乳腺癌患者血浆D-二聚体水平与临床病理特征的关系  

Relationship between plasma D-D level and clinical pathologic characterstics in breast cancer

作　　者：冯红蕾[1,2] 崔林[1,2] 李泽[1,2] 韩月婷[1,2] 张鹏[1,2] 

机构地区：[1]天津医科大学肿瘤医院,天津300060 [2]国家肿瘤临床医学研究中心

出　　处：《山东医药》2014年第42期8-10,共3页Shandong Medical Journal

基　　金：国家高新技术研究发展计划863计划资助项目(2011AA02A111)

摘　　要：目的分析不同临床病理特征的乳腺癌患者血浆D-二聚体（D-D）水平的差异,探讨血浆D-D检测在乳腺癌病情监测及预后判断中的应用价值。方法选择资料保存完整的乳腺癌患者189例,其中接受外科手术治疗者129例,接受全身辅助治疗者60例。所有患者经治疗6～8个月后复诊时,完全缓解（CR）53例、部分缓解（PR）47例、疾病稳定（SD）48例、疾病进展（PD）41例。分别于治疗前、治疗后14 d、治疗后6～8个月复诊时,采用酶联免疫荧光法检测静脉血血浆D-D水平。比较不同年龄、乳腺癌病理类型、TNM分期、肿瘤大小、淋巴结转移、雌激素受体（ER）表达、孕激素受体（PR）表达、人类表皮生长因子受体-2（HER-2）表达、手术治疗前后、全身辅助治疗前后及不同临床疗效（CR、PR、SD、PD）患者的血浆D-D水平。结果 TNM分期Ⅲ、Ⅳ期者血浆D-D水平高于Ⅰ、Ⅱ期患者,肿瘤直径≥5 cm者血浆D-D水平高于肿瘤直径〈5 cm者,有淋巴结转移者血浆D-D水平高于未转移者,手术治疗后血浆D-D水平低于治疗前,全身辅助治疗后血浆D-D水平低于治疗前（P均〈0.05）。临床疗效为CR、PR者治疗后血浆D-D水平低于治疗前,PD者治疗后血浆D-D水平高于治疗前（P均〈0.05）,SD者治疗前后血浆D-D水平差异无统计学意义。结论血浆D-D水平与乳腺癌患者的TNM分期、肿瘤直径、淋巴结转移及预后有关,手术及全身辅助治疗可降低血浆D-D水平。Objective To analyze the correlation between the serum level of D-D and clinicopathologic feature of breast cancer patients,to investigate the clinical value of D-D in therapeutic effect monitoring and prognosis judgement of breast cancer. Methods A total of 189 breast cancer patients were involved in this study,including 129 surgery patients and 60 systemic chemotherapy patients. After a recertification of 6 to 8 months later,the curative effects were collected as53 cases of complete remission（ CR）,47 cases of partial remission（ PR）,48 cases of stable disease（ SD） and 41 cases of progressive disease（ PD）. The serum D-D level of all patients were detected by ELISA method at the time of treatment before,14 days after treatment and 6 to 8 months recertification. The correlation between the serum level of D-D and age,pathological type,TNM-stage,tumor size,lymph node metastasis,surgical treatment,systemic therapy,ER expression,PR expression,HER-2 expression,clinical prognosis of breast cancer were analyzed. Results The serum level of D-D inⅢ,Ⅳ stage,tumor size≥5 cm,lymph node metastasis,surgery treatment,systemic chemotherapy were significant higher（ P〈0. 05）. The post treatment serum level of D-D in CR,PR patients were significant lower than treatment before（ P〈0. 05）. The post treatment serum level of D-D in PD patients were significant higher than treatment before（ P〈0. 05）.The serum level of D-D in SD patients showed no significant difference before and post treatment. Conclusions The serum level of D-D in breast cancer was positively correlated with the clinical pathologic characteristics such as TNM-stage,tumor size,lymph node metastasis and prognoses. The serum level of D-D level in breast cancer patients decreased after surgery and systemic treatment.

关 键 词：乳腺癌 D-二聚体 临床病理特征 预后 

分 类 号：R737.9[医药卫生—肿瘤]