Elevated levels of plasma D-dimer predict a worse outcome in patients with nasopharyngeal carcinoma

被引：32

作者：

Chen, Wen-Hui ^{[1
]}

Tang, Lin-Quan ^{[1
,2
]}

Wang, Feng-Wei ^{[1
]}

Li, Chang-Peng ^{[1
]}

Tian, Xiao-Peng ^{[1
]}

Huang, Xiao-Xia ^{[1
]}

Mai, Shi-Juan ^{[1
]}

Liao, Yi-Ji ^{[1
]}

Deng, Hai-Xia ^{[1
]}

Chen, Qiu-Yan ^{[1
,2
]}

Liu, Huai ^{[1
,2
]}

Zhang, Lu ^{[1
,2
]}

Guo, Shan-Shan ^{[1
,2
]}

Liu, Li-Ting ^{[1
,2
]}

Yan, Shu-Mei ^{[1
,3
]}

Li, Chao-Feng ^{[1
,4
]}

Zhang, Jing-Ping ^{[1
,5
]}

Liu, Qing ^{[1
,6
]}

Liu, Xue-Wen ^{[1
,7
]}

Liu, Li-Zhi ^{[1
,7
]}

Mai, Hai-Qiang ^{[1
,2
]}

Zeng, Mu-Sheng ^{[1
]}

Xie, Dan ^{[1
]}

机构：

[1] Sun Yat Sen Univ, Ctr Canc, State Key Lab Oncol South China, Collaborat Innovat Ctr Canc Med, Guangzhou 510060, Guangdong, Peoples R China

[2] Sun Yat Sen Univ, Dept Nasopharyngeal Carcinoma, Ctr Canc, Guangzhou 510060, Guangdong, Peoples R China

[3] Sun Yat Sen Univ, Ctr Canc, Dept Pathol, Guangzhou 510060, Guangdong, Peoples R China

[4] Sun Yat Sen Univ, Ctr Canc, Dept Informat Technol, Guangzhou 510060, Guangdong, Peoples R China

[5] Sun Yat Sen Univ, Ctr Canc, Dept Clin Lab, Guangzhou 510060, Guangdong, Peoples R China

[6] Sun Yat Sen Univ, Ctr Canc, Dept Stat & Epidemiol, Guangzhou 510060, Guangdong, Peoples R China

[7] Sun Yat Sen Univ, Ctr Canc, Imaging Diagnost & Intervent Ctr, Guangzhou 510060, Guangdong, Peoples R China

来源：

BMC CANCER | 2014年 / 14卷

关键词：

Nasopharyngeal carcinoma; D-dimer; Survival; BARR-VIRUS DNA; PROGNOSTIC VALUE; CONCURRENT CHEMORADIOTHERAPY; VENOUS THROMBOEMBOLISM; NODE-METASTASIS; POOR-PROGNOSIS; EBV DNA; RADIOTHERAPY; CANCER; CHEMOTHERAPY;

D O I：

10.1186/1471-2407-14-583

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Hemostatic alterations occur during the development of cancer. Plasma D-dimer is a hypercoagulability and fibrinolytic system marker that is increased in patients with various solid tumours. The aim of this study was to evaluate the hemostatic status of nasopharyngeal carcinoma (NPC) patients by assessing plasma D-dimer levels to investigate its value as a prognostic marker. Methods: We retrospectively analysed 717 patients with nasopharyngeal carcinoma, and we applied Cox regression and log-rank tests to assess the association of D-dimer levels with disease-free survival (DFS), distant metastasis-free survival (DMFS), and overall survival (OS). D-dimer levels were measured using a quantitative D-dimer latex agglutination assay. Results: Using the 3rd quartile values (0.8 mu g/L) as the optimal cut-offs, we found that patients with high D-dimer levels have a shorter 3-year DFS, (79%, 95%CI (73.1-84.9)) vs. (69%, 95% CI (59.2-78.8)), DMFS (87%, 95% CI (83.1-90.9)) vs. (77%, 95%CI (69.2-84.8)), and overall survival (82%, 95%CI (76.1-87.9)) vs. (76%, 95% CI (66.2-85.8)). Multivariate analysis revealed that pre-treatment D-dimer levels and EBV DNA were significant independent factors for DFS, DMFS, and OS in NPC patients. Subgroup analyses indicated that the plasma D-dimer levels could effectively stratify patient prognosis for early cancer, advanced stage cancer, and patients with EBV DNA >= 4000 copies/ml. Conclusions: High D-dimer levels were associated with poor disease-free survival, distant metastasis-free survival, overall survival, and increased risk of mortality in NPC patients. Prospective trials are required to assess the prognostic value of D-dimer levels.

引用

页数：11

共 43 条

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