D-二聚体测定在结肠癌中的临床意义

Value of D two dimer in colon cancer

[目的]观察D-二聚体测定在结肠癌中的临床意义。[方法]62例接受治疗的结肠癌患者为观察组,以同期体检的健康人群为对照组;观察2组患者D-二聚体阳性率,观察组中发生转移及未发生转移患者化疗前的D-二聚体测定结果比较、化疗前后D-二聚体变化与疗效之间的关系、临床分期与D-二聚体含量之间的关系。[结果]观察组D-二聚体检查阳性率为46.77%,对照组为0%,观察组患者D-二聚体检查阳性率明显高于对照组(P<0.05)。观察组中未发生转移、发生周围淋巴结转移、发生远处脏器转移患者D-二聚体含量分别为(0.23±0.09)mg/L、(1.51±1.45)mg/L、(2.23±1.29)mg/L,三者之间比较差异有统计学意义(P<0.05);结肠癌Ⅱ期、Ⅲ期、Ⅳ期D-二聚体含量分别为(0.27±0.08)mg/L、(1.16±0.36)mg/L、(2.01±0.82)mg/L,各分期D-二聚体含量比较差异有统计学意义(P<0.05)。观察组化疗后完全缓解+部分缓解患者D-二聚体变化值为(-0.43±0.21)mg/L,较治疗前显著性下降(P<0.05);病变稳定患者为(0.08±0.09)mg/L,与治疗前无明显改变(P>0.05);病变进展患者为(0.92±0.34)mg/L,较治疗前显著升高(P<0.05)。[结论]D-二聚体含量与结肠癌发病情况、是否发生转移及转移情况、疾病临床分期、预后等有着密切的联系,应灵活运用并掌握该项检查。

[Objective]To investigate the clinical significance of determination of D two dimer in colon cancer. [Methods] Sixty-two patients with colon cancer in our hospital were selected as the observation group, while the healthy people at the same period in the medical examination center were selected as the control. The positive rate of D two dimer in two groups, value of D two dimer in patients with colon cancer metastasis and without metastasis, patients before and after receiving chemotherapy was determined. Relationship between the D two dimer change and the symptoms＇ improvement was analyzed. Relationship between clinical stage and D two dimer were investigated. [Results]The positive rate of D two dimer in the observation group was 46.77%,while it was 0% in the control group （P〈0.05）. The concentration of D two dimer in the patients with no metastasis,lymph node metastasis, distant organ metastasis were （0. 23± 0.09） mg/L, （1.51±1.45） mg/L,and （2.23± 1.29） mg/L,respectively（P〈0.05） ,which indicated that the value of D two dimer aggravated with colorectal cancer metastasis. The concentration of D two dimer in stage II,III,IV of colon cancer was （0. 27±0. 08）mg/L, （1.16±0. 36）mg/L,and（2.01±0.82）mg/L,respectively（P〈0.05）, which suggested the later colon cancer staging, the higher concentration of the two D dimer. After chemotherapy,the value of two D dimer in patients with colon cancer （CR＋PR） decreased to （0. 43±0.21）mg/L（P〈0.05）, and in SD patients,it decreased to （0.08±10.09）mg/L （P〉0.05）,in PD patients,it increased to （0. 92±0. 34）mg/L（P〈0. 05）. [Conclusion]D two dimer shows close relationship with colon cancer incidence, metastasis, clinical staging and prognosis of diseases.