Liu Chan, Ning Yueguo, Chen Xiaoming, Zhu Qian
Department of General Surgery, Jingmen First People's Hospital, Jingmen, Hubei Province.
Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Pancreatic Surgery Center, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
Medicine (Baltimore). 2020 Feb;99(7):e19243. doi: 10.1097/MD.0000000000019243.
D-dimer level is a direct measure of activated coagulation and has been used as a biomarker of hypercoagulability. In this study, we aimed to explore the associations between D-dimer level and the clinicopathological features and prognosis in metastatic colorectal cancer (mCRC) patients. One hundred seventy-eight patients diagnosed with mCRC from the Department of General Surgery, Jingmen First People's Hospital from September 2014 to December 2018 were collected. Data of coagulation index was evaluated and survival analysis was performed to identify the biomarker of mCRC. Among 178 cases of colorectal cancer, we found that the value of 0.55 mg/L, 5ng/ml and 40U/ml were cut-off values of D-Dimer, CEA and CA-199 for patients survival, respectively. hypercoagulability was much more frequent in patients aged ≥60 years than <60 years (P < .001) and also in patients with ECOG ≥2 points (P < .001). Moreover, those patients who have CEA >5ng/ml and CA-199>40U/ml had hypercoagulable state (P < .001). There was a significant difference in D-Dimer >0.55 mg/L and D-Dimer ≤0.55 mg/L among the number of metastatic sites (P < .01) and patients with comorbidities (P < .01). Survival analysis showed that patients with D-Dimer >0.55 mg/L have significantly unfavorable overall survival (P = .006) and progressive free survival (P = .011).
D-二聚体水平是活化凝血的直接指标,已被用作高凝状态的生物标志物。在本研究中,我们旨在探讨转移性结直肠癌(mCRC)患者的D-二聚体水平与临床病理特征及预后之间的关联。收集了2014年9月至2018年12月在荆门市第一人民医院普通外科确诊为mCRC的178例患者。评估凝血指标数据并进行生存分析,以确定mCRC的生物标志物。在178例结直肠癌患者中,我们发现D-二聚体、癌胚抗原(CEA)和糖类抗原199(CA-199)对于患者生存的临界值分别为0.55mg/L、5ng/ml和40U/ml。≥60岁患者的高凝状态比<60岁患者更为常见(P<.001),东部肿瘤协作组(ECOG)评分≥2分的患者也是如此(P<.001)。此外,CEA>5ng/ml且CA-199>40U/ml的患者处于高凝状态(P<.001)。转移部位数量(P<.01)和合并症患者(P<.01)中,D-二聚体>0.55mg/L和D-二聚体≤0.55mg/L之间存在显著差异。生存分析表明,D-二聚体>0.55mg/L的患者总生存期(P=.006)和无进展生存期(P=.011)明显较差。