Plasma D-dimer levels in operable breast cancer patients correlate with clinical stage and axillary lymph node status
Plasma D-dimer levels in operable breast cancer patients correlate with clinical stage and axillary lymph node status
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DOI：
10.1200/jco.2000.18.3.600
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发表时间：
2000-02-01
影响因子：
45.3
通讯作者：
Greenberg, C
中科院分区：
文献类型：
--
作者：
Blackwell, K;Haroon, Z;Greenberg, C
目的：为了探讨术前血浆D-二聚体水平和肿瘤的参与程度之间的关系，在可操作的乳腺癌patients.Patients和方法：共140术前血浆标本从妇女预定进行诊断性乳腺活检。初始组中的95名患者继续接受腋窝淋巴结清扫术。在获得血浆样本的140名患者中，102名随后被诊断为浸润性乳腺癌，9名随后被诊断为导管原位癌，20名随后被诊断为良性乳腺疾病。使用市售免疫测定试剂盒（DIMERTEST; American Diagnostica，格林威治，CT）定量血浆D-二聚体水平。血浆D-二聚体与其他预后指标的关系（肿瘤大小、雌激素受体、孕激素受体、细胞核分级、组织学分级、淋巴管浸润和临床分期分组）然后使用单变量和多变量线性和逻辑回归分析进行检查。中位血浆D-浸润性癌患者的二聚体水平显著高于良性乳腺疾病或原位癌患者（P = .0001）。D-二聚体升高（> 100 ng/mL）与腋窝淋巴结受累之间存在显著相关性（χ 2检验; P = 0.001）。在单变量回归（P = 0.0035）和多变量线性回归（P = 0.012）模型中，D-二聚体水平升高预测阳性淋巴结受累。此外，在单变量logistic回归分析（P = 0.0025）和多变量logistic回归分析（P = 0.0053）中，D-二聚体水平升高预测淋巴血管浸润的存在。定量D-二聚体水平与临床分期分组高度相关（方差分析检验; P = 0.002）。结论：血浆D-二聚体水平是可手术乳腺癌淋巴管浸润、临床分期和淋巴结受累的标志物。这种相关性表明，可检测的纤维蛋白降解，如血浆D-二聚体测量，是一个临床上重要的标志物淋巴血管浸润和早期肿瘤转移的可手术乳腺癌。J Clin Oncol 18：600-608. (C)2000年，美国临床肿瘤学会。
Purpose: To investigate the relationship between preoperative plasma D-dimer levels and extent of tumor involvement in operable breast cancer patients.Patients and Methods: A total Of 140 preoperative plasma specimens were obtained from women scheduled to undergo diagnostic breast biopsies. Ninety-five patients in the initial group went on to undergo axillary lymph node dissection. Of the 140 patients from whom plasma samples were obtained, 102 were subsequently diagnosed with invasive breast carcinoma, nine were subsequently diagnosed with ductal carcinoma-in-situ, and 20 were subsequently diagnosed with benign breast disease. Plasma D-dimer levels were quantitated using a commercially available immunoassay kit (DIMERTEST; American Diagnostica, Greenwich, CT). The relationships between plasma D-dimer and other prognostic variables (tumor size, estrogen receptor, progesterone receptor, nuclear grade, histologic grade, lymphovascular invasion, and clinical stage grouping) were then examined using univariate and multivariate linear and logistic regression analyses.Results: Median plasma D-dimer levels were significantly higher in patients with invasive carcinoma than those patients with either benign breast disease or carcinoma-in-situ (P = .0001). A significant relationship existed between the presence of elevated D-dimer (> 100 ng/mL) and involved axillary lymph nodes (chi(2) test; P = .001). Elevated D-dimer levels predicted positive lymph node involvement in both univariate regression (P = .0035) and multivariate linear regression (P = .012) models. In addition, elevated D-dimer levels predicted the presence of lymphovascular invasion in univariate logistic regression (P = .0025) and multivariate logistic regression analysis (P = .0053). Quantitative D-dimer levels were highly correlated with clinical stage grouping (analysis of variance test; P = .002).Conclusion: Plasma D-dimer levels were markers of lymphovascular invasion, clinical stage, and lymph node involvement in operable breast cancer. This correlation suggests that detectable fibrin degradation, as measured by plasma D-dimer, is a clinically important marker for lymphovascular invasion and early tumor metastasis in operable breast cancer. J Clin Oncol 18:600-608. (C) 2000 by American Society of Clinical Oncology.