The clinical significance of preoperative serum fibrinogen levels and platelet counts in patients with Gallbladder carcinoma

Abstract

Background: Gallbladder carcinoma (GBC) was the most common malignancy of biliary tract. Patients with malignancies frequently present with activated coagulation pathways, which mightpotentially related to tumor progression and prognosis. The purpose of the study was to investigate the clinical significance of preoperative serum fibrinogen levels and platelet counts in GBC patients.Methods: The preoperative fasting serum fibrinogen levels and platelet counts of 58 patients with GBC were measured by AUV2700 automatic biochemical analyzer, as well as 60 patients with cholesterol polyps and 60 healthy volunteers. Kaplan–Meier survival analysis was applied to show the correction between fibrinogen levels and outcome after surgery.Results: The fibrinogen levels of patients with GBC were significantly higher than healthy gallbladder and cholesterol polyp of gallbladder (p<0.001 and p<0.001,respectively). In GBC, fibrinogen levels were associated with tumor depth (p=0.001), lymph node metastasis (p=0.002), distant metastasis (p<0.001) and Tumor Node Metastasis (TNM) stage (p<0.001).The levels in TNM stage Ⅳ disease were significantly higher than stage Ⅲ or stage Ⅰ+Ⅱ disease（p=0.048 and p<0.001, respectively）, and in TNM stage Ⅲ disease were significantly higher than stageⅠ+Ⅱ disease（p=0.002）.Furthermore, the overall survival was better in low fibrinogen level group than in high fibrinogen level group (p<0.001).However, thrombocytosis was not significantly associated with overall survivals(p>0.05) in univariate analysis.Conclusion: The preoperative serum fibrinogen levels and platelet counts might be reliable biomarkers for the occurance of disease, tumor depth, lymph node metastasis, distant metastasis and advanced TNM stage in patients with GBC. The serum fibrinogen levels might be a prognostic factor to predict outcome for GBC patients suffering from surgery treatment. Anticoagulation therapy might be considered to control cancer progression in future studies.

The significance of preoperative serum fibrinogen in patients with gallbladder carcinoma after curative-intent resection: A Lasso predictive model with an extremely high predictive accuracy and a meta-analysis

“…studies have indicated that preoperative brinogen was closely associated with the long-term prognosis of patients with GBC, which has been regarded as a prognostic factor (4,(12)(13)(14). The observations reported in other studies have also been validated in our cohort as well as the subsequent meta-analysis that an elevated preoperative brinogen indicated a more advanced tumor stage and a much worse prognosis.…”

“…Accumulating evidence has revealed the co-existence of cancer-derived coagulation abnormalities and demonstrated the prognostic value of the coagulation-related medium, especially brinogen, in various human malignancies, such as peri-hilar cholangiocarcinoma (9), colorectal carcinoma (10), and pancreatic carcinoma (11). The prognostic role of preoperative brinogen in patients with GBC has also been deeply explored (4,(12)(13)(14). CA199 has always been regarded the most commonly used and gold-standard tumor biomarker in patients with biliary cancers (15)(16)(17)(18).…”