术前D-二聚体水平检测对卵巢癌预后判断的价值

Predictive value of preoperative D-dimer level in the prognosis of ovarian cancer

目的探讨D-二聚体水平对卵巢癌患者预后的影响和预测价值。方法回顾性分析2015年1月至2017年12月在山西省肿瘤医院初治并接受手术治疗的384例卵巢癌患者的临床资料,根据统计学方法选取D-二聚体水平截断值,并根据截断值将患者分组,分析D-二聚体水平与患者复发情况的相关性。结果384例卵巢癌患者中,失访32例(8.33%)。352例完成随访的患者中复发141例(40.1%),中位复发时间9(7,14)个月。根据受试者工作特征曲线(ROC曲线)分析,选取D-二聚体=366.5μg/L作为截断值。高D-二聚体组患者复发率高于低D-二聚体组,差异有统计学意义(P<0.05)。在控制其他因素的前提下,D-二聚体高表达的卵巢癌患者易出现复发[95%CI=1.954(1.319~2.896)]。结论D-二聚体水平易获取,卵巢癌患者D-二聚体水平是影响卵巢癌复发的一个独立的预后因素,可作为临床预测卵巢癌患者预后的参考指标。

Objective To investigate the influence and predictive value of D-dimer level on the prognosis of patients with ovarian cancer.Methods The clinical data of 384 patients with ovarian cancer who were treated in Shanxi Cancer Hospital from January 2015 to December 2017 were retrospectively analyzed.The cut-off value of D-dimer Ievel was selected by statistical methods.The patients were grouped according to cut-off values,and the correlation between D-dimer levels and recurrence rate were analyzed.Results Among 384 eases of ovarian cancer,32 cases (8.33%)were lost to follow up.Of the 352 patients who completed follow-up,141 cases (40.1%)recurred,and the median recurrence time was 9(7,14)months.According to the receiver operating characteristic curve (ROC curve), D-dimer =366.5μg/L was selected as the cut-off value.The recurrence rate in high D-dimer level group was significantly higher than that in low D-dimer level group (P<0.05).Under the premise of controlling other factors,patients with high D-dimer level were prone to having recurrence of ovarian cancer (95% CI =1.954,1.319-2.896).Conclusions The level of D-dimer is easy to obtain.The level of D-dimer in ovarian cancer patients is an independent prognostic factor for the recurrence of ovarian cancer,which can be used as a reference index for predicting the prognosis of patients with ovarian cancer.