非小细胞肺癌患者围术期血浆D-二聚体水平变化及临床意义  

The changes and clinical significance of plasma D-dimer levels in patients with non small cell lung cancer during perioperative period

作　　者：胡国栋[1] 王亚勤[1] 方良伟[1] 王红英[1] 胡海波[1] 

机构地区：[1]江苏省淮安市第二人民医院胸心外科,223002

出　　处：《河北医药》2016年第21期3234-3236,3240,共4页Hebei Medical Journal

摘　　要：目的探讨非小细胞肺癌患者围术期血浆D-二聚体水平变化及其与患者预后的关系,为改善患者预后提供参考依据。方法选择67例非小细胞肺癌患者作为病例组,并选取同时期门诊健康体检者50例作为对照组,采用酶联免疫吸附法(ELISA)测定对照组及病例组手术前后血浆D-二聚体水平,计算D-二聚体阳性表达率;随访2年,比较D-二聚体阳性和阴性患者的复发转移率及生存率。结果病例组术前、术后血浆D-二聚体水平显著高于对照组,术后血浆D-二聚体水平显著低于术前(P<0.05);Ⅲ期+Ⅳ期患者术前血浆D-二聚体水平显著高于Ⅰ期+Ⅱ期患者(P<0.05);病例组患者术前D-二聚体阳性表达率为49.25%显著高于术后的26.87%(P<0.05);术前D-二聚体阳性患者术后复发或转移率为27.27%,2年生存率为45.45%,与术前D-二聚体阴性患者比较差异有统计学意义(P<0.05);多因素Cox回归分析发现,TNM分期、术前D-二聚体阳性为影响非小细胞肺癌患者预后的独立危险因素(P<0.05)。结论非小细胞肺癌患者血浆D-二聚体水平明显升高,术后血浆D-二聚体水平显著降低,且与患者TNM分期、分化程度、复发转移及预后有密切关系。Objective To investigate the changes of plasma D-dimer levels in patients with non small cell lung cancer（ NSCLC） during perioperative period and their correlation with prognosis of patients in order to provide reference for improving the prognosis of patients. Methods Sixty-seven patients with NSCLC who were admitted and treated in our hospital from January 2012 to December 2013 were selected as case group,at the same time,50 healthy subjects were served as control group. The plasma levels of D-dimer were detected by enzyme-linked immunosorbent assay（ ELISA） before and after operation for both groups,moreover,the positive expression rate of D-dimer was calculated. These patients were followed-up for two years,and the recurrence rate,metastasis rate and survival rate in patients with positive D-dimer and patients with negative D-dimer were observed and compared. Results The plasma levels of D-dimer before and after operation in case group were significantly higher than those in control group,moreover,the plasma levels of D-dimer before operation were significantly lower than those after operation（ P〈0. 05）. The plasma levels of D-dimer in patients at stage Ⅲ and Ⅳ were significantly higher than those of patients at stageⅠand Ⅱ（ P〈0. 05）. Before operation the positive expression rate of D-dimer in case group was 49. 25%,which was significantly higher than that（ 26. 87%） after operation（ P〈0. 05）. The postoperative recurrence or metastasis rate in patients with positive D-dimer before operation was 27. 27%,and 2-year survival rate was45. 45%,there were significant differences between the patients with positive D-dimer and the patients with negative D-dimer（ P〈0. 05）. The multifactor Cox regression analysis showed that TNM staging and positive D-dimer before operation were independent risk factors of influencing prognosis of patients with NSCLC（ P〈0. 05）. Conclusion The plasma levels of D-dimer are significantly increased in patients with NSCLC,however,which are obvi

关 键 词：非小细胞肺癌 D-二聚体 预后 

分 类 号：R734.2[医药卫生—肿瘤]