Aksoy Rahmi Atıl, Koca Timur, Şengün Yasemin, Atak Ece, Korcum Aylin Fidan
Department of Radiation Oncology, Akdeniz University Faculty of Medicine, Antalya 07070, Turkey.
Department of Radiation Oncology, Izmir City Hospital, Izmir 35530, Turkey.
Medicina (Kaunas). 2025 Apr 19;61(4):756. doi: 10.3390/medicina61040756.
: Glioblastoma presents a significant challenge in oncology due to its aggressive nature and poor prognosis, despite advancements in treatment. This study aims to comprehensively evaluate the prognostic significance of coagulation biomarkers, including the novel albumin/D-dimer ratio, in adult glioblastoma patients. : This retrospective study included 74 adult glioblastoma patients who underwent Stupp protocol treatment. Blood samples were collected before radiotherapy to measure biomarkers, including prothrombin time (PT), activated partial thromboplastin time (aPTT), albumin, D-dimer, and the albumin/D-dimer ratio. The prognostic significance of these biomarkers for progression-free survival (PFS) and overall survival (OS) was assessed using both univariate and multivariate Cox regression analyses. : The median follow-up time was 12.2 months (range, 1-77.4 months). Univariate analysis revealed that ECOG performance status ( = 0.001), D-dimer ( = 0.03), and albumin ( = 0.001) were significant prognostic factors for PFS. Multivariate analysis identified albumin ( = 0.02) as an independent prognostic biomarker for PFS. For OS, univariate analysis showed that age ( = 0.004), ECOG performance status ( = 0.001), tumor volume ( = 0.007), extent of resection ( = 0.01), radiotherapy dose ( = 0.001), D-dimer ( = 0.02), albumin ( = 0.001), albumin/D-dimer ratio ( = 0.02), and PT ( = 0.002) were significant prognostic factors. Multivariate analysis revealed age ( = 0.04), extent of resection ( = 0.02), and PT ( = 0.04) as independent prognostic factors for OS. : Our findings highlight the prognostic significance of coagulation biomarkers, particularly PT, D-dimer, albumin, and the albumin/D-dimer ratio, in glioblastoma. These biomarkers may serve as valuable tools for prognostic assessment and personalized treatment strategies, warranting further exploration in larger prospective studies.
胶质母细胞瘤因其侵袭性和预后不良，尽管治疗有所进展，但在肿瘤学中仍构成重大挑战。本研究旨在全面评估凝血生物标志物，包括新型白蛋白/D-二聚体比值，在成胶质母细胞瘤患者中的预后意义。本回顾性研究纳入了74例接受Stupp方案治疗的成胶质母细胞瘤患者。在放疗前采集血样以测量生物标志物，包括凝血酶原时间（PT）、活化部分凝血活酶时间（aPTT）、白蛋白、D-二聚体和白蛋白/D-二聚体比值。使用单因素和多因素Cox回归分析评估这些生物标志物对无进展生存期（PFS）和总生存期（OS）的预后意义。中位随访时间为12.2个月（范围1 - 77.4个月）。单因素分析显示，ECOG体能状态（P = 0.001）、D-二聚体（P = 0.03）和白蛋白（P = 0.001）是PFS的显著预后因素。多因素分析确定白蛋白（P = 0.02）是PFS的独立预后生物标志物。对于OS，单因素分析表明年龄（P = 0.004）、ECOG体能状态（P = 0.001）、肿瘤体积（P = 0.007）、切除范围（P = 0.01）、放疗剂量（P = 0.001）、D-二聚体（P = 0.02）、白蛋白（P = 0.001）、白蛋白/D-二聚体比值（P = 0.02）和PT（P = 0.002）是显著预后因素。多因素分析显示年龄（P = 0.04）、切除范围（P = 0.02）和PT（P = 0.04）是OS的独立预后因素。我们的研究结果突出了凝血生物标志物，特别是PT、D-二聚体、白蛋白和白蛋白/D-二聚体比值在胶质母细胞瘤中的预后意义。这些生物标志物可作为预后评估和个性化治疗策略的有价值工具，值得在更大规模的前瞻性研究中进一步探索。
