Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People's Republic of China.
National Clinical Research Center for Cancer, Tianjin, 300060, People's Republic of China.
Int J Clin Oncol. 2018 Dec;23(6):1070-1075. doi: 10.1007/s10147-018-1320-5. Epub 2018 Aug 27.
To investigate the predictive value of plasma D-dimer levels for short-term therapeutic effect and progression-free survival (PFS) in patients with small-cell lung cancer (SCLC); and to analyze the correlation between baseline plasma D-dimer levels and other clinicopathological features. The aim of the study was to investigate whether the levels of plasma D-dimer could serve as a predictive and prognostic factor in patients with SCLC.
A retrospective review of the clinicopathological data of 160 patients with pathologically confirmed SCLC, who were treated at the Department of Thoracic Oncology of Tianjin Medical University Tumor Institute and Hospital between June 2011 and June 2016, was performed. At the same time, we collected 100 patients with benign pulmonary diseases as a control group. The correlations between baseline plasma D-dimer levels and other clinical features, therapeutic effect and PFS were analyzed statistically.
The level of plasma D-dimer in patients with SCLC was significantly higher than that of patients with benign pulmonary diseases (P = 0.001). The PFS of patients with elevated D-dimer levels before therapy were significantly shorter than that of patients with normal D-dimer levels (6.0 versus 7.5 months, P = 0.013). The patients whose plasma D-dimer level always (before and after treatment) in the normal range have the best prognosis, and continuously elevated D-dimer carried out a poor prognosis (8.0 versus 5.0 months). According to multivariate analysis, elevated D-dimer level was confirmed to be an independent prognostic factor for worse survival (P = 0.029). The level of D-dimer was associated with tumor stage, the level of neuron-specific enolase, the presence of distant metastasis, hyponatremia, and the Karnofsky performance status score; and levels decreased when therapy was effective, but increased when the disease progressed.
High levels of baseline plasma D-dimer may indicate advanced disease stage and poor prognosis. Therefore, plasma D-dimer levels could serve as a predictive and prognostic factor in patients with SCLC.
研究血浆 D-二聚体水平对小细胞肺癌（SCLC）患者短期疗效和无进展生存期（PFS）的预测价值；分析基线血浆 D-二聚体水平与其他临床病理特征的相关性。本研究旨在探讨血浆 D-二聚体水平是否可作为 SCLC 患者的预测和预后因素。
回顾性分析 2011 年 6 月至 2016 年 6 月在天津医科大学肿瘤医院胸部肿瘤科经病理证实的 160 例 SCLC 患者的临床病理资料，同时收集 100 例良性肺部疾病患者作为对照组。统计分析基线血浆 D-二聚体水平与其他临床特征、疗效和 PFS 的相关性。
SCLC 患者血浆 D-二聚体水平明显高于良性肺部疾病患者（P=0.001）。治疗前 D-二聚体升高患者的 PFS 明显短于 D-二聚体正常患者（6.0 个月比 7.5 个月，P=0.013）。血浆 D-二聚体水平始终（治疗前后）正常的患者预后最佳，持续升高的 D-二聚体预后较差（8.0 个月比 5.0 个月）。多因素分析证实，D-二聚体升高是生存预后不良的独立预后因素（P=0.029）。D-二聚体水平与肿瘤分期、神经元特异性烯醇化酶水平、远处转移、低钠血症、卡氏功能状态评分有关；治疗有效时水平降低，疾病进展时水平升高。
基线时血浆 D-二聚体水平升高可能提示疾病处于晚期，预后不良。因此，血浆 D-二聚体水平可作为 SCLC 患者的预测和预后因素。
