血浆D-二聚体在胰腺癌患者中的临床意义  

Clinical significance of D-dimer in the plasma of pancreatic cancer patients

作　　者：王文闻 肖燕[2] 王琦[1] WANG Wenwen;XIAO Yan;WANG Qi(Department of Oncology,Wuxi No.2 People's Hospital Affiliated to Nanjing Medical University,Wuxi 214002,China;Department of Pathology,Wuxi No.2 People's Hospital Affiliated to Nanjing Medical University,Wuxi 214002,China)

机构地区：[1]南京医科大学附属无锡市第二人民医院肿瘤科,江苏无锡214002 [2]南京医科大学附属无锡市第二人民医院病理科,江苏无锡214002

出　　处：《中国肿瘤外科杂志》2020年第3期219-222,共4页Chinese Journal of Surgical Oncology

基　　金：无锡市卫生计生委青年项目(Q201601);南京医科大学科技发展基金面上项目(2016NJMU133);无锡市卫生计生委“科教强卫工程”市医学青年人才(QNRC004);无锡市人力资源和社会保障局2017年留学人员项目。

摘　　要：目的胰腺癌恶性程度极高,具有复发快、死亡率高,表现为预后差的临床特征。该研究以胰腺癌患者为对象,旨在探讨监测血浆D-二聚体水平在胰腺癌中的临床意义。方法选取2012年10月至2018年11月在南京医科大学附属无锡市第二人民医院行胰腺癌根治术的患者,通过胶乳凝集法测定44例胰腺癌患者血浆D-二聚体水平,化学发光法测定患者血清糖类抗原19-9(CA19-9)水平,免疫组织化学法测定胰腺癌组织乙醛脱氢酶1a1(ALDH1a1)、人类表皮生长因子受体2(HER2)、P53的蛋白表达;通过Kaplan-Meier法分析D-二聚体水平对胰腺癌患者无病生存期的影响。结果胰腺癌患者术前D-二聚体异常高水平提示无病生存期短;复发期的D-二聚体水平显著高于初诊期;病程中,D-二聚体变化趋势与CA19-9具有一致性,且呈现术后降低复发时升高;D-二聚体高水平与ALDH1a1、HER2高表达相关。结论胰腺癌患者D-二聚体水平具有监测复发、预测预后的价值。Objective Pancreatic cancer is an extremely malignant disease with the clinical features of poor prognosis,rapid recurrence and high mortality.The aim of this study is to investigate the clinical significance of plasma D-dimer in patients with pancreatic cancer.Methods The levels of plasma D-dimer of 44 patients who underwent radical surgery for pancreatic cancer from October 2012 to November 2018 in the Second People's Hospital of Wuxi City were determined by latex agglutination.And the levels of serum carbohydrate antigen 19-9(CA19-9)were determined by chemiluminescence method.The protein expressions of aldehyde dehydrogenase(ALDH1a1),human epidermal growth factor receptor 2(HER2)and p53(tumor protein P53)in pancreatic cancer tissues were detected by immunohistochemistry.The disease-free survivals of patients with different levels of plasma D-dimer were compared by Kaplan-Meier method.Results Patients with abnormal high levels of preoperative D-dimer showed short disease free survival.The levels of D-dimer in the patients at relapsed time were significantly higher than those at initial diagnosis.In the course of disease,the changes of D-dimer and CA19-9 levels were consistent which showed a decrease after surgery and an increase at relapse.The level of D-dimer was positively associated with the expressions of ALDH1a1 and HER2.Conclusions The levels of D-dimer in patients with pancreatic cancer has the value of monitoring relapse and predicting prognosis.

关 键 词：胰腺癌 D-二聚体 复发 预后 

分 类 号：R73[医药卫生—肿瘤]