Plasma D-dimer Levels In Patients Research Articles

Clinical value of measuring plasma D-dimer levels in patients with esophageal cancer

BackgroundEsophageal cancer represents a significant public health concern; however, reliable diagnostic and prognostic markers have not been established. This study aimed to investigate the clinical value of plasma D-dimer levels in patients with esophageal cancer.MethodsOverall, 120 patients with esophageal cancer who underwent radical surgical resection at our department between January 2019 and 2020 were included (esophageal cancer group). Plasma D-dimer levels were measured preoperatively and on postoperative days 1 and 14. Additionally, 60 healthy participants (control group) with measured plasma D-dimer levels were included. The preoperative D-dimer levels and positive D-dimer test rates were compared between the groups. The 3-year survival rate in patients with esophageal cancer was calculated using the Kaplan–Meier method.ResultsPreoperative D-dimer concentration in the esophageal cancer group was (0.65 ± 0.859 µg/mL) significantly higher than that in the control group (0.32 ± 0.369 µg/mL). The positivity rate in the esophageal cancer group (35.0%, 42/120) was significantly higher than that in the control group (15%, 9/60). D-dimer concentrations were significantly higher 1 day postoperatively than preoperatively. Conversely, D-dimer concentrations were significantly lower 14 days postoperatively than preoperatively. Patients in the esophageal cancer group with plasma D-dimer concentrations ≤ 0.5 µg/mL had significantly higher 3-year survival rates than those with higher concentrations. In the logistic multivariate analysis, tumor pathological stage and preoperative plasma D-dimer levels were independent prognostic factors of 3-year survival rates in patients with esophageal cancer.ConclusionPlasma D-dimer concentrations are clinically valuable in esophageal cancer diagnosis, postoperative recurrence monitoring, and prognosis prediction.

Predictive value of D-dimer in patients with unexplained recurrent implantation failure during freeze-thaw embryo transfer cycles.

This study aimed to evaluate whether D-dimer can predict the clinical outcomes of patients with unexplained recurrent implantation failure (URIF) during freeze-thaw embryo transfer (FET) cycles. Our study was divided into two parts. The first part was a retrospective study that included 433 patients. Plasma D-dimer levels were monitored in all patients before FET, and the patients were classified into two groups according to whether they delivered at least one live infant or not. D-dimer was compared between groups, and receiver operating characteristic (ROC) curves were constructed to analyze the impact of D-dimer on live birth. The second part was a prospective study that included 113 patients who were categorized into high and low D-dimer groups based on the ROC curve analysis from the retrospective study. Clinical outcomes were compared between these two groups. In the first part, we found that plasma D-dimer levels in patients with live birth were significantly lower than those in patients without live birth. According to the ROC curve, 0.22mg/L was the cutoff value for D-dimer in the prediction of the live birth rate (LBR) (AUC 0.806, 95% CI: 0.763, 0.848). The second part of the study confirmed that clinical pregnancy rate (50.98%vs. 32.26%, P=.044) and LBR (41.18%vs. 22.58%, P=.033) of patients with D-dimer ≤0.22mg/L were all significantly higher than those of patients with D-dimer>0.22mg/L. Our study indicates that D-dimer>0.22mg/L is a useful index for predicting URIF during FET cycles.

Elevated plasma D-dimer levels in patients with anti-N-methyl-D-aspartate receptor encephalitis.

We aimed to explore the difference in coagulation function between healthy individuals and patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis and its relationship with disease severity. We retrospectively compared coagulation function in 161 patients with first-attack anti-NMDAR encephalitis and 178 healthy individuals. The association between D-dimer levels and disease severity was analyzed using binary logistic regression. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of D-dimer levels for the severity of anti-NMDAR encephalitis. Compared to control individuals, patients with anti-NMDAR encephalitis had higher D-dimer levels (median 0.14 vs. 0.05 mg/L, p < 0.001), blood white blood cell (WBC) count (median 8.54 vs. 5.95 × 109/L, p < 0.001), and neutrophil count (median 6.14 vs. 3.1 × 109/L, p < 0.001). D-dimers (median 0.22 vs. 0.10 mg/L, p < 0.001), blood WBC count (median 9.70 vs. 7.70 × 109/L, p < 0.001), neutrophil count (median 7.50 vs. 4.80 × 109/L, p < 0.001), and C-reactive protein (median 2.61 vs. 1.50 mg/l, p = 0.017) were higher; however, eosinophils (median 0.02 vs. 0.06 × 109/L, p < 0.001), and blood calcium (median 2.26 vs. 2.31 mmol/L, p = 0.003) were lower in patients with severe forms of anti-NMDAR encephalitis than in those with mild to moderate forms, and were associated with initial modified Rankin Scale scores. Multivariate analysis showed that D-dimer levels were significantly associated with severity [odds ratio =2.631, 95% confidence interval (CI) = 1.018-6.802, p = 0.046]. The ROC curve was used to analyze the predictive value of D-dimer levels for disease severity. The area under the curve was 0.716 (95% CI = 0.64-0.80, p < 0.001), and the best cut-off value was D-dimer = 0.147 mg/L (sensitivity 0.651; specificity, 0.705). Serum D-dimer and neutrophil levels were independent predictors of disease severity in patients with first-attack anti-NMDAR encephalitis.

D-dimer as a safe, convenient and easily available biomarker, when combined with conventional sentinel node biopsy in clinically node negative breast cancer to assess metastatic disease in axilla and reduce false negative results

Background: Breast cancer is frequently associated with activation of the hemostatic system and the extent of this activation correlates with a more advanced tumor stage. D-dimer is a biomarker that indicates the activation of hemostasis and fibrinolysis.Methods: This is a prospective, observational, analytical study in which we compare plasma D-dimer levels among three groups’ i.e., healthy subjects, benign patients and breast cancer patients. We have also evaluated plasma D-dimer levels in patients with lymphadenopathy and in those patients who did not have palpable lymph nodes. Plasma D-dimer levels were further characterized based on TNM classification in breast cancer patients where quantitative D-dimer levels were correlated with clinical stage grouping.Results: Through our study we have observed that D-dimer level is inexpensive and a convenient method for diagnosis and prognosis of breast cancer. We have used a control group so as to evaluate a more accurate result. Comparison between benign and malignant lesions was made and we have achieved a significant p value, which proved our study positive for raised D-dimer levels in cancer breast.Conclusions: D-dimer proves to be a safe, convenient and easily available biomarker which can be combined with conventional sentinel node biopsy in clinically node negative breast cancer to assess metastatic disease in axilla and reduce false negative results. Plasma D-dimer level was positively correlated with clinical stage of solid cancers.

Concomitant genetic alterations are associated with plasma D-dimer level in patients with non-small-cell lung cancer.

Objective: D-dimer is correlated to the poor prognosis of non-small-cell lung cancer. The study aimed to investigate the association between plasma D-dimer and concomitant mutations in non-small-cell lung cancer. Methods: A total of 517 non-small-cell lung cancer patients were recruited and tested for ALK, BRAF, EGFR, HER2/ERBB2, KRAS, MET, PIK3CA, RET and ROS1 mutationby next-generation sequencing. Multiple gene mutation information, clinical baseline data and laboratory test data were analyzed statistically. Results: All patients were divided into three groups: wild-type group, single-gene mutation group and concomitant mutation group. The analysis of D-dimer, uric acid, gender, family history, smoking history, histology and distant metastasis all showed significant differences in the three groups (p<0.05). D-dimer was considered as a risk factor for concomitant mutations according to the unordered multiple logistic regression analysis. The receiver operating characteristic curve analysis indicated that D-dimer had an important predictive value for the occurrence of concomitant mutations (area under the curve [AUC]: 0.94; sensitivity: 88.71%; specificity: 86.46). There was significantly shorter median progression-free survival in the concomitant mutation group compared with the single mutation group (7.70 months vs 14.00 months; p=0.0133). Conclusion: Plasma D-dimer is significantly associated with concomitant mutations and may be regarded as a potent predictor of concomitant mutations for non-small-cell lung cancer patients.

Soluble C-Type Lectin-Like Receptor 2 Elevation in Patients with Acute Cerebral Infarction.

Background: Acute cerebral infarction (ACI) includes cardiogenic ACI treated with anticoagulants and atherosclerotic ACI treated with antiplatelet agents. The differential diagnosis between cardiogenic and atherosclerotic ACI is still difficult. Materials and Methods: The plasma sCLEC-2 and D-dimer levels were measured using the STACIA system. Results: The plasma sCLEC-2 level was significantly high in patients with ACI, especially those in patients with atherosclerotic or lacunar ACI, and plasma D-dimer levels were significantly high in patients with cardioembolic ACI. The plasma levels of sCLEC-2 and the sCLEC-2/D-dimer ratios in patients with atherosclerotic or lacunar ACI were significantly higher than those in patients with cardioembolic ACI. The plasma D-dimer levels in patients with atherosclerotic or lacunar ACI were significantly lower than those in patients with cardioembolic ACI. The plasma levels of sCLEC-2 and the sCLEC-2/D-dimer ratios were significantly higher in patients with atherosclerotic or lacunar ACI or acute myocardial infarction in comparison to patients with cardioembolic ACI or those with deep vein thrombosis. Conclusion: Using both the plasma sCLEC-2 and D-dimer levels may be useful for the diagnosis of ACI, and differentiating between atherosclerotic and cardioembolic ACI.

High pretreatment plasma D-dimer levels predict poor survival in patients with diffuse large B-cell lymphoma in the real world.

BackgroundData on the role of pretreatment plasma D-dimer levels in the prognostic prediction of patients with diffuse large B-cell lymphoma (DLBCL) are limited. We here studied the potential prognostic roles of pretreatment plasma D-dimer levels in patients with DLBCL.MethodsWe retrospectively analyzed medical records of 308 newly diagnosed patients with DLBCL admitted to the Fujian Medical University Union Hospital between January 2011 and December 2018. Receiver operating characteristic (ROC) curve analysis were used to generate an optimal cut-off value for pretreatment plasma D-dimer levels in patients with DLBCL. According to the cut-off value, all patients were divided into the low D-dimer and high D-dimer groups. We analyzed the relationship between pretreatment plasma D-dimer levels and clinical and laboratory characteristics in patients with DLBCL. Univariate and multivariate analyses were used to assess prognostic factors for overall survival (OS) and progression-free survival (PFS).ResultsPatients with B symptoms, plasma lactate dehydrogenase levels >upper limit of normal (ULN), poor Eastern Cooperative Oncology Group score (2 to 4), advanced stage (III–IV), >1 extranodal site, higher International Prognostic Index (IPI) (2 to 5) and higher National Comprehensive Cancer Network IPI (NCCN-IPI) (≥4) (all P<0.001) had higher pretreatment plasma D-dimer levels (≥1.4 µg/mL). Patients with higher plasma D-dimer levels had worse OS and PFS (P<0.001 and P=0.001, respectively).ConclusionsHigher pretreatment plasma D-dimer level was associated with poor survival and was an independent poor predictor of OS among untreated patients with DLBCL.

Plasma D-Dimer Level in Vietnamese Patients with Chronic Urticaria.

Background:Chronic Urticaria (CU) is one of the most common skin diseases, affecting 2–3% of the population. Many studies have demonstrated that plasma D-dimer levels could be considered as a biomarker for disease activity and treatment response in patients with CU.Aim:To evaluate plasma D-dimer levels in patients with CU and their correlation with disease severity.Methods:The present study was a case-controlled study conducted in 97 patients with CU and 40 healthy subjects. Plasma D-dimer levels were measured using the enzyme-linked immunosorbent assay.Results:The mean plasma D-dimer level in patients with CU (807.76 ng/mL) was significantly higher than that in normal subjects (424.63 ng/mL) (P < 0.001). A significant correlation was observed between plasma D-dimer levels and the urticaria active score (P = 0.005, r = 0.28). Our study also suggested a significant difference in plasma D-dimer levels between patients with CU with and without angioedema.Conclusions:Patients with CU had higher plasma D-dimer levels than the control group. A positive statistical correlation was observed between plasma D-dimer levels and severity of CU.

Prognostic Value of the Preoperative Plasma D-Dimer Levels in Patients with Upper Tract Urothelial Carcinoma in a Retrospective Cohort Study.

PurposeElevated plasma D-dimer levels were thought to be associated with decreasing survival in various cancers. The relationship between plasma D-dimer levels and clinicopathology and the optimal D-dimer cutoff as a prognostic predictor has not been determined in patients with upper tract urothelial carcinoma (UTUC). We aimed to investigate the prognostic value of preoperative plasma D-dimer levels as a predictor of patient outcomes in UTUC following radical nephroureterectomy.Patients and MethodsWe retrospectively reviewed data for 232 patients. The D-dimer cutoff value was set at 0.36 mg/L, and we used the Kaplan–Meier method and Cox’s proportional hazards regression models to analyze the association between D-dimer levels and oncological outcomes. Multivariate Cox regression was used to develop a nomogram, which we evaluated for accuracy using a receiver operating characteristic curve, calibration plot, and decision curve analysis.ResultsPlasma D-dimer levels ≥0.36 mg/L were significantly associated with advanced tumor status regarding size, location, hydronephrosis, tumor grade, lymph node involvement, grade, and stage (all p < 0.05). The Kaplan–Meier analysis showed that plasma D-dimer levels ≥0.36 mg/L predicted worse oncological outcomes vs levels <0.36 mg/L (all p < 0.001). Univariate and multivariate analyses showed that elevated preoperative plasma D-dimer level was an independent predictor of recurrence-free survival (hazard ratio (HR): 1.67, 95% confidence interval (CI): 1.07–2.63; p = 0.025), cancer-specific survival (HR: 2.34, 95% CI: 1.30–4.19; p = 0.004), and overall survival (HR: 1.98, 95% CI: 1.18–3.34; p = 0.010). We also developed a nomogram predicting 3- and 5-year overall survival probability.ConclusionD-dimer levels may be a useful prognostic predictor of survival and improve risk stratification and precisely individualize treatment for patients with UTUC.

Preoperative plasma D-dimer level is a useful prognostic marker in ovarian cancer

A high pre-treatment plasma D-dimer level was recently identified as a poor prognostic factor in several malignancies. The aim of this study was to evaluate the prognostic significance of plasma D-dimer levels in epithelial ovarian cancer (EOC). Data of 199 patients were retrospectively analysed. The relationships between pre-treatment D-dimer levels and other clinical parameters and prognosis were evaluated. Univariate analysis identified age, pre-treatment plasma D-dimer level, massive ascites, residual tumours, pre-treatment CA125 level, histological type, and FIGO stage as predictors of overall survival. The multivariate analysis showed that a high pre-treatment plasma D-dimer level (p=.017), residual tumours (p < .001), and FIGO stage (p = .036) were independent risk factors of overall survival. Venous thromboembolism (VTE) did not influence overall survival (p=.091). High pre-treatment D-dimer levels are associated with a poor prognosis independent of VTE status in EOC patients, and might be a useful prognostic biomarker.Impact statementWhat is already known on this subject? In recent years, a high pre-treatment plasma D-dimer level has been identified as a prognostic factor in several malignancies, but only a handful of studies have assessed the role of pre-treatment plasma D-dimer levels in patients with EOC patients. Thus, the clinical significance and prognostic value of the plasma D-dimer level in EOC remain controversial, and there is also debate related to the association of the higher mortality rate among cancer patients with elevated D-dimer levels with VTE.What do the results of this study add? In our study, high pre-treatment D-dimer levels are associated with a poor prognosis independently of VTE in EOC patients.What are the implications of these findings for clinical practice and/or further research? The D-dimer level might emerge as a valuable prognostic biomarker, which will help doctors in the choice of initiating a more aggressive therapy, the combination of chemotherapy with anticoagulation therapy.

Prognostic significance of pretreatment plasma D-dimer levels in patients with spinal chordoma: a retrospective cohort study.

Plasma D-dimer levels, a marker of hypercoagulation, have not only been used as an indicator for cascaded reaction in the coagulation process but are also reported to be an underlying biomarker in several types of cancers. This retrospective cohort study was designed to evaluate the prognostic value of preoperative plasma D-dimer level in patients with spinal chordoma. We enrolled 224 patients who underwent surgery for spinal chordoma between 2002 and 2015 at Changzheng Orthopedic Oncology Center. Preoperative clinical parameters were recorded and evaluated by univariate and multivariate Cox regression models. The correlation between preoperative plasma D-dimer levels and survival was assessed using the Kaplan-Meier method. The optimal cutoff value of pretreatment D-dimer was 840μg/L determined by X-tile. DFS (disease-free survival) was 64.7% and OS (overall survival) was 75% in the cohort. Multivariate Cox regression model identified D-dimer level as an independent prognostic factor of DFS and OS, as well as treatment history, preoperative Karnofsky Performance Scale, preoperative Frankel score, pathology classification and adjuvant radiotherapy (p < 0.05). In addition, D-dimer level may also be an effective supplement for defining tumor Enneking staging (p < 0.05). Higher pretreatment plasma D-dimer level was associated with a poor prognosis in chordoma and could be used as an independent prognostic factor for the survival of the patients with spinal chordoma. With supplementation of D-dimer level, Enneking stage may be more able to accurate stratify individualized risk and determine clinical management. These slides can be retrieved under Electronic Supplementary Material.

Evaluation of plasma d-dimer level in patients with chronic urticaria

Background: Urticaria is a common disease impacting negatively on multiple aspects of patients' lives. Acute urticaria is defined as the occurrence of wheals with or without angioedema for less than 6weeks, whereas chronic urticaria is defined as the occurrence of wheals and pruritus anywhere on the body and/or angioedema occurring for 6weeks or longer. D-dimer is a fibrin degradation product so it is a marker of thrombin activity and fibrin turnover and thus reflects both haemostasis and fibrinolysis. Recent findings showed that in outpatients with sever to moderate CU, mean D-dimer plasma levels were significantly higher than in a group of age- and sex-matched normal controls. Objectives: To evaluate plasma D-dimer correlation with chronic urticaria disease activity. Settings: Dermatology outpatient clinic of Al Azhar University Hospital in Damietta (Egypt), tertiary referral center. Subjects and methods: This study included 40 patients with chronic urticaria. They were recruited from dermatology outpatient clinic of Al-Azhar University Hospital in Damietta. All cases were subjected to complete history taking, general examination and dermatological examination was performed for all patients with emphasis to determine the site and the type of the lesion and the presence of any dermatological diseases, laboratory investigations including CBC, ESR, PT, PTT and D-dimer. Results: In this study we found normal plasma D-dimer level in (62.5%) of enrolled patients and elevated plasma D-dimer level in (37.5%) of them. We also demonstrated that there was statistically significant positive correlation to clinical disease severity. Conclusions: Investigation for plasma D-dimer level may be an alternative way to evaluate disease activity and severity in patients with CU.

D-dimer levels as marker of deep vein thrombosis in patients with cervical cancer: A study of a northern Nigerian patient population

Background: Cervical cancer is the most common genital tract malignancy in Nigeria and an important cause of cancer-related death in women. Patients with advanced cervical cancer are often victims of deep venous thrombosis (DVT) that increases morbidity and mortality. Strategies at screening and early diagnosis enable prompt treatment which improves quality of life. Objectives: The objective of this study is to determine the plasma D-dimer level in patients with cervical cancer and its relationship to the presence of DVT, Well's score, and stage of malignancy. Materials and Methods: It is a prospective cross-sectional descriptive study of patients with histological diagnosis of cervical cancer in a Nigerian population. Patients' clinical, laboratory, and radiological data were obtained, and their body mass index (BMI) was calculated. Well's chart 17 was used to categorize patients using a cutoff of 2. Plasma D-dimer was quantified by immunoturbidimetric method and interpreted as significant if >0.099 g/dl. High-resolution ultrasound with 5–10 MHZ linear probe was used to evaluate the lower limbs veins of the patients. Data were analyzed with SPSS version 20. The test of association was done using Chi-square with a P

Prognostic value of pretreatment plasma D-dimer levels in patients with diffuse large B cell lymphoma (DLBCL)

BackgroundWe assessed the prognostic significance of D-dimer in patients of diffuse large B cell lymphoma (DLBCL). MethodsWe performed a retrospective study including 254 patients who were newly diagnosed DLBCL. X-tile was used to generate a cutoff value for D-dimer. Both univariate screen by Cox proportional hazard model and multivariable analysis by Cox regression model were used to assess the impact of pretreatment D-dimer levels on the overall survival (OS). ResultAccording to X-tile, the optimal cut-off value of D-dimer for prediction of survival was set as 1.6 μg/mL, and a D-dimer level ≥ 1.6 μg/mL was significantly associated with poor overall survival (OS) (OS: 31.7 vs. 79.1%, P < 0.001). In multivariable analysis, it was found that a higher D-dimer level was an independent predictor for worse OS (Hazard ratio (HR): 3.594 95% Confidence interval (CI): 2.296–5.267, P < 0.001). In subgroup analysis of International Prognostic Index (IPI), survival of low-risk and intermediate-risk group with a D-dimer level ≥ 1.6 μg/mL were both similar to that of the high-risk group (OS: 31.6 vs. 36.5%, P = 0.957; OS: 38.0 vs. 36.5%, P = 0.758). In addition, among patients treated with surgery, those with higher D-dimer had substantially worse survival than that with lower D-dimer (OS: 27.0 vs. 84.5%, P < 0.001). ConclusionPretreatment D-dimer is a simple but effective predictor of survival among patients with DLBCL.

Prognostic significance of preoperative plasma D-dimer level in patients with surgically resected clinical stage I non-small cell lung cancer: a retrospective cohort study

BackgroundPlasma D-dimer level, a marker of hypercoagulation, has been reported to be associated with survival in several types of cancers. The present study aimed to evaluate the prognostic significance of preoperative D-dimer levels in patients with surgically resected clinical stage I non-small cell lung cancer (NSCLC).MethodsParticipants comprised 237 patients with surgically resected clinical stage I NSCLC. In addition to factors such as age, sex, and smoking status, the association between preoperative D-dimer level and survival was explored.ResultsPatients were divided into two groups according to D-dimer level: Group A, ≤ 1.0 μg/ml (n = 170); and Group B, > 1.0 μg/ml (n = 67). The 5-year recurrence-free survival rate was 81.6% for Group A and 66.6% for Group B (p < 0.001). The 5-year overall survival rate was 93.6% for Group A and 84.7% for Group B (p = 0.002). Multivariate survival analysis identified D-dimer level as an independent prognostic factor, along with age, maximum standardized uptake value of the primary tumor, and pathological stage.ConclusionsPreoperative D-dimer level is an independent prognostic factor in patients with surgically resected clinical stage I NSCLC.

P1.05-017 Prognostic Significance of Preoperative Plasma D-Dimer Level in Patients with Surgically Resected Clinical Stage I Non-Small Cell Lung Cancer

P1.05-017 Prognostic Significance of Preoperative Plasma D-Dimer Level in Patients with Surgically Resected Clinical Stage I Non-Small Cell Lung Cancer

Dynamic change of plasma D-dimer level in patients with acute craniocerebral injury and cerebral hemorrhage and its significance

Objective To explore the dynamic change and clinical significance of plasma D-dimer level in patients with cerebral hemorrhage and acute craniocerebral injury. Methods 50 patients with cerebral hemorrhage and 40 patients with acute craniocerebral injury were selected, The enzyme-linked immunosorbent assay (ELISA) was used to measure plasma D-dimer level in two groups of patients after onset, and the results were compared with 40 healthy controls. Results The levels of plasma D-dimer in the patients with cerebral hemorrhage were 1.59mg/L, 2.10mg/L, 1.03mg/L, 0.82mg/L at 3h, 6h, 12h, 2d after onset, which in the patients with acute craniocerebral injury were 1.61mg/L, 2.02mg/L, 1.01mg/L and 0.67mg/L, respectively.And the plasma D-dimer levels were 0.50mg/L, 0.49mg/L, 0.47mg/L, 0.48mg/L in the control group at 3h, 6h, 12h and 2d after onset.The levels of plasma D-dimer in the patients with acute craniocerebral injury were significantly higher than those in the control group, and the differences were statistically significant (t=9.35, 12.17, 4.03, 3.05, all P 0.05). Conclusion Cerebral hemorrhage patients and acute craniocerebral injury patients have high coagulation and fibrinolytic activity in brief increase trend, dynamic observation of plasma D-dimer level in patients with cerebral hemorrhage and acute craniocerebral injury is helpful to determine courses, condition and evaluate prognosis. Key words: Craniocerebral trauma; Cerebral hemorrhage; D-dimer

Prognostic value of plasma D-dimer levels in patients with small-cell lung cancer.

Little data exists with respect to the relationship between the level of plasma D-dimer and prognosis of small cell lung cancer (SCLC).The aim of this study was to investigate whether the levels of plasma D-dimer could be served as a prognostic factor in patients with SCLC. A total of 393 patients with SCLC were addressed in the present retrospective study. Plasma D-dimer levels were measured by immunoturbidimetric assay. The correlation between plasma D-dimer levels and other clinical features, progression free survival (PFS) and overall survival (OS) was analyzed statistically. The plasma D-dimer levels were significantly correlated with karnofsky performance status (KPS), tumor stage, number of metastatic sites, and treatment response. The PFS and OS of patients with elevated D-dimer levels before chemotherapy were significantly shorter than that of patients with normal D-dimer levels (PFS: 6.2 months versus 9.6 months, P<0.001; OS: 15.7 months versus 24.4 months, P<0.001). The patients with D-dimer levels converting from high to normal had better PFS and OS than those with D-dimer levels remaining high after two cycles of chemotherapy. According to multivariate analysis, elevated D-dimer level was confirmed to be an independent prognostic factor for worse survival. Elevated plasma D-dimer level could be served as an independent determinant of poor prognosis in patients with SCLC.

The value of detecting perioperative plasma D-dimer level in patients with esophageal cancer or esophageal gastric junction cancer

Objective To evaluate the value of detecting the perioperative plasma D-dimer level in patients with esophageal cancer or esophageal gastric junction cancer. Methods 71 patients with esophageal carcinoma or esophageal gastric junction cancer who received operation were enrolled in this study.Plasma D-dimer lever before the operation and on 1st,4th,7th,10th day postoperation were detected and to find the relation between the D-dimer level and patients clinical characters. Results Plasma D-dimer lever before the operation was higher when the stage was later in esophageal cancer or in the esophageal gastric junction cancer[stage 0:(141. 5±71. 4)μg/L; stageⅠ:(205. 5± 89. 0)μg/L;stageⅡ:(267. 1±123. 4)μg/L;stageⅢ:(446. 5±227. 9)μg/L;stageⅣ:(289. 0± 0. 0)μg/L], and there was no relation with other clinical characters.Plasma D-dimer level reach the max on 1st day postoperation[(1 193. 0±670. 5)μg/L], and decreasing on 4th day[(893. 2± 287. 5)μg/L]; it rise again on 7th day postoperation[(1 089. 1±178. 9)μg/L], and then drop down on 10th day[(1 043. 8±202. 9)μg/L]. Conclusion Plasma D-dimer lever before the operation was positive relative with the stage of esophageal cancer or esophageal gastric junction cancer. Plasma D-dimer level rise after operation.It reach max on 1st day because the surgical trauma and microthrombus, and decrease signicicantly on 4th day.It rise again on 7th day,and then,it decrease gradually.If it rise after 7 days postoperation, deep venous thrombosis(DVT) and pulmonary thromboembolism(PTE)should be considered. Key words: Esophageal carcinoma; Esophageal gastric junction cancer; D-dimer; Perioperative

High Pretreatment Plasma D-dimer Levels Are Associated With Poor Prognosis in Patients With Ovarian Cancer Independently of Venous Thromboembolism and Tumor Extension.

ObjectiveElevated plasma D-dimer (DD) is associated with decreased survival among patients with breast, lung, and colon cancers. The present study clarifies the prognostic significance of pretreatment plasma DD levels in patients with epithelial ovarian cancer (EOC).MethodsWe investigated pretreatment DD levels and other variables for overall survival using univariate and multivariate analyses in 134 consecutive patients with EOC stages II to IV who were initially treated between November 2004 and December 2010.ResultsThe median follow-up period was 53 (7–106) months. Univariate analysis significantly associated elevated pretreatment DD (≥2.0 μg/mL) levels to poor 5-year overall survival rates irrespective of previously treated venous thromboembolism (72.2% vs 52.6%, P = 0.039). Cancer antigen 125 levels of 200 U/mL or higher (P = 0.011), distant metastases (P = 0.0004), residual tumors (P < 0.0001), and International Federation of Gynecology and Obstetrics stage III/IV (P = 0.0033) were also poor prognostic factors. Multivariate analysis independently associated DD levels of 2.0 μg/mL or higher (P = 0.041), distant metastases (P = 0.013), and residual tumors (P < 0.0001) with poor overall survival.ConclusionsHigh pretreatment DD levels are associated with poor overall survival in patients with EOC independently of venous thromboembolism and tumor extension and might comprise a promising prognostic biomarker for patients with EOC.