New study below. [1]
Fibrinogen circulates at normal levels for use in the event that a blood clot is required. In that case, thrombin will convert fibrinogen to the fibrin that forms the clot. Normal levels are OK, although I like to be at the low end of the reference range.
Fibrinogen is also an acute-phase protein & is elevated when there is inflammation. I included it in my series on inflammation markers 3 years ago:
"Inflammation. [3] SedRate, Fibrinogen, IL-6, TNFalpha." [2]
Elevated fibrinogen in the absence of thrombin doesn't mean that there is an increased risk of unwanted clotting.
However, it is not unusual for fibrinogen to be elevated in men with PCa, and cancer alters coagulation factors & risk.
Abnormal coagulation is associated with metastasis.
In the new study:
"Fibrinogen positively correlated with Gleason score ... PSA levels ... and number of metastatic lesions"
"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" high volume disease.
As I have mentioned before, a D-dimer test can be used to monitor clotting status and nattokinase can be used to accelerate the breakdown of fibrin.
I don't accept the fatalistic view that it is pointless to target metastasis when mets have occurred. I use nattokinase not only to prevent another DVT, but also to eliminate microclots that offer a safe haven to circulating PCa cells.
Once again, we have a study where the authors seem to view the finding in terms of prognosis, rather than a call to action.
-Patrick
[1] ncbi.nlm.nih.gov/pubmed/317...
Chin Med J (Engl). 2019 Nov 12. doi: 10.1097/CM9.0000000000000506. [Epub ahead of print]
Clinical association between pre-treatment levels of plasma fibrinogen and bone metastatic burden in newly diagnosed prostate cancer patients.
Xie GS1, Li G, Li Y, Pu JX, Huang YH, Li JH, Yin HM.
Author information
1
Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215031, China.
Abstract
BACKGROUND:
Due to the different treatments for low-volume metastatic prostate cancer (PCa) as well as high-volume ones, 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.
PMID: 31725446 DOI: 10.1097/CM9.0000000000000506
