Supplementary MaterialsSupplementary Desk 1 NOS for assessing characteristics of 5 cohort research because of this meta-analysis jgo-28-e36-s001. straight down by the worthiness of 400 mg/dL of plasma fibrinogen amounts.Operating-system, overall success; PFS, progression-free success. jgo-28-e36-s005.ppt (267K) GUID:?8CB92271-47BE-4F15-9BFC-5DCAAE9D51C0 Abstract Objective To judge the result of raised plasma fibrinogen levels in the prognosis of epithelial ovarian tumor (EOC). Strategies We reviewed the data of 217 patients with advanced-stage EOC between 2000 and 2012, and investigated the prognostic role of elevated plasma fibrinogen levels compared with serum CA-125 levels, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR). For further evaluation, we performed a meta-analysis using 5 cohort studies published to July 2015, including our cohort study after a literature review. Results Among the four biomarkers, only plasma fibrinogen levels 485.2 mg/dL were correlated with impaired progression-free survival (PFS) and overall survival (OS) (median, 13.9 vs. 20.3 months and 42.2 vs. 55.4 months; p 0.010). Elevated plasma fibrinogen levels were an independent factor for poor PFS with marginal significance and OS (adjusted hazard ratios [HRs]=1.389 and 1.581; 95% confidence intervals [CIs]=0.979C1.972 and 1.032C2.423, respectively). Furthermore, crude and subgroup meta-analyses exhibited that elevated plasma fibrinogen levels were associated with impaired PFS and OS in patients with all stage EOC. Conclusion Elevated plasma fibrinogen levels be more important for predicting survival than serum CA-125 levels, NLR and PLR in patients with EOC, in particular, advanced-stage disease. BIX 02189 manufacturer Moreover, it may be related to poor prognosis of EOC. strong class=”kwd-title” Keywords: Fibrinogen, Survival, Ovarian Neoplasms, Meta-Analysis INTRODUCTION Epithelial ovarian malignancy (EOC) exhibits the highest mortality among female genital tract cancers because of no effective screening methods for early detection , resulting in a diagnosis of advanced-stage disease in most patients with EOC . Although serum CA-125 level is useful for early detection and prediction of survival in patients with EOC [3,4], its role as a prognostic factor remains controversial in advanced-stage disease and non-serous EOC [5,6,7]. Thus, considerable attention has been focused on the development of prognostic biomarkers of EOC for quick application in clinical settings. Although many studies have suggested novel biomarkers showing the relationship between prognosis of EOC and genetic BIX 02189 manufacturer alteration, only a few biomarkers such as HE-4 are considered as a prognostic factor of EOC in clinical setting . On the other hand, clinical biomarkers using systemic inflammation and coagulation has been suggested to be useful to predict prognosis of EOC with the advantage of being clinically very easily measured . In particular, systemic inflammation leading to secondary hematological changes has been shown in various types of malignancies [10,11], and changes, such as the neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR), have been investigated BIX 02189 manufacturer as prognostic biomarkers in EOC [12,13]. Moreover, biomarkers using systemic coagulation have been also investigated because the relationship between malignancy and hemostatsis-related procoagulants has been widely established . Among related biomarkers suing coagulation factors, plasma fibrinogen levels have been in the limelight because they increase via the extrahepatic synthesis of tumor cells, resulting in a hypercoagulable status , tumor progression, and metastasis in various types of malignancies [16,17,18]. However, the role of elevated plasma fibrinogen levels as a prognostic biomarker has not been also sufficiently investigated in EOC. Thus, we performed two-step studies due to the insufficient evidences. First, we performed a cohort study to evaluate the effect of elevated plasma fibrinogen levels for predicting the prognosis of advanced-stage EOC compared with serum CA-125 levels and systemic inflammatory biomarkers, such as NLR and PLR. Second, we evaluated the BIX 02189 manufacturer role of elevated plasma fibrinogen levels as a prognostic biomarker in EOC by a meta-analysis using relevant studies. MATERIALS AND METHODS 1. Between January 2000 and December 2012 Cohort research We extracted clinico-pathologic data from a data source of EOC sufferers. The institutional review plank at our organization approved the existing research (No. 1409-154-616). We included sufferers with the next criteria: sufferers with EOC; sufferers with International Federation of Gynecology and Obstetrics (FIGO) stage III to IV disease; sufferers who received bloodstream lab tests including differential white bloodstream cells matters, serum CA-125, and plasma fibrinogen amounts checked within 14 days prior to the treatment routinely; and sufferers with Eastern Cooperative Oncology Group functionality position of 0C2. Nevertheless, we excluded Rabbit polyclonal to ATF2 sufferers with inflammatory illnesses.