Oya M, Akiyama Y, Yanagida T, Akao S, Ishikawa H
Department of Surgery, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama, Japan.
Surg Today. 1998;28(4):373-8. doi: 10.1007/s005950050144.
The purpose of this study was to explore the relationship between the preoperative plasma D-dimer (DD) levels and the tumor pathology of colorectal cancer. The plasma DD levels were measured preoperatively in 108 patients with colorectal cancer, and then were correlated with the tumor pathology and stage. The diagnostic value of the DD levels for the tumor stage was then compared with that of the preoperative carcinoembryonic antigen (CEA) levels. The preoperative DD levels were higher in patients with either a large-sized tumor or a tumor showing deep wall penetration. Lymph-node metastasis, lymphatic invasion, hepatic metastasis, and peritoneal dissemination were all associated with higher DD levels. A stepwise increase in the median DD level was found with the tumor stage. The preoperative DD levels also significantly correlated with CEA levels. When a cutoff value of 0.6 microg/ml was used in the DD assay, the sensitivity and specificity for Dukes C or D cancer were 67.2% and 64.0%, and those for Dukes D cancer were 91.3% and 57.6%, respectively. Although the DD assay was less specific, its diagnostic value in the preoperative staging of colorectal cancer was comparable to that of the CEA assay. The measurement of the preoperative DD level is thus considered to be useful for the preoperative staging of colorectal cancer.
本研究的目的是探讨术前血浆D-二聚体（DD）水平与结直肠癌肿瘤病理学之间的关系。对108例结直肠癌患者术前测定血浆DD水平，然后将其与肿瘤病理学和分期进行关联。随后将DD水平对肿瘤分期的诊断价值与术前癌胚抗原（CEA）水平的诊断价值进行比较。肿瘤体积大或肿瘤显示深壁浸润的患者术前DD水平较高。淋巴结转移、淋巴管浸润、肝转移和腹膜播散均与较高的DD水平相关。发现随着肿瘤分期的增加，DD中位数水平呈逐步上升。术前DD水平也与CEA水平显著相关。当DD检测采用0.6μg/ml的临界值时，对Dukes C期或D期癌症的敏感性和特异性分别为67.2%和64.0%，对Dukes D期癌症的敏感性和特异性分别为91.3%和57.6%。虽然DD检测的特异性较低，但其在结直肠癌术前分期中的诊断价值与CEA检测相当。因此，术前DD水平的测定被认为对结直肠癌的术前分期有用。
