Meng Zeyu, Liu Lu, Yang Xu, Hu Xingxu, Xi Yaping, Yang Qinglin, Luo Yun, Wang Donghong, Liu Jun
The First Clinical Institute, Zunyi Medical University, No.6 Xuefu Xilu, Zunyi, People's Republic of China.
Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, No.6 Xuefu Xilu, Zunyi, People's Republic of China.
Res Pract Thromb Haemost. 2025 Jan 28;9(2):102690. doi: 10.1016/j.rpth.2025.102690. eCollection 2025 Feb.
The role of preoperative D-dimer in the prediction of postoperative venous thromboembolism (VTE) with gynecological tumor remains unclear. This meta-analysis sought to assess the association between preoperative D-dimer and the risk of VTE after gynecological tumor surgeries and to identify prognostic significance of D-dimer in the prediction of postoperative VTE. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement. Eight electronic databases were searched for cohort studies from the date of inception to April 2024. The Newcastle-Ottawa Scale scoring tool and the Risk of Bias in Non-Randomized Studies-Intervention tool were used to assess the quality of the literature and the risk of bias in cohort studies, respectively. The relative risk and 95% CIs of the highest vs the lowest category and per milligram per liter of D-dimer were pooled relative to the VTE risk after gynecological tumor surgeries. Fifteen studies that met the criteria were included. Among these studies, D-dimer was considered as a continuous variable in 8 studies. The random-effect model results showed that the VTE risk was increased by 42% (15%-69%) per milligram per liter increase in D-dimer. Furthermore, based on the cutoff thresholds of D-dimer, 7 studies that reported the effect estimates of postoperative VTE in women with gynecological tumor by D-dimer were categorized as binary variables. Compared with the reference levels, the pooled relative risk of VTE after gynecological tumor surgeries for the higher level was 2.58 (95% CI, 1.49-4.47). Elevated preoperative D-dimer was associated with higher VTE risks after gynecological tumor surgeries.
术前D-二聚体在预测妇科肿瘤术后静脉血栓栓塞症（VTE）中的作用仍不明确。本荟萃分析旨在评估术前D-二聚体与妇科肿瘤手术后VTE风险之间的关联，并确定D-二聚体在预测术后VTE中的预后意义。本研究是根据《系统评价和荟萃分析的首选报告项目2020声明》进行的。检索了八个电子数据库，以查找从数据库建立之日至2024年4月的队列研究。分别使用纽卡斯尔-渥太华量表评分工具和非随机研究中的偏倚风险-干预工具来评估文献质量和队列研究中的偏倚风险。相对于妇科肿瘤手术后的VTE风险，汇总了最高类别与最低类别以及每升每毫克D-二聚体的相对风险和95%置信区间。纳入了15项符合标准的研究。在这些研究中，8项研究将D-二聚体视为连续变量。随机效应模型结果显示，D-二聚体每升每毫克增加，VTE风险增加42%（15%-69%）。此外，根据D-二聚体的临界阈值，7项报告了D-二聚体对妇科肿瘤女性术后VTE影响估计值的研究被分类为二元变量。与参考水平相比，妇科肿瘤手术后较高水平的VTE汇总相对风险为2.58（95%CI，1.49-4.47）。术前D-二聚体升高与妇科肿瘤手术后较高的VTE风险相关。
