血浆D-二聚体检测在肺癌化疗评估中的临床意义

Clinical significance of plasma D-dimer in evaluating the chemotherapeutic efficacy of lung cancer

目的探讨血浆D-二聚体在肺癌化疗评估中的意义。方法观察组选取2017年1月至2019年1月阜阳市人民医院68例首次确诊的肺癌病人,所有病人经含铂双药一线方案进行化疗,同时另选取同医院34例健康体检者为健康对照组。采用免疫比浊法测定肺癌组病人化疗前后血浆D-二聚体的含量,以及体检者的血浆D-二聚体含量。结果肺癌组化疗前及化疗后血浆D-二聚体水平均高于对照组(P<0.001);Ⅳ期肺癌病人血浆D-二聚体含量高于Ⅲ期肺癌病人(P<0.05);小细胞肺癌(SCLC)与非小细胞肺癌(NSCLC)病人的血浆D-二聚体含量差异无统计学意义(P>0.05);化疗后,疗效评估为有效组病人的血浆D-二聚体含量0.650(0.360,1.000)mg/L低于化疗前0.810(0.360,1.680)mg/L(Z=-2.989,P=0.003);进展组血浆D-二聚体含量0.830(0.550,2.130)mg/L高于化疗前0.470(0.240,1.030)mg/L(Z=-3.582,P<0.001)。结论肺癌分期越晚、化疗效果越差、病情越重,血浆D-二聚体水平越高,血浆D-二聚体检测对于肺癌化疗疗效、病情变化的评估具有一定临床价值。

Objective To investigate the significance of plasma D-dimer in evaluating the chemotherapeutic efficacy of lung cancer.Methods Sixty-eight patients with lung cancer confirmed for the first time in Fuyang People’s Hospital from January 2017 to January 2019 were all treated by platinum-based chemotherapy.In addition,34 healthy people in the same hospital were selected as the control group.Immunoturbidimetry was used to determine the level of plasma D-dimer in patients with lung cancer before and after chemotherapy,and the level of plasma D-dimer in healthy controls.Results The levels of plasma D-dimer of the observation group were significantly higher than those of the control group(P<0.001).The levels of plasma D-dimer in patients with stage IV lung cancer was significantly higher than that in patients with stage Ⅲ lung cancer(P<0.05).There was no significant difference in the level of plasma D-dimer between small cell lung cancer(SCLC)patients and non-small cell lung cancer(NSCLC)patients(P>0.05).After chemotherapy,the level of plasma D-dimer in patients with CR and PR was lower than that before chemotherapy[0.810(0.360,1.680)mg/L vs.0.650(0.360,1.000)mg/L,Z=-2.989,P=0.003];but the level of plasma D-dimer in patients with PD was higher than that before chemotherapy[0.470(0.240,1.030)mg/L vs.0.830(0.550,2.130)mg/L,Z=-3.582,P<0.001].Conclusion The later the stage of lung cancer,the poorer the chemotherapeutic efficacy,the worse the disease,the higher the level of the plasma D-dimer.The detection of plasma D-dimer may be helpful to evaluate chemotherapeutic efficacy and change in patients’condition in patients of lung cancer.