Zhao Yuanzheng, Han Jiaqi, Yang Rong, Wang Shuqin, Zhao Xinran, Wang Ziyuan, Lu Hongxia
Fenyang College Shanxi Medical University, Shanxi, China; No.16 College Road, Lvliang City, Shanxi Province, China.
Department of Gastroenterology, Shanxi Province Cancer Hospital/ Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Shanxi, ChinaNo. 3, Zhigong New Street, Taiyuan City, Shanxi Province, China.
PLoS One. 2025 Apr 8;20(4):e0320193. doi: 10.1371/journal.pone.0320193. eCollection 2025.
Gastric cancer represents a highly aggressive form of malignant tumor originating from the epithelial cells lining the gastric mucosa. Despite notable improvements in treatment approaches over the last few years, the associated mortality rate continues to be considerably high. Therefore, there is a pressing requirement for dependable biomarkers that can be utilized to predict and monitor prognosis, as well as to formulate targeted treatment strategies for patient groups at high risk.
We conducted an analysis of data collected from patients who were diagnosed with gastric cancer and underwent radical gastrectomy at Shanxi Cancer Hospital from June 2017 to June 2018, with follow-up data gathered over a five-year duration until 2023. Patient follow-up information was sourced from the hospital's monitoring system. The analysis focused on the variances in effectiveness of D-dimer against different tumor markers through Cox stratification analysis. The tumor marker that exhibited the most pronounced impact was selected to formulate a novel combined indicator. Furthermore, we examined how this combined indicator influences five-year overall survival (OS) outcomes following gastric cancer surgery using Cox multivariate regression analysis.
The Cox multivariate regression analysis revealed that the effect value of the D_Dimer-CA724 Middle group on the overall survival rate post-surgery for gastric cancer was found to be 1.42 (1.13-1.78), p = 0.003 (<0.05), in comparison with the D_Dimer-CA724 Low group. For the D_Dimer-CA724 High group, the effect value on overall survival after gastric cancer surgery was 2.11 (1.65-2.68), p < 0.001. Additionally, the trend test results indicated a value of 1.46 (1.29-1.64) with p < 0.001, demonstrating statistical significance. When compared to the D_Dimer-CA724 Low group, both the D_Dimer-CA724 Middle and High groups showed markedly poorer prognoses, with increased risks of 42% and 111%, respectively, highlighting a highly significant finding in clinical practice.
The integrated measure of D-dimer and CA724, referred to as D-dimer_CA724, serves as an independent predictor for the postoperative outcomes of gastric cancer, demonstrating superior predictive capability compared to the individual markers. In clinical settings, patients with gastric cancer exhibiting elevated levels of D-dimer_CA724 tend to experience worse prognoses following surgery. This measure holds significant potential for widespread application and promotion within clinical practice.
胃癌是一种起源于胃黏膜上皮细胞的高度侵袭性恶性肿瘤。尽管在过去几年中治疗方法有了显著改进，但相关死亡率仍然相当高。因此，迫切需要可靠的生物标志物，可用于预测和监测预后，以及为高危患者群体制定靶向治疗策略。
我们对2017年6月至2018年6月在山西省肿瘤医院被诊断为胃癌并接受根治性胃切除术的患者收集的数据进行了分析，并收集了截至2023年的五年随访数据。患者随访信息来自医院的监测系统。通过Cox分层分析，重点关注D-二聚体与不同肿瘤标志物有效性的差异。选择影响最显著的肿瘤标志物来制定一个新的联合指标。此外，我们使用Cox多变量回归分析研究了这个联合指标如何影响胃癌手术后的五年总生存率（OS）结果。
Cox多变量回归分析显示，与D_Dimer-CA724低分组相比，D_Dimer-CA724中分组对胃癌手术后总生存率的效应值为1.42（1.13-1.78），p = 0.003（<0.05）。对于D_Dimer-CA724高分组，对胃癌手术后总生存率的效应值为2.11（1.65-2.68），p < 0.001。此外，趋势检验结果显示值为1.46（1.29-1.64），p < 0.001，具有统计学意义。与D_Dimer-CA724低分组相比，D_Dimer-CA724中分组和高分组的预后均明显较差，风险分别增加42%和111%，这在临床实践中是一个非常重要的发现。
D-二聚体和CA724的综合测量指标，即D-dimer_CA724，可作为胃癌术后结果的独立预测指标，与单个标志物相比，具有更好的预测能力。在临床环境中，D-dimer_CA724水平升高的胃癌患者术后预后往往较差。该指标在临床实践中具有广泛应用和推广的巨大潜力。
