血浆D-二聚体检测在肝癌分期与预后中的临床价值

目的：检测肝癌患者血浆中的D-二聚体，探讨其在肝癌不同分期及预后治疗中的临床价值。方法采用免疫比浊法对2012年1月至2014年1月在新疆自治区人民医院就诊且资料完整的50例肝癌患者和35例正常对照组血浆中D-二聚体含量进行检测，比较肝癌患者不同分期及治疗前后的D-二聚体水平变化。结果本组50例肝癌患者各临床期血浆D-二聚体检测含量为Ⅰ期(0.43±0.10) mg/L，Ⅱ期(0.60±0.14) mg/L，Ⅲ期(1.65±0.32) mg/L，与正常对照组比较，肝癌患者血浆中D-二聚体含量均上升且随肿瘤分期逐步进展而升高，差异均有统计学意义(P<0.05或P<0.01)；肝癌患者治疗后缓解组40例，未缓解组10例，治疗前D-二聚体含量为(0.84±0.12) mg/L，治疗后缓解组D-二聚体含量为(0.50±0.21) mg/L，治疗后血浆中D-二聚体含量较治疗前明显降低，差异有统计学意义(P<0.05)。结论肝癌患者存在不同程度的继发性纤维蛋白溶解功能亢进，检测血浆中D-二聚体含量可作为判断病情严重程度及治疗预后的参考指标。

Clinical significance of plasma D-dimer in patients with different liver cancer staging and prognosis

Objective To detect the plasma D-dimer levels in patients with hepatocellular carcinoma (HCC), and to investigate the clinical significance of D-dimer levels in different stages of HCC and the prognosis of treatment. Methods By using immunoturbidimetric method, the plasma D-dimer levels were detected in 50 patients with HCC and and 35 healthy controls from January 2012 to January 2014 in the People's Hospital of Xinjiang Uigur Au-tonomous Region. The changes of D-dimer levels in different stages of HCC and before and after treatment were com-pared. Results In HCC patients, the D-dimer level was (0.43±0.10) mg/L for periodⅠ, (0.60±0.14) mg/L for periodⅡ, (1.65 ± 0.32) mg/L for periodⅢ. Compared with healthy controls, the plasma D-dimer levels in HCC patients were in-creased, and the levels increased gradually with the progression of clinical tumor stage (P<0.05 or 0.01). In the 50 HCC patients, 40 patients were alleviated after treatment and 10 patients were not alleviated. The plasma D-dimer level before treatment was (0.84±0.12) mg/L, and the level was (0.50±0.21) mg/L in the alleviated group, with statistically significant difference (P<0.05). Conclusion HCC patients have high condensation state and fibrinolytic hyperthyroidism of differ-ent degree. The plasma D-dimer levels may serve as an important parameter for differentiation and evaluating the severi-ty of the disease.