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. 2023 Nov 30;12(11):3105-3112.
doi: 10.21037/tcr-23-908. Epub 2023 Oct 26.

New use of preoperative fibrinogen in ovarian cancer management

Jiacong Wu #  1 , Ya Zhang #  2 , Guangquan Liu  2 , Lili Ge  2
Affiliations

New use of preoperative fibrinogen in ovarian cancer management

Jiacong Wu et al. Transl Cancer Res. .

Abstract

Background: Ovarian cancer (OC) is often diagnosed at an advanced stage due to the absence of specific symptoms in its early stages. And the prognosis greatly depends on when the disease is diagnosed. Thus, we conducted to evaluate the value of preoperative fibrinogen (Fib) levels for the diagnosis of OC in the hope of improving its diagnostic efficiency.

Methods: A total of 126 ovarian tumor patients were retrospectively included in this study. Four candidate OC markers, including cancer antigen 125 (CA125), Fib, platelet (PLT) and homocysteine (Hcy) were employed to establish a diagnosis model for OC. The diagnostic performance of the model was evaluated using the area under the receiver operating characteristic curve (AUC) and Youden index.

Results: All included markers could be used for the diagnosis of OC. The AUCs of CA125, Fib, PLT and Hcy were 0.881, 0.825, 0.676 and 0.647, respectively. The new diagnosis model combining CA125 and Fib (CA125-Fib) had a higher AUC (0.924), Youden index (0.730), and best sensitivity (SN) (74.6%) and specificity (SP) (98.41%). CA125-Fib also had a high value in the diagnosis of stage I-II OC (AUC, Youden index, SN and SP: 0.853, 0.624, 81.48% and 80.95%).

Conclusions: Fib could be used for OC diagnosis. In particular, the combination of Fib and CA125 could further improve the diagnostic efficiency. And the diagnostic value of PLT and Hcy was found to be poor.

Keywords: Cancer antigen 125 (CA125); diagnosis; fibrinogen (Fib); ovarian cancer (OC); platelet (PLT).

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tcr.amegroups.com/article/view/10.21037/tcr-23-908/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
A flow chart showing the ovarian cancer patient selection process.
Figure 2
Figure 2
Clinical information of 126 patients. (A) CA125, PLT, Hcy, and Fib level in patients in EG and CG; (B) pathological types of EG and CG. **, P<0.01; ***, P<0.001. CA125, cancer antigen 125; PLT, platelet; Hcy, homocysteine; Fib, fibrinogen; EG, experimental group; CG, control group.
Figure 3
Figure 3
The diagnostic value and correlation of candidate markers in ovarian cancer. (A) The relationship between candidate markers and ovarian cancer based on multivariate analysis; (B) ROC for individual candidate marker assays for ovarian cancer. CA125, cancer antigen 125; Fib, fibrinogen; Hcy, homocysteine; PLT, platelet; ROC, receiver operating characteristic.
Figure 4
Figure 4
ROC, Youden index, SN and SP for CA125-Fib. (A) All ovarian cancer patients as EG; (B) patients with stage I–II ovarian cancer as EG. SN, sensitivity; SP, specificity; ROC, receiver operating characteristic; CA125, cancer antigen 125; Fib, fibrinogen; EG, experimental group.
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