1st Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland.
Oncological Surgery Department, Masovian Cancer Hospital, Wieliszew, Poland.
Cancer Control. 2023 Jan-Dec;30:10732748231204713. doi: 10.1177/10732748231204713.
The importance of D-dimers (DD) assessment in the diagnostic algorithm of venous thromboembolic (VTE) disease is well known. Increase of DD concentration may be also associated with neoplastic disease. Many studies documented that high concentration of DD before solid tumour surgery indicates more advanced disease and poor life expectancy. The prognostic value of the DD concentration variability in the perioperative period, in women undergoing breast cancer surgery, has not been analysed so far. Thus, the aim of the present prospective study was to assess whether the trend of DD concentration changes in the perioperative period may predict cancer recurrence in women undergoing breast cancer surgery.
189 consecutive women with histopathological diagnosis of breast cancer (BC) referred for surgical treatment were included. DD concentration was measured twice in each patient: at the time of admission to hospital and at the time of discharge home. Enoxaparin in standard dose of 40 mg daily s. c. was used as primary VTE prophylaxis in all of the patients.
The recurrence of BC, within 1 year observation time, occurred in 13 patients (6.8%), in 11 (5.8%) patients with DD increase after surgery and only in 2 (1.1%) without an increase in DD, = .0179. Increase in DD concentration after BC surgery was an independent positive predictor of disease relapse (OR 8.600, LCI 1.451, UCI 96.80, = .0371) together with the lack of postoperative radiotherapy (OR 6.009, LCI 1.305, UCI 31.95, = .0245), whereas the lack of postoperative chemotherapy predicted no BC relapse (OR .07355, LCI .0056, UCI .58, = .0245).
Increase of DD in the early postoperative period may be considered as additional independent predictor of recurrence of BC within 1 year.
D-二聚体（DD）评估在静脉血栓栓塞（VTE）疾病的诊断算法中的重要性是众所周知的。DD 浓度的增加也可能与肿瘤疾病有关。许多研究证明，实体瘤手术后 DD 浓度升高表明疾病更晚期，预期寿命更短。迄今为止，尚未分析围手术期 DD 浓度变化的趋势是否可预测接受乳腺癌手术的女性的癌症复发。
纳入了 189 名经组织病理学诊断为乳腺癌（BC）的连续女性患者，这些患者接受手术治疗。在每位患者中两次测量 DD 浓度：住院时和出院回家时。所有患者均使用标准剂量的 40 毫克依诺肝素每日皮下注射作为主要的 VTE 预防措施。
在 1 年的观察时间内，13 例（6.8%）发生了 BC 复发，在手术后 DD 增加的 11 例（5.8%）患者中，只有 2 例（1.1%）DD 未增加， =.0179。BC 手术后 DD 浓度的增加是疾病复发的独立正预测因子（OR 8.600，LCI 1.451，UCI 96.80， =.0371），同时缺乏术后放疗（OR 6.009，LCI 1.305，UCI 31.95， =.0245），而缺乏术后化疗则预示着没有 BC 复发（OR.07355，LCI.0056，UCI.58， =.0245）。
在术后早期 DD 的增加可被视为 1 年内 BC 复发的附加独立预测因子。
