调整D-二聚体截值在恶性肿瘤患者肺栓塞诊断中的价值

目的评估提高D-二聚体截值在恶性肿瘤患者肺栓塞诊断中的价值。方法回顾性分析Wells评分≤4分的疑似肺栓塞患者134例,包括恶性肿瘤患者60例,非恶性肿瘤患者74例。应用ROC曲线制定疑似肺栓塞患者的诊断截值,计算不同截值的敏感度、特异度、阳性预测值及阴性预测值。结果非恶性肿瘤患者以500μg/L为截值,敏感度93.8%,特异度31.6%;恶性肿瘤患者以500μg/L为截值,敏感度100%,特异度7.9%。提高特异度至800μg/L,敏感度保持不变,特异度增加至31.6%。结论选取800μg/L为恶性肿瘤患者肺栓塞诊断截值可提高筛查效能。

Diagnostic value of adjusting D-dimer cut-off point for pulmonary embolism in cancer patients

Objective To assess the value of higher D-dimer cut-off point for the exclusion of pulmonary em-bolism (PE)in cancer patients.Methods Retrospective analysis were performed on 133 suspected PE patients in-cluded 60 patients with cancer and 74 patients with non-cancer.The difference of cut-off points were developed by re-ceiver operating characteristics (ROC)curves,and the sensitivity and specificity and the predictive value were com-pared and analyzed.Results The sensitivity and specificity were 93.8% and 31.6% at the cut-off point of 500μg/L in the non-cancer group.At the same cut-off point,the sensitivity and specificity were 100% and 7.9% in the cancer group.The cut-off point varying from 500μg/L to 800μg/L,the sensitivity was fixed and the specificity in-creased from 7.9% to 31.6%.Conclusion The D-dimer cut-off point (800μg/L)can increase the usefulness of the exclusion of pulmonary embolism in cancer patients.