Clinical significance of plasma D-dimer in ovarian cancer: A meta-analysis.
Clinical significance of plasma D-dimer in ovarian cancer: A meta-analysis.
复制标题
血浆 D-二聚体在卵巢癌中的临床意义：一项荟萃分析。
DOI：
10.1097/md.0000000000007062
复制
发表时间：
2017-06
期刊：
影响因子：
1.6
通讯作者：
Jia X
中科院分区：
文献类型：
--
作者：
Wu J;Fu Z;Liu G;Xu P;Xu J;Jia X
D-二聚体已被广泛应用于卵巢癌的诊断和预后判断，但其对卵巢癌的预测价值仍存在争议。系统探讨血浆D-二聚体水平在卵巢癌中的临床意义。使用PubMed、科克伦图书馆和Web of Science图书馆，检索了截至2016年5月30日关于血浆D-二聚体对卵巢癌的诊断和预后价值以及D-二聚体水平升高与卵巢癌静脉血栓栓塞（VTE）风险之间关系的所有相关研究。适当合并标准化均值差（SMD）、比值比（OR）、风险比（HR）和95%置信区间（CI）。共纳入了15项合格研究，共涉及1437例癌症患者。未发现高D-二聚体水平与卵巢癌患者的总生存期之间存在显着相关性（HR 1.32，95%CI：0.90-1.95，P = 0.044）。 然而，亚组分析表明，样本量可以解释研究之间的异质性。当样本量>100时，D-二聚体升高可预测死亡风险增加（HR 1.800，95% CI：1.283-2.523，P =.845）。 恶性卵巢癌患者血浆D-二聚体水平显著高于良性卵巢癌患者（SMD 0.774，95%CI：0.597-0.951，P = 0.39），晚期卵巢癌患者血浆D-二聚体水平显著 高于 良性卵巢癌患者（SMD 0.774，95%CI：0.597-0.951，P = 0.39（国际妇产科联合会[FIGO]分类III和IV）比早期卵巢癌患者（FIGO分类I和II，SMD 0.611，95%可信区间：0.373-0.849，P = .442）。D-二聚体水平升高提示卵巢癌患者发生静脉血栓栓塞的危险性增高（OR 4.068，95% CI：2.423-6.829，P = 0.629）。 卵巢癌患者血浆D-二聚体水平的变化可预测其与疾病进展及VTE风险的相关性。但其对卵巢癌预后的预测价值明显依赖于样本量。需要更多设计良好的大样本研究来验证和更新本研究的结果。
D-dimer has been widely used for the diagnosis and prognosis of ovarian cancer, but there is still controversy on its prediction value of ovarian cancer. To explore the clinical significance of plasma D-dimer level on ovarian cancer systematically. Using PubMed, Cochrane Library, and Web of Science libraries, all the relevant studies for the diagnostic and prognostic value of plasma D-dimer for ovarian cancer and the relationship between elevated D-dimer level and venous thromboembolism (VTE) risk of ovarian cancer were searched till May 30, 2016. Standardized mean difference (SMD), odds ratio (OR), hazard ratio (HR), and 95% confidence interval (CI) were appropriately pooled. A total of 15 eligible studies involving a total of 1437 cancer patients were included. No significant association was found between high D-dimer level and overall survival of patients with ovarian cancer (HR 1.32, 95% CI: 0.90–1.95, P = .044). However, subgroup analysis indicated that the sample sizes could explain the heterogeneity between studies. And elevated D-dimer could predict increased risk of mortality when the sample sizes were >100 (HR 1.800, 95% CI: 1.283–2.523, P = .845). Besides, plasma D-dimer level was significantly higher in malignant ovarian cancer patients compared with benign controls (SMD 0.774, 95% CI: 0.597–0.951, P = .39), higher in advanced ovarian cancer patients (International Federation of Gynecology and Obstetrics [FIGO] classification III and IV) than in early stage ovarian cancer patients (FIGO classification I and II, SMD 0.611, 95% CI: 0.373–0.849, P = .442). And high D-dimer level indicated high VTE risk (OR 4.068, 95% CI: 2.423–6.829, P = .629) of ovarian cancer patients. The plasma D-dimer level in ovarian cancer patients can predict the changes that correlated with disease progression and the VTE risk. But its predictive value for the prognosis of ovarian cancer was significantly dependent on the sample sizes. More well-designed studies with large sample sizes are needed to validate and update the findings of present study.
影响因子：
5.2
作者：
Echrish H;Madden LA;Greenman J;Maraveyas A
通讯作者：
Maraveyas A