摘要
Background:Due to the different treatments for low-volume metastatic prostate cancer(PCa)as well as high-volume evaluation of bone metastatic status is clinically significant.In this study,we evaluated the correlation between pre-treatment plasma fibrinogen and the burden of bone metastasis in newly diagnosed PCa patients.Methods:A single-center retrospective analysis,focusing on prostate biopsies of newly diagnosed PCa patients,was performed.A total of 261 patients were enrolled in this study in a 4-year period.All subjects were submitted to single-photon emission computerized tomography-computed tomography to confirm the status of bone metastasis and,if present,the number of metastatic lesions would then be calculated.Clinical information such as age,prostate-specific antigen(PSA),fibrinogen,clinical T stage,and Gleason score were collected.Patients were divided into three groups:(i)a non-metastatic group,(ii)a high volume disease(HVD)group(>3 metastases with at least one lesion outside the spine),and(iii)a low volume disease(LVD)group(metastatic patients excluding HVD ones).The main statistical methods included non-parametric Mann-Whitney test,Spearman correlation,receiver operating characteristic(ROC)curves,and logistic regression.Results:Fibrinogen positively correlated with Gleason score(r=0.180,P=0.003),PSA levels(r=0.216,P<0.001),and number of metastatic lesions(r=0.296,P<0.001).Compared with the non-metastatic and LVD groups,the HVD group showed the highest PSA(104.98 ng/mL,median)and fibrinogen levels(3.39 g/L,median),as well as the largest proportion of Gleason score>7(86.8%).Both univariate(odds ratio[OR]=2.16,95%confidential interval[CI]:1.536-3.038,P<0.001)and multivariate(OR=1.726,95%CI:1.206-2.472,P=0.003)logistic regressions showed that fibrinogen was independently associated with HVD.The ROC curve suggested that fibrinogen acts as a predictor of HVD patients,yielding a cut-off of 3.08 g/L,with a sensitivity of 0.684 and a specificity of 0.760(area under the curve=0.739,95%CI:0.644-0.833,P<0.001).Conclusions:Pre-treatment plasma fibrinogen is positively associated with bone metastatic burden in PCa patients.Our results indicate that fibrinogen might be a potential predictor of HVD.
