Chen Chong, Li Jianhua, Li Jing, Wang Xu, Wang Xiaoyan, Du Na, Ren Li
Department of Clinical Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, National Human Genetic Resources Sharing Service Platform, Tianjin, China.
Ann Transl Med. 2020 Sep;8(18):1153. doi: 10.21037/atm-20-5947.
Tumor-related coagulation dysfunction has been reported to be closely associated with poor prognosis. The present study is aimed to evaluate the prognostic prediction of an elevated plasma D-dimer cut-off value in advanced non-small cell lung cancer (NSCLC).
A total of 233 patients initially diagnosed with advanced NSCLC were retrospectively analyzed, an elevated plasma cut-off value 981 ng/mL of D-dimer, which was instead of the clinical cut-off value 500 mg/mL, was used to determine the high and low. Univariate analysis using the Kaplan-Meier method and log-ranking test, and the multivariate analysis using the Cox proportional hazard regression model were performed.
Results showed when using the D-dimer value of 500 ng/mL as an evaluation standard, there was no significant difference in gender, age, smoking status, histopathology and overall survival rate between normal D-dimer (≤500 ng/mL) and high D-dimer (>500 ng/mL) group. However, when the evaluation standard for plasma D-dimer was set at 981 ng/mL, the age distribution of the high D-dimer (>981 ng/mL) group was significantly different from the normal D-dimer (≤981 ng/mL) group. Moreover, the overall survival rate in the high D-dimer (>981 ng/mL) group was significantly lower than that in the normal D-dimer (≤981 ng/mL) group.
The present study implied that increasing the plasma D-dimer cut-off value to 981 ng/mL is more beneficial to prognosis prediction in advanced NSCLC.
肿瘤相关凝血功能障碍与预后不良密切相关。本研究旨在评估血浆D-二聚体临界值升高对晚期非小细胞肺癌（NSCLC）预后预测的价值。
回顾性分析233例初诊为晚期NSCLC的患者，采用血浆D-二聚体临界值981 ng/mL而非临床临界值500 ng/mL来划分高低水平。使用Kaplan-Meier法和对数秩检验进行单因素分析，并用Cox比例风险回归模型进行多因素分析。
结果显示，以500 ng/mL的D-二聚体值作为评估标准时，正常D-二聚体（≤500 ng/mL）组和高D-二聚体（>500 ng/mL）组在性别、年龄、吸烟状况、组织病理学和总生存率方面无显著差异。然而，当血浆D-二聚体的评估标准设定为981 ng/mL时，高D-二聚体（>981 ng/mL）组的年龄分布与正常D-二聚体（≤981 ng/mL）组显著不同。此外，高D-二聚体（>981 ng/mL）组的总生存率显著低于正常D-二聚体（≤981 ng/mL）组。
本研究表明，将血浆D-二聚体临界值提高到981 ng/mL对晚期NSCLC的预后预测更有益。
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