoral innate immune system is composed of three major branches, complement, coagulation, and natural antibodies. To persist in the host, pathogens, such as bacteria, viruses, and cancers must evade parts of the innate humoral immune system. Disruptions in the humoral innate immune system also play a role in the development of autoimmune diseases. This review will examine how gram positive bacteria, viruses, cancer, and the autoimmune conditions Systemic Lupus Erythematosus and Anti-phospholipid syndrome, interact with these immune system components. Through examining evasion techniques it becomes clear that interplay between these three systems exists. By exploring the interplay and the evasion/disruption of the humoral innate immune system, we can develop a better understanding of pathogenic infections, cancer, and autoimmune disease development.

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“…It has been found have prognostic value for various malignant tumours including ovarian cancer [ 20 – 27 ]. We have previously reported that pre-operative plasma fibrinogen is independently associated with ovarian cancer presence in patients with adnexal masses [ 25 ]. This study was limited by the failure to adjust for the effects of ultrasound results and its statistical design.…”

Section: Introductionmentioning

confidence: 99%

Development of a tool for prediction of ovarian cancer in patients with adnexal masses: Value of plasma fibrinogen

et al. 2017

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ObjectiveTo develop a tool for individualized risk estimation of presence of cancer in women with adnexal masses, and to assess the added value of plasma fibrinogen.Study designWe performed a retrospective analysis of a prospectively maintained database of 906 patients with adnexal masses who underwent cystectomy or oophorectomy. Uni- and multivariate logistic regression analyses including pre-operative plasma fibrinogen levels and established predictors were performed. A nomogram was generated to predict the probability of ovarian cancer. Internal validation with split-sample analysis was performed. Decision curve analysis (DCA) was then used to evaluate the clinical net benefit of the prediction model.ResultsOvarian cancer including borderline tumours was found in 241 (26.6%) patients. In multivariate analysis, elevated plasma fibrinogen, elevated CA-125, suspicion for malignancy on ultrasound, and postmenopausal status were associated with ovarian cancer and formed the basis for the nomogram. The overall predictive accuracy of the model, as measured by AUC, was 0.91 (95% CI 0.87–0.94). DCA revealed a net benefit for using this model for predicting ovarian cancer presence compared to a strategy of treat all or treat none.ConclusionWe confirmed the value of plasma fibrinogen as a strong predictor for ovarian cancer in a large cohort of patients with adnexal masses. We developed a highly accurate multivariable model to help in the clinical decision-making regarding the presence of ovarian cancer. This model provided net benefit for a wide range of threshold probabilities. External validation is needed before a recommendation for its use in routine practice can be given.

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Plasma fibrinogen levels in patients with benign and malignant ovarian tumors

Cited by 16 publications

References 27 publications

Development of a Tool for Prediction of Ovarian Cancer in Patients With Adnexal Masses: Value of Plasma Fibrinogen

Development of a Tool for Prediction of Ovarian Cancer in Patients With Adnexal Masses: Value of Plasma Fibrinogen

Evasion and interactions of the humoral innate immune response in pathogen invasion, autoimmune disease, and cancer

Development of a tool for prediction of ovarian cancer in patients with adnexal masses: Value of plasma fibrinogen

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