Plasma levels of D-dimer in lung carcinoma - Clinical and prognostic significance
Plasma levels of D-dimer in lung carcinoma - Clinical and prognostic significance
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DOI：
10.1002/cncr.11432
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发表时间：
2003-06-15
期刊：
影响因子：
6.2
通讯作者：
Ferrigno, D
中科院分区：
文献类型：
--
作者：
Buccheri, GR;Torchio, P;Ferrigno, D
背景在癌症患者中凝血-纤溶系统的激活是常见的，并且代表不利的临床体征。D-二聚体（DD）是一种敏感的纤溶指标。目前的研究包括826例新的肺癌患者连续看到在一个单一的机构超过10年的时间（1992-2001）。对于每例患者，31个变量，包括DD和生存时间，可用于分析。DD变量与乳酸脱氢酶水平、体能状态、组织多肽抗原、疾病分期和转移灶数量相关性最好（rho分别为0.33、-0.25、0.18、0.18和0.15）。D-二聚体可区分不同疾病的患者。异常升高和正常值的中位生存期分别为154天（95%置信区间[CI]，122-189天）和308天（95% CI，227-409天;对数秩统计，26.56; P < 0.01）。在腺癌患者和表现为不太晚期疾病的患者中，特别是在病理学Ia期疾病的患者中，差异更大。最好的多变量生存模型选择了10个显著的协变量，包括DD。作者建议对所有新发肺癌患者测定血浆DD水平。这种测量可能有助于制定个体化诊断，并可用于指示手术患者的辅助治疗。(C)2003年美国癌症协会。
BACKGROUND. The activation of the clotting-fibrinolytic system in cancer patients is common and represents an unfavorable clinical sign. D-dimer (DD) is a sensitive marker of fibrinolysis.METHODS. The current study comprised 826 new lung carcinoma patients seen consecutively in a single institution over a 10-year period (1992-2001). For each patient, 31 variables, including DD and survival duration, were available for analysis.RESULTS. Only weak relationships between DD and the other variables were found. The DD variable correlated best with the level of lactate dehydrogenase, performance status, tissue polypeptide antigen, stage of disease, and the number of metastases (rho 0.33, -0.25, 0.18, 0.18, and 0.15, respectively). The D-dimer distinguished patients with different prognoses. The median survival periods were 154 days (95% confidence interval [CI], 122-189 days) and 308 days (95% Cl, 227-409 days; log rank statistic, 26.56; P < 0.01), respectively, for abnormally elevated and normal values. The difference was greater in patients with adenocarcinoma and in patients presenting with a less advanced disease, especially in patients with pathologic Stage la disease. The best multivariate survival model selected 10 significant covariates, including DD.CONCLUSIONS. The authors recommend measuring the plasma level of DD in all new lung carcinoma patients. This measurement may help to formulate individual prognoses and can be used to indicate adjuvant treatment for surgical patients. (C) 2003 American Cancer Society.