Hyperfibrinogen Is Associated With the Systemic Inflammatory Response and Predicts Poor Prognosis in Advanced Pancreatic Cancer

Objective The aim of this study was to examine the prognostic prediction value of plasma fibrinogen level for overall survival (OS) in patients with advanced pancreatic cancer. Methods A total of 321 patients with locally advanced or metastatic pancreatic adenocarcinoma were retrospectively recruited. The association between plasma fibrinogen level and OS was analyzed. We also evaluated the relationship between plasma fibrinogen level and the systemic inflammatory response markers: the neutrophil-lymphocyte ratio, platelets/lymphocyte ratio, and lymphocyte/monocyte ratio. Results High plasma fibrinogen levels were significantly correlated with shorter OS in patients with advanced pancreatic cancer (175 days for patients with high fibrinogen levels vs 357 days for patients with low fibrinogen levels; log rank,22.949; P < 0.001). Multivariate analyses confirmed that plasma fibrinogen level was an independent prognostic predictor for OS (hazard ratio, 2.184; 95% confidence interval, 1.574-3.032; P < 0.001). Receiver operating characteristic analyses showed that including plasma fibrinogen level alongside traditional factors (tumor stage and CA 19-9) significantly improved prognostic prediction capability (traditional model area under the curve of 0.62 versus combined model area under the curve of 0.708; P = 0.016). In addition, plasma fibrinogen level was positively correlated with neutrophil-lymphocyte ratio and platelets/lymphocyte ratio and negatively correlated with lymphocyte/monocyte ratio. Conclusions Hyperfibrinogen is associated with the systemic inflammatory response and predicts poor prognosis for advanced pancreatic cancer.