血浆D-二聚体与妊娠滋养细胞肿瘤临床病理特征和预后的相关性研究

Study on the Relationship between Plasma D-Dimer and Clinicopathological Features and Prognosis of Gestational Trophoblastic Neoplasia

目的分析血浆D-二聚体与妊娠滋养细胞肿瘤(GTN)临床病理特征和预后的相关性。方法选取我院2016年9月至2017年9月期间收治的90例GTN患者,采用自动血凝仪检测其血浆D-二聚体水平。将血浆D-二聚体≥0.50 mg/L的55例患者设为D-二聚体升高组,血浆D-二聚体<0.50 mg/L的35例患者设为D-二聚体正常组。分析血浆D-二聚体与GTN临床病理特征和预后的相关性。结果 D-二聚体升高组的最大肿瘤大小、临床分期、转移性病灶和化疗前血β-HCG与D-二聚体正常组比较差异均有统计学意义(P<0.05)。与D-二聚体正常组比较,D-二聚体升高组的FIGO预后评分低危率较低,FIGO预后评分高危率较高(P<0.05);血浆D-二聚体与FIGO预后评分呈正相关(r=0.657,P<0.05)。结论血浆D-二聚体可促进滋养细胞的异常增生和恶性转化,并提示肿瘤的预后不良。

Objective To analyze the relationship between plasma D-dimer and clinicopathological features and prognosis of gestational trophoblastic neoplasia（GTN）. Methods 90 cases of GTN patients admitted to our hospital from September 2016 to September 2017 were selected, and their plasma D-dimer levels were detected by automatic coagulometer. 55 cases of patients with plasma D-dimer ≥0.50 mg/L were set as the D-dimer elevation group, and the other 35 cases of patients with plasma D-dimer 0.50 mg/L were set as the D-dimer normal group. The relationship between plasma D-dimer and clinicopathological features and prognosis of of GTN was analyzed.Results Statistical difference was found in the maximum tumor size, clinical stage, metastatic lesions, and serum β-HCG levels before chemotherapy between the two groups（P〈0.05）. Compared with the D-dimer normal group, the rate of low-risk FIGO prognosis score of the D-dimer elevation group was lower, and the rate of high-risk FIGO prognosis score was higher（both P〈0.05）; Plasma D-dimer was positively correlated with the FIGO prognosis score（r = 0.657, P〈0.05）. Conclusions Plasma D-dimer can promote the abnormal hyperplasia and malignant transformation of trophoblasts and suggest the poor prognosis of tumor.