血浆D-二聚体与非小细胞肺癌患者远期预后的关系

Relationship between plasma D-D level and long-term prognosis in patients with non-small cell lung cancer

目的探讨血浆D-二聚体(D-D)水平对非小细胞肺癌(NSCLC)患者生存状况的影响。方法选取2011年2-12月该院收治的96例NSCLC患者为研究对象。术前及术后7d,采集患者清晨空腹血清检测D-D水平。D-D≤0.3μg/mL为阴性,D-D>0.3μg/mL为阳性。采用电话随访的形式进行随访,随访截至2016年12月30日。结果术前,96例NSCLC患者中D-D阳性者26例(27.08%)。D-D水平与癌症肿瘤分期(TNM分期)、分化程度和美国东部肿瘤协作组(ECOG)评分有相关性,差异有统计学意义(P<0.05),与年龄、性别、病理类型无相关性(P>0.05)。术后7d,D-D阳性者14例(14.58%),与术前D-D阳性率比较差异有统计学意义(P<0.05)。D-D阳性和阴性患者总生存时间分别为44.9个月和56.8个月,5年总生存率分别为23.08%和57.14%,比较差异有统计学意义(P<0.05)。多变量COX回归分析表明,患者年龄、TNM分期、分化程度和D-D是NSCLC患者远期预后的独立预测因素。结论血清D-D水平与TNM分期、分化程度和ECOG评分相关。血清D-D水平可作为NSCLC患者预后判断的指标,具有一定的临床应用价值。

Objective To investigate the effect of plasma D-dimer(D-D)on the survival patients with non-small cell lung cancer(NSCLC).Methods A total of 96 patients with NSCLC in hospital were enrolled in this study from February to December 2011.Early morning fasting blood of preoperative and postoperative 7 d were collected to test D-D.When the concentration of D-D was lower 0.3μg/mL,the result was negative.When the D-D was higher 0.3μg/mL,the result was positive.And the telephone follow-up continued to December 30,2016.Results There were 26 D-D positive cases in 96 NSCLC patients,accounting for 27.08%.D-D level was correlated with TNM stage,differentiation degree and ECOG score(P<0.05),except age,sex and pathological type(P>0.05).Seven days after surgery,there were 14 cases with D-D detected positive,accounting for 14.58%.There was significant difference in the positive rate of D-D between the two groups(P<0.05).The total survival time of D-D positive and D-D negative patients were 44.9 months and 56.8 months respectively.The 5-year overall survival rates were 23.08%and 57.14%respectively,the difference was statistically significant(P<0.05).Multivariate COX regression analysis showed that patients′age,TNM stage,differentiation degree and D-D were independent predictors of long-term prognosis in NSCLC patients.Conclusion Serum D-D levels is correlated with TNM stage,differentiation degree and ECOG score.Serum D-D level can be used as a prognostic indicator of patients with NSCLC,with a certain clinical value.