The D-dimer level predicts the postoperative prognosis in patients with non-small cell lung cancer


Autoři: Yuki Shiina aff001;  Takahiro Nakajima aff001;  Takayoshi Yamamoto aff001;  Kazuhisa Tanaka aff001;  Yuichi Sakairi aff001;  Hironobu Wada aff001;  Hidemi Suzuki aff001;  Ichiro Yoshino aff001
Působiště autorů: Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Chiba Japan aff001
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222050

Souhrn

Background

Carcinoma cells often modulate coagulation and fibrinolysis among cancer patients. Plasma dimerized plasmin fragment D (D-dimer) has been reported as a prognostic marker of various types of malignancies, including non-small cell lung cancer (NSCLC). However, the associations between the plasma D-dimer level and peripheral small NSCLC remain unclear.

Methods

Three hundred and sixty-two patients with NSCLC who underwent radical surgery were retrospectively reviewed. Patients who received anticoagulation therapy before surgery or who lacked preoperative D-dimer data were excluded. The other 235 patients were divided into a high D-dimer (over 1.0 μg/mL) group (HDD group, n = 47) and a normal D-dimer group (NDD group, n = 188) and investigated for their clinical characteristics, computed tomography (CT) findings, pathological findings, and clinical outcomes.

Results

The mean D-dimer levels was 2.49±2.58 μg/ml in the HDD group and 0.42±0.23 μg/ml in the NDD group. The HDD group was characterized by a predominance of male gender, older age, pure solid appearance on chest CT, vascular invasion in pathology, and a large solid part of the tumor. The HDD group showed a worse overall survival, disease-free survival, and disease-specific survival than the NDD group (p<0.001, <0.001, <0.001, respectively). These survival features were also observed in p-Stage IA disease. There was no marked survival difference when tumors showed ground-glass opacity on CT.

Conclusion

In NSCLC patients with a solid tumor appearance on CT, high D-dimer levels predict a poor survival and early recurrence.

Klíčová slova:

Blood plasma – Carcinomas – Computed axial tomography – Histology – Non-small cell lung cancer – Opacity – Prognosis – Surgical and invasive medical procedures


Zdroje

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2019 Číslo 12