Preoperative Plasma Fibrinogen Level Associates With Clinical And Pathological Characteristics In Patients With Urothelial Cell Carcinoma Of The Ureter

Background Upper urinary tract tumours are relatively less common and are associated with several familial syndromes. The peak incidence of upper tract tumours is 10 per 100,000 per year, occurring in the age range of 75 t0 79 years. As is the case with bladder cancer, there are difference between differ gender, women who develop upper urinary tract cancer are 25% more likely than men to die of their disease. Recent studies suggest that the risk factors included Balkan Nephropathy, Smoking, coffee consumption, analgesics, occupation, arsenic, chronic inflammation, heredity and so on. The upper urinary tract tumours which are located in the retroperitoneal are more difficult to visualize directly and to reach with topical therapies; Given the anatomic difference between the upper and lower uninary tracts in the terms of muscle thickness and other factors, they may have different prognoses. The interactionally recognized gold standard treatment for upper urinary tract tumours is radical nephroureterectomy, and the 5-year survival rate is about 52%.Objectives The purpose of this study was to investigate the association between preoperative plasma fibrinogen levels and clinicopathological features in patients with urothelial cell carcinoma of ureter.Patients and methods In a retrospective, single-center study, we evaluated preoperative plasma fibrinogen levels in 155 patients with newly diagnosed urothelial cell carcinoma of ureter and 52 patients with diagnosed ureterostenosis from Jan 2005 and Jun 2015. All the tumourous’ patients received surgical intervention as their primary treatment method. The association between preoperative plasma fibrinogen levels and clinicopathological parameters was analyzed. Univariate and multivariate logistic regression analyses were performed to identify an independent association.Results The mean (SD) level of preoperative plasma fibrinogen in patients with carcinoma level was 3.85±1.12 g/L, and it’s higher than the level in patients with urethral stricture. Elevated plasma fibrinogen level was associated with the symptom of macroscopic hematuria (P=0.046), hydronephrosis (P=0.019), pathological stage (P=0.029) and clinical stage (P=0.007). Patients of the hyperfibrinogen group (fibrinogen level≥4.5mg/dl) were more frequently to have pathological and clinical advanced-stage than the hyporfibrinogen group (fibrinogen level<4.5mg/dl) did (P=0.021 and P=0.002). In the univariate and multivariate model plasma fibrinogen level≥4.5mg/dl was identified to be independently associated with the presence of clinical advanced-stage (HR=3.391,P=0.019).Conclusion Patients with an elevated preoperative plasma fibrinogen level could be predicted to have a higher risk of malignant ureteral tumours as well as advanced-stage carcinomas. Plasma fibrinogen can serve as a promising diagnostic and prognostic biomarker, especially because of its universal detection and underspent.