D-二聚体水平在评估胆囊癌预后中的价值

Prognostic value of preoperative D - dimer level in gallbladder cancer

目的 探讨D-二聚体在胆囊癌预后评估中的价值。方法 对浙江省肿瘤医院2016年1月—2021年12月确诊的75例胆囊癌患者进行回顾性分析。收集患者一般临床资料、病理资料、术前肿瘤标志物和D-二聚体水平。根据D-二聚体参考值将患者分成低水平和高水平2组,利用卡方检验比较2组临床病理特征。采用log-rank单因素和Cox多因素分析预后相关因素。结果 log-rank检验单因素分析显示,癌症临床分期、T分级、淋巴结转移、脉管栓塞、神经侵犯、癌结节、分化程度术、手术R0切除、术前D-二聚体、糖类抗原19-9(CA19-9)和糖类抗原125(CA125)水平是胆囊癌患者不良的预后因素(P<0.05)。Cox多因素分析显示,肿瘤R0切除和患者术前D-二聚体水平是影响胆囊癌患者预后的独立危险因素(P<0.05)。结论 术前D-二聚体水平是胆囊癌患者预后的良好指标。

Objective This paper aims to investigate the prognostic value of D-dimer in gallbladder cancer.Methods A retrospective analysis was performed on 75 patients with gallbladder cancer diagnosed in Zhejiang Cancer Hospital from January 2016 to December 2021.The clinical data,pathological data and preoperative tumor marker and D-dimer levels were collect⁃ed.All enrolled patients were divided into low-level group and high-level group according to the reference value of D-dimer,and the clinicopathological characteristics of the two groups were compared by Chi-square test.The log-rank univari⁃ate analysis and Cox multivariate analysis were used to analyze the prognostic factors.Results The log-rank test showed that clinical stage,T grade,lymph node metastasis,tumor vascular embolism,nerve invasion,cancer nodule,differentiation degree,R0 resection,preoperative D-dimer,CA19-9 and CA125 levels were adverse prognostic factors for gallbladder cancer(P<0.05).Cox multivariate analysis showed that R0 resection and preoperative D-dimer level were independent risk factors for prognosis of patients with gallbladder cancer(P<0.05).Conclusion Preoperative D-dimer level is a good prog⁃nostic indicator for patients with gallbladder cancer.