D-二聚体和纤维蛋白原联合检测对恶性肿瘤合并深静脉血栓的诊断价值

Diagnostic value of combined detection of D-dimer and fibrinogen for malignant tumor with deep vein thrombosis

目的通过联合检测D-二聚体(D-D)和纤维蛋白原(Fbg)水平,评价两者联合检测对恶性肿瘤患者合并深静脉血栓(DVT)的诊断价值。方法选取2016年1月至2017年6月于天津医科大学附属肿瘤医院收治的99例肿瘤患者进行回顾性分析,其中DVT患者47例(DVT组)、非DVT患者52例(对照组)。分析比较静脉血中D-D和Fbg水平的差异。DVT的诊断以经彩色多普勒或经静脉造影检查阳性为标准。采用受试者工作特征曲线(ROC)评估D-D、Fbg以及两指标联合诊断肿瘤患者中DVT的诊断价值。结果DVT肿瘤患者组和非DVT对照组血浆中D-D水平分别为7.17μg/ml和4.25μg/ml(均P<0.01),DVT肿瘤患者组和非DVT对照组血浆中Fbg水平分别为4.01 mg/ml和2.02 mg/ml(均P<0.01);D-D水平用于诊断肿瘤患者合并DVT的曲线下面积(AUC)、特异性和敏感性分别是0.728、62.50%和72.50%,Fbg水平用于诊断肿瘤患者合并DVT的曲线下面积(AUC)、特异性和敏感性分别是0.642、65.50%和58.80%,D-D和Fbg两项指标联合诊断肿瘤患者合并DVT的曲线下面积(AUC)、灵敏度和特异度分别为0.764、83.30%和59.00%。结论D-D和Fbg在发生深静脉血栓的恶性肿瘤患者中显著升高,两者的联合检测对于肿瘤患者中发生DVT的早期诊断有重要的诊断价值,对临床早期采取干预治疗和提高患者预后有潜在应用价值。

Objective To detect the levels of D-dimer(D-D)and fibrinogen(Fbg)in plasma of patients with malignant tumors,and to evaluate the diagnostic value of combined detection of D-D and Fbg.Methods The clinical data of 99 patients with malignant tumors were retrospectively analyzed,including 47 patients in DVT group and 52 patients in control group.DVT diagnosis was based on color Doppler or venography.The ROC curve was used to evaluate the diagnostic value of D-D,Fbg and the combination of D-D and Fbg for the malignant tumor patients with DVT.Results The D-D levels in the DVT group and the control group were 7.17μg/ml and 4.25μg/ml,respectively,and the Fbg levels were 4.01 mg/ml and 2.02 mg/ml,respectively,and the differences were statistically significant(all P<0.01).For the area under the ROC curve(AUC),specificity and sensitivity for diagnosing malignant tumors with DVT,D-D were 0.728,62.50%,and 72.50%,respectively,and Fbg was 0.642,65.50%,and 58.80%,respectively,and D-D+Fbg was 0.764,83.30%and 59.00%respectively.Conclusions D-D and Fbg has a significantly high level in malignant tumor patients with DVT.The combined detection of D-D and Fbg has potential application value in the early diagnosis,early intervention and better prognosis for the malignant tumors patients with DVT.