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764 Preoperative fibrinogen levels as a potential diagnostic marker for uterine sarcomas: a retrospective multivariate analysis
  1. Stoyan Kostov1,2,
  2. Denitsa Grigorova3,
  3. Yavor Kornovski2,
  4. Yonka Ivanova2,
  5. Stanislav Slavchev2,
  6. Ihsan Hasan4,
  7. Rafal Watrowski5,6,
  8. Mariela Slaveva1,7,
  9. Dimitar Mitkov8,9 and
  10. Angel Yordanov10
  1. 1Research Institute, Medical University Pleven, 5800, Pleven, Bulgaria
  2. 2Department of Gynecology, Hospital ‘Saint Anna’, Medical University—’Prof. Dr. Paraskev Stoyanov’, 9002, Varna, Bulgaria
  3. 3Department of Probability, Operations Research and Statistics, Faculty of Mathematics and Informatics, Sofia University,, Sofia, Bulgaria
  4. 4Department of Obstetrics and Gynecology, University Hospital Sofiamed, Sofia, Bulgaria
  5. 5Department of Obstetrics and Gynecology, Helios Hospital Müllheim, 79379, Müllheim, Germany
  6. 6Faculty Associate, Medical Center, University of Freiburg, 79106, Freiburg, Germany
  7. 7Department of Breast Surgery, Shterev Hospital, Sofia, Bulgaria
  8. 8Clinical Pathology Laboratory, MHAT ‘Nadezda’ Women’s Health Hospital, 1373, Sofia, Bulgaria
  9. 9Neuropathological Laboratory, University Hospital ‘Saint Ivan Rilski’, 1431, Sofia, Bulgaria
  10. 10Department of Gynecologic Oncology, Medical University Pleven, 5800, Pleven, Bulgaria


Introduction/Background Uterine sarcomas (USs) are rare mesenchymal malignancies with aggressive behavior and poor prognosis. Preoperative differentiation accuracy of USs and uterine leiomyomas (ULMs) is not satisfactory.

Methodology We collected observational data on two groups of women. Group I included USs patients with postoperatively confirmed sarcoma on histology and group II included patients with histologically diagnosed uterine leiomyoma. The study included 26 women with USs and 49 women with ULMs. Patients with USs had the following histological subtypes: 16 leiomyosarcomas, 6 endometrial stromal sarcomas, 3 adenosarcomas, and 1 undifferentiated uterine sarcoma. A blood test was performed 24 hours before surgery. Our work aimed to analyze the effects of age, preoperative blood serum levels of leucocytes, platels, hemoglobin, fibrinogen, and granulocytes/lymphocytes ratio on the probability of women being in the USs group. Data were analyzed using R. We applied multiple logistic regression with backward elimination to model the odds ratio (OR) of USs versus ULMs.

Results We report the results from the model with predictors of age, hemoglobin, fibrinogen and granulocytes/lymphocytes ratio. The variables hemoglobin and granulocytes/lymphocytes ratio are with p-values close to the boundary of the standard significance level of 5% (6.5% and 6.9% respectively) and we suspect that there is some evidence for their importance in the model. Older with one year women (OR 1.15, 95% CI: (1.06, 1.25), p-value < 0.001) and women with higher levels of the preoperative fibrinogen with one unit (OR 3.71, 95% CI: (1.36, 10.10), p-value = 0.01) were found to have statistically significantly bigger odds of USs.

Conclusion Based on the results from the data, the preoperative fibrinogen levels could have a significant role in differentiating patients with USs and ULMs. Further investigation based on data with a bigger sample size is needed to confirm our findings.

Disclosures The authors have no relevant financial or non-financial interests to disclose.

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