D-二聚体在宫颈癌预后评价的应用

Application of D-dimer in prognostic evaluation of cervical cancer

目的:探讨血浆D-二聚体(D-D)对宫颈癌临床预后判断的指导意义。方法:将手术及病理证实的宫颈癌患者分为有转移及无远处转移两组,进行D-D水平对比分析,并依据宫颈癌2009 FIGO分期标准,选取Ⅰ期、Ⅱa期、Ⅱb期三组患者进行D-D水平对比分析及D-D阳性率分析。结果:宫颈癌组患者D-D阳性率是48.6%;有转移组D-D水平高于无远处转移组,差异有统计学意义(P<0.05)。依临床分期D-D水平及阳性率随宫颈癌病变的恶性程度升高而呈上升趋势,差异有统计学意义(P<0.05)。Ⅰ期、Ⅱa期宫颈癌患者手术前后的D-D下降程度及转阴率显著高于Ⅱb期宫颈癌患者。结论:血浆D-D与宫颈癌有远处转移、临床分期、手术预后密切相关,其水平可作为临床预测宫颈癌患者临床分期及手术预后的重要指标。

Objective： To explore the guiding significance of plasma D - dimer for prognostic evaluation of cervical cancer in clin- ic. Methods： The patients with cervical cancer confirmed by surgery and pathology were randomly divided into metastasis group and non - metastasis group, the levels of D - dimer in the two groups were compared and analyzed ; according to the 2009 FIGO staging criteria of cervi- cal cancer, the patients were divided into stage Ⅰ group, stage Ⅱ a group, and stage Ⅱb group, the levels of D -dimer in the three groups were compared and analyzed, the positive rates of D - dimer in the three groups were analyzed. Results ： The positive rate of D - dimer in the patients with cervical cancer was 48.6%. The level of D - dimer in metastasis group was statistically significantly higher than that in non - metastasis group （ P 〈 0. 05 ） . According to clinical stages, the level and positive rate of D - dimer showed an increasing trend with increase of malignant degree of cervical cancer, there was statistically significant difference （P 〈 0. 05 ） . The degrees of decrease and negative con- version rate of D - dimer before and after surgery in patients with cervical cancer of stage Ⅰ and stage Ⅱa were significantly higher than those in patients with cervical cancer of stage Ⅱ b. Conclusion： Plasma D - dimer is closely correlated with distant metastasis, clinical stages, and surgical prognosis of cervical cancer, the level of D - dimer can be used as an important index to predict clinical stages and surgical prognosis of patients with cervical cancer.