Rella C, Coviello M, De Frenza N, Falco G, Chiuri E, Colavito P, Quaranata M, De Leonardis A
Hemostasis and Hematology Laboratory, Oncology Institute, Bari, Italy.
Tumori. 1993 Oct 31;79(5):347-51. doi: 10.1177/030089169307900513.
Fibrin is formed and degraded intra-abdominally in ovarian cancer, and the cross-linked fibrin degradation product, D-dimer (D-D), has been found in increased concentrations in the plasma of these patients.
D-dimer and Ca 125 levels were determined simultaneously in 110 patients with gynecologic neoplasms. D-dimer and Ca 125 assays were performed using the Dimertest Stripwell EIA Kit (Ortho) and CA 125-II EIA assay (Roche), respectively.
D-dimer plasma and Ca 125 serum levels were significantly higher in patients with ovarian cancer (mean +/- SE = 894.2 +/- 173.7 ng/ml and 760.5 +/- 292.7 U/ml, respectively) than in those with uterine cancer (mean DD +/- SE = 109.7 +/- 23.5 ng/ml and mean Ca 125 +/- SE = 50.0 +/- 23.1 U/ml) or those with benign disease (mean D-D +/- SE = 70.5 +/- 5.5 ng/ml and mean Ca 125 +/- SE = 6.6 +/- 2.8 U/ml). The levels of both markers increased with regard to ovarian cancer disease status. Mean D-D +/- SE was 90.0 +/- 22.8 ng/ml and mean Ca 125 +/- SE was 2.1 +/- 1.2 U/ml in patients with complete remission; mean D-D +/- SE was 143.3 +/- 33.5 ng/ml and mean Ca 125 +/- SE was 26.2 +/- 13.6 U/ml in patients with partial remission. In active disease, both markers had very high levels: D-D mean +/- SE = 1021.6 +/- 173.0 ng/ml and Ca 125 mean +/- SE = 1154.7 +/- 458.1 U/ml. In all groups of ovarian cancer patients, D-dimer sensitivity was better than that of Ca 125. In advanced ovarian cancer patients, the D-dimer concentration in ascites was up to 100 fold that in plasma.
Our results suggest that D-dimer can serve as a sensitive indicator to monitor the extent and course of the disease in ovarian cancer patients. The patient follow-up is ongoing to establish the predictive value of D-dimer measurement with respect to prognosis.
在卵巢癌中，纤维蛋白在腹腔内形成并降解，且已发现交联纤维蛋白降解产物D-二聚体（D-D）在这些患者血浆中的浓度升高。
对110例妇科肿瘤患者同时测定D-二聚体和癌抗原125（Ca 125）水平。分别使用Dimertest Stripwell EIA试剂盒（奥多公司）和CA 125-II EIA检测法（罗氏公司）进行D-二聚体和Ca 125检测。
卵巢癌患者的血浆D-二聚体水平和血清Ca 125水平（分别为平均±标准误=894.2±173.7 ng/ml和760.5±292.7 U/ml）显著高于子宫癌患者（平均D-D±标准误=109.7±23.5 ng/ml，平均Ca 125±标准误=50.0±23.1 U/ml）或良性疾病患者（平均D-D±标准误=70.5±5.5 ng/ml，平均Ca 125±标准误=6.6±2.8 U/ml）。两种标志物的水平均随卵巢癌疾病状态而升高。完全缓解患者的平均D-D±标准误为90.0±22.8 ng/ml，平均Ca 125±标准误为2.1±1.2 U/ml；部分缓解患者的平均D-D±标准误为143.3±33.5 ng/ml，平均Ca 125±标准误为26.2±13.6 U/ml。在疾病活动期，两种标志物水平都非常高：D-D平均±标准误=1021.6±173.0 ng/ml，Ca 125平均±标准误=1154.7±458.1 U/ml。在所有卵巢癌患者组中，D-二聚体的敏感性优于Ca 125。在晚期卵巢癌患者中，腹水中D-二聚体浓度高达血浆中的100倍。
我们的结果表明，D-二聚体可作为监测卵巢癌患者疾病范围和病程的敏感指标。目前正在对患者进行随访，以确定D-二聚体检测对预后的预测价值。
