乳腺癌患者血浆D-二聚体监测的临床意义

目的探讨监测乳腺癌患者血浆D-二聚体水平的意义和判断乳腺癌预后的价值。方法选择临床明确诊断的乳腺癌患者149例（乳腺癌组）和同期收治的乳腺良性肿瘤患者89例（良性疾病组）及健康体检女性82例（健康对照组），均检测D-二聚体、癌胚抗原（CEA）、癌抗原15—3（CA15—3）、癌抗原125（CA125）及乳腺癌受体并进行比较。结果乳腺癌组D-二聚体水平明显高于其他两组，差异有统计学意义（P〈0．001）；良性疾病组和健康对照组比较差异无统计学意义（P〉0．05）。Ⅲ～Ⅳ期乳腺癌患者D-二聚体水平明显高于Ⅰ～Ⅱ期乳腺癌患者，差异有统计学意义（P〈0．001）；有淋巴结转移的乳腺癌患者D-二聚体水平明显高于无淋巴结转移的乳腺癌患者，差异有统计学意义（P〈0．001）；伴远处脏器转移的患者D-二聚体水平明显高于无远处转移的患者，差异有统计学意义（P〈0．001）。血浆D-二聚体水平与CEA、CA15．3、CA125水平具有相关性（P=0．012、0．027和0．035）。结论D-二聚体水平与乳腺癌转移和临床分期相关，可作为判断乳腺癌预后的指标。

Clinical Significance of Plasma D-Dimeride Detection in Patients with Breast Cancer

Objective To explore the clinical significance and judge prognostic value of plasma D-dimeride detection in patients with breast cancer.Methods 149 patients with breast cancer(breast cancer group),89 patients with mammary benign tumor(benign tumor group) and 82 healthy women(healthy control group) were enrolled in the study.The level of D-dimeride,carcinoembryonic antigen(CEA),cancer antigen 15-3(CA15-3),cancer antigen 125(CA125) and acceptor of breast cancer were measured.Results The level of D-dimeride in breast cancer group was significantly higher than that of the other two groups(P<0.001),while there was no statistical significance between benign tumor group and healthy control group(P>0.05).The level of D-dimeride in the breast cancer patients in stages Ⅲ~Ⅳ was significantly higher than that in stagesⅠ~Ⅱ(P<0.001).Plasma D-dimeride was significantly higher in patients with axillary lymph node metastasis than that in patients without axillary lymph node metastasis(P<0.001).Plasma D-dimeride was significantly higher in patients with distant organ metastasis than that in patients without distant organ metastasis(P<0.001).Plasma D-dimeride was correlated with CEA,CA15-3 and CA125.Conclusion The D-dimeride level is associated with clinical stages and metastasis.Clinically it is an important prognostic marker in breast cancer.