Serum fibrinogen as a diagnostic and prognostic biomarker for pancreatic ductal adenocarcinoma

Abstract

Background/Objectives: Early diagnosis of pancreatic ductal adenocarcinoma (PDAC) is important as PDAC can lead to mortality; however, no specific biomarker has been identified for its early diagnosis. We previously identified fibrinogen a chain as a promising biomarker for differentiating between patients with and without PDAC using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Here, we aimed to validate the clinical usefulness of serum fibrinogen as a biomarker for PDAC. Methods: From 2009 to 2011, blood samples of 67 PDAC patients and 43 healthy adults (controls) were prospectively collected. Serum fibrinogen levels and their clinical significances were evaluated. Results: Mean fibrinogen levels were significantly higher in the PDAC group than in the control group (3.08 +/- 0.565 vs. 2.54 +/- 0.249 log(10) ng/mL, P < 0.001). In the receiver operating characteristic analysis, overall sensitivity, and specificity of serum fibrinogen levels for differentiating PDAC patients from control patients were 67.4% and 83.6%, respectively, with a 427-ng/mL cutoff value. Serum fibrinogen levels were significantly higher in PDAC patients with distant metastasis than in those without distant metastasis (3.38 +/- 0.581 vs. 2.93 +/- 0.499 login ng/mL, P = 0.002). Median overall survival was significantly longer in PDAC patients with low fibrinogen levels (<1000 ng/mL) than in those with high fibrinogen levels (>= 1000 ng/mL) [489 days (95% confidence interval, 248.1-729.9) vs. 172 days (58.4 -285.6) (P = 0.008)]. Although serum fibrinogen levels were poorly correlated with carbohydrate antigen 19-9 levels, these two biomarkers together predicted survival better. Conclusions: Serum fibrinogen levels may be a useful biomarker for diagnosing and predicting PDAC prognosis. (C) 2020 IAP and EPC. Published by Elsevier B.V. All rights reserved.