Shengjing Hospital of China Medical University, Shenyang, China.
Cancer Chemother Pharmacol. 2019 Apr;83(4):797-802. doi: 10.1007/s00280-019-03778-6. Epub 2019 Feb 13.
To explore the clinical significance of plasma D-dimer increase for transcatheter arterial chemoembolization (TACE) in patients with primary liver cancer (PLC).
The clinical data of 80 PLC patients who underwent TACE in our hospital from January 2015 to January 2017 were collected, including the plasma D-dimer level 1 week before TACE (D0), D-dimer level 1 month after TACE (D1) and D-dimer level when the disease begins to progress (D2). 1 Month after TACE, these patients were divided into two groups according to the mRecist criteria: disease-controlled group (CR + PR + SD) and disease-progressing group (PD). In all subjects, progression-free survival (PFS) was recorded. D0 and D1 were compared between the two groups by the rank sum test; and the relation between D-dimer level and PFS was assessed by the Kaplan-Meier test and Breslow test.
In the disease-controlled group, there was no significant difference between D0 and D1 (P > 0.05); in the disease-progressing group, D1 was significantly higher than D0 (P < 0.05) and the D1 is higher than that in disease-controlled group. In the patients with a negative D1 or D2, PFS was longer than those with a positive level (both P < 0.05), but such difference was not statistically significant in D0 (P > 0.05). In the patients with a D-dimer level increase after TACE (group 3), PFS was shorter than that in those with a D-dimer level decrease after TACE (Group 1) and that in those with a relatively stable D-dimer level before and after TACE (Group 2) (P < 0.05); survival in Group 1 was slightly but not significantly longer than that in Group 2 (P > 0.05).
The change in plasma D-dimer level can be used as a biological index to assess the efficacy of TACE and prognosis for PLC patients, and thus, a positive D-dimer level or D-dimer increase after TACE is an unfavorable factor.
探讨原发性肝癌（PLC）患者经肝动脉化疗栓塞术（TACE）后血浆 D-二聚体升高的临床意义。
收集我院 2015 年 1 月至 2017 年 1 月接受 TACE 的 80 例 PLC 患者的临床资料，包括 TACE 前 1 周（D0）、TACE 后 1 个月（D1）和疾病开始进展时（D2）的血浆 D-二聚体水平。TACE 后 1 个月，根据 mRecist 标准将这些患者分为两组：疾病控制组（CR+PR+SD）和疾病进展组（PD）。记录所有患者的无进展生存期（PFS）。秩和检验比较两组 D0 和 D1 的差异；Kaplan-Meier 检验和 Breslow 检验评估 D-二聚体水平与 PFS 的关系。
疾病控制组 D0 与 D1 无显著性差异（P>0.05）；疾病进展组 D1 显著高于 D0（P<0.05），且高于疾病控制组。D1 阴性或 D2 阴性患者的 PFS 长于 D1 阳性患者（均 P<0.05），但 D0 无统计学差异（P>0.05）。TACE 后 D-二聚体升高的患者（第 3 组）的 PFS 短于 TACE 后 D-二聚体降低的患者（第 1 组）和 TACE 前后 D-二聚体相对稳定的患者（第 2 组）（P<0.05）；第 1 组的生存情况略长于第 2 组，但无统计学差异（P>0.05）。
血浆 D-二聚体水平的变化可作为评估 PLC 患者 TACE 疗效和预后的生物学指标，因此阳性 D-二聚体水平或 TACE 后 D-二聚体升高是不利因素。
