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Open Access Research article

Hyperfibrinogenemia is associated with lymphatic as well as hematogenous metastasis and worse clinical outcome in T2 gastric cancer

Hiroharu Yamashita1*, Joji Kitayama1, Nobuko Kanno2, Yutaka Yatomi2 and Hirokazu Nagawa1

Author Affiliations

1 Department of Surgical Oncology, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan

2 Department of Laboratory Medicine, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan

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BMC Cancer 2006, 6:147  doi:10.1186/1471-2407-6-147

Published: 1 June 2006

Abstract

Background

Abnormal hemostasis in cancer patients has previously been described, however the correlation between the plasma fibrinogen level and cancer metastasis and prognosis has not been reported in a large-scale clinical study.

Methods

Preoperative plasma fibrinogen levels were retrospectively examined in 405 patients who underwent surgery for advanced gastric cancer. The association of fibrinogen levels with clinical/pathological findings and clinical outcome was evaluated.

Results

There was a positive correlation between plasma fibrinogen levels and the depth of invasion (p < 0.05). Hyperfibrinogenemia (>310 mg/dl) was independently associated with lymph node (Odds Ratio; 2.342, P = 0.0032) and liver (Odds Ratio; 2.933, P = 0.0147) metastasis, not with peritoneal metastasis in this series. Patients with hyperfibrinogenemia showed worse clinical outcome in T2 gastric cancer, however, there was no correlation of plasma fibrinogen level with prognosis in T3/T4 gastric cancer.

Conclusion

Our results might support the idea that hyperfibrinogenemia can augment lymphatic and hematogeneous metastasis of advanced gastric cancer, which is major determinant of the prognosis in T2 gastric cancer. Therefore, in the situation without peritoneal involvement, hyperfibrinogenemia is a useful biomarker to predict the possible metastasis and worse clinical outcome in T2 gastric cancer.