非小细胞肺癌患者血浆D-二聚体水平及其临床意义

目的 探讨非小细胞肺癌（NSCLC）患者的血浆D-二聚体水平及其临床意义。方法采用酶联免疫吸附法（ELISA）检测215例NSCLC患者治疗前后、90例良性肺部疾病患者及60例健康对照者的血浆D-二聚体水平。随访1年，记录NSCLC患者术后肿瘤复发转移率，计算NSCLC患者化疗后的中位生存时间。结果NSCLC患者血浆D-二聚体水平为（1.73±0.26）mg／L，显著高于良性肺部疾病患者的（0.26±0.03）mg／L和健康对照者的（0.23±0.01）mg／L，差异有统计学意义（P＜0.05）。Ⅲ～Ⅳ期NSCLC患者D-二聚体水平为（2.31±0.34）mg／L，明显高于Ⅰ～Ⅱ期NSCLC患者的（0.87±0.38）mg／L，差异有统计学意义（P＜0.05）。105例NSCLC患者术后血浆D-二聚体的阳性率为28.6%，明显低于术前的49.5%（P＜0.05）；而110例NSCLC患者化疗前、后血浆D-二聚体的阳性率差异无统计学意义。术前血浆D-二聚体阳性患者的肿瘤复发或转移率为28.8％，明显高于术前阴性患者的5.7％（P＜0.05）。化疗前血浆D-二聚体阳性患者的中位生存时间为8.7个月，显著低于阴性患者的12.8个月（P＜0.05）。结论 NSCLC患者的血浆D-二聚体水平与肿瘤分期有关，可能有助于评估手术疗效及预测预后。

Plasma levels and clinical significance of D-dimer in non-small cell lung cancer patients

Objective To explore the plasma levels of D-dimer in non-small cell lung cancer（NSCLC） patients and its clini- cal significance. Methods Plasma D-dimer levels in 215 NSCLC patients ,90 patients with benign lung disease and 60 healthy people were measured by enzyme linked immunosorbent assay（ELISA）. The patients were followed-up for one year. The rates of relapse and metastasis in operative patients was recorded, and median survival of patients received chemotherapy was measured. Results The plasma D-direct levels of NSCLC group, benign lung disease group and normal control group were （ 1.73 ± 0. 26 ） mg/L, （ 0. 26± 0. 03 ） mg/L and（0. 23± 0. 01 ）mg/L, respectively. The levels of NSCLC group were significantly higher than those of benign lung disease group and control group（ P 〈 0. 05 ）. The plasma D-dimer levels of Ⅲ-Ⅳstage NSCLC patients was （ 2. 31 ± 0. 34 ） mg/L, which was higher than （ 0. 87 ± 0. 38 ） mg/L in the Ⅰ - Ⅱ stage patients （ P 〈 0.05 ）. The positive rates of D-dimer after operation in 105 NSCLC pa- tients was 28.6% （30/105）, which was significantly lower than that of preoperative patients （49.5%）. But there was no significant change of D-dimer after chemotherapy. The rates of relapse and metastasis in patients with a positive D-dimer preoperatively（28.8% ） was higher than those with a negative D-dimer（ 5.7% ）, the difference was statistically significant（ P 〈 0. 05 ）. The median survival for patients with a positive D-dimer before chemotherapy was 8.7 months, which was shorter than those with a negative D-dimer（ 12. 8 months）, the difference was statistically significant （P 〈 0. 05 ）. Conclusion The plasma levels of D-dimer is closely related to tumor staging and can also be used to determine effects of surgery and evaluation of prognosis.