The role of plasma D-dimer levels for predicting lymph node and mediastinal lymph node involvement in non-small cell lung cancer
The role of plasma D-dimer levels for predicting lymph node and mediastinal lymph node involvement in non-small cell lung cancer
复制标题
血浆 D-二聚体水平在预测非小细胞肺癌淋巴结和纵隔淋巴结受累中的作用
DOI：
10.1111/crj.12786
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发表时间：
2018-06-01
影响因子：
1.7
通讯作者：
Liu, Wei
中科院分区：
文献类型：
--
作者：
Gao, Xin-Liang;Wang, Si-Si;Liu, Wei
前言血浆D-二聚体水平升高被认为是非小细胞肺癌预后不良的预测指标。目的探讨血浆D-二聚体水平在预测非小细胞肺癌(NSCLC)淋巴结和纵隔淋巴结转移中的作用。方法对253例行根治性肺切除和全身淋巴结清扫的非小细胞肺癌患者术前血浆D-二聚体水平进行测定。结果N0组血浆D-二聚体水平(94.0g/L)明显低于N1+N2组(177.0 g/L)和N0+N1组(122.0 g/L)，明显低于N2组(198.0 g/L)。在按年龄、性别、吸烟状况和组织类型分层的患者中也发现了类似的结果，鳞癌患者除外。N_0与N_1+N_2血浆D-二聚体水平的受试者工作特征曲线的曲线下面积(AUC)为0.757，当D-二聚体浓度为0.80 g/L DDU时，敏感性和特异性分别为0.80和0.68。血浆D-二聚体水平N0+N1与N2ROC曲线显示AUC值为0.720，当血浆D-二聚体浓度为0.75 g/L DDU时，其敏感性和特异性分别为0.75和0.67。结论血浆D-二聚体水平对预测可手术非小细胞肺癌患者的淋巴结和纵隔淋巴结状态有一定价值。
IntroductionElevated plasma D-dimer levels have been suggested as a predictor of poor prognosis in NSCLC. But rare study showed the relationship between D-dimer levels and lymph node involvement.ObjectivesTo evaluate the role of plasma D-dimer levels in predicting lymph node and mediastinal lymph node involvement in NSCLC.MethodsPreoperative plasma D-dimer levels were quantified in 253 NSCLC patients that underwent radical lung resection with systemic lymph node dissection. Patients were classified as lymph node negative (N0) versus lymph node positive (N1+N2) and mediastinal lymph node negative (N0+N1) versus mediastinal lymph node positive (N2).ResultsMedian plasma D-dimer level was significantly lower in Group N0 (94.0 g/L) compared to Group N1+N2 (177.0 g/L) and in Group N0+N1 (122.0 g/L) compared to Group N2 (198.0 g/L). Similar results were found in patients stratified by age, sex, smoking status and histological type, expect in patients with squamous carcinoma. The Receiver Operating Characteristic (ROC) curve for plasma D-dimer levels of N0 versus N1+N2 showed an area under the curve (AUC) of 0.757 and when a cutoff value was 124.0 g/L DDU, the sensitivity and specificity was 0.80 and 0.68. The ROC curve for plasma D-dimer levels of N0+N1 versus N2 showed an AUC of 0.720 and when a cutoff value was 147.0 g/L DDU, the sensitivity and specificity was 0.75 and 0.67.ConclusionsPlasma D-dimer level has utility for predicting lymph node and mediastinal lymph node status in patients with operable NSCLC.