Integrated fibrinogen-platelet score (F-P Score) in ovarian carcinoma: diagnostic value for differentiating early and advanced stage

Abstract

Introduction: Ovarian carcinoma is often diagnosed at an advanced stage due to the absence of early symptoms. While the tumor marker CA-125 is highly sensitive, it has limited specificity. Modern research demonstrates that tumor-induced systemic inflammation and hypercoagulation play a key role in tumor progression. Objective: The study aims to evaluate the correlation between preoperative CA-125 levels and the combined Fibrinogen-Platelet Score (F-P Score) in patients at different stages of ovarian carcinoma, and to analyze their potential to differentiate between early and advanced stages of the disease. Material and Methods: A retrospective study was conducted involving 60 patients with histologically confirmed ovarian carcinoma (Stage I, n = 19; Stage II, n = 19; Stage III, n = 22). Patients in Stage IV were not included in the study. Serum CA-125, plasma fibrinogen, and platelet count (PLT) were examined. The F-P Score was calculated (0, 1, or 2 points based on the reference ranges for fibrinogen and PLT). Statistical analysis included ANOVA, the Kruskal-Wallis test, the χ2 (Chi-square) test, and ROC analysis. Results: A statistically significant increase in all examined parameters was observed alongside the advancement of the clinical stage (p < 0.001). In stage I, 100% of the patients had an F-P Score of 0, whereas in Stage III, 54.5% reached the maximum score of 2 points. ROC analysis showed that the individual assessment of fibrinogen (AUC = 0.927) and platelets (AUC = 0.754) was inferior in diagnostic accuracy to the combined F-P Score, which demonstrated the highest area under the curve (AUC = 0.932; 95% CI: 0.869-0.995). Conclusion: While CA-125 remains a highly sensitive marker for the presence of a tumor process, the F-P Score is a more reliable marker for preoperative staging and assessment of invasiveness. Its inclusion in clinical practice may improve patient stratification and the prediction of the tumor’s biological behavior.