Relationship between plasma D-dimer levels and clinicopathologic parameters in resectable colorectal cancer patients

AIM: To assess the clinical significance of the D-dimer levels and the relationship between plasma D-dimer levels and clinicopathologic parameters in operable colorectal cancer patients. METHODS: The plasma levels of D-dimer were measured pre- and postoperatively in 35 patients with colorectal cancer, and 30 healthy subjects served as controls by the method of quantitative enzyme-linked immunosorbent assay (ELISA). RESULTS: The mean preoperative plasma levels of D-dimer in the patients with colorectal cancer (1.06+/-0.24 mg/L) were significantly higher than those of controls (0.33+/-0.12 mg/L,P<0.01). The D-dimer levels were remarkably elevated on the 1st day after operation (1.22+/-0.55 mg/L, P<0.01). On the 3rd day the level of D-dimer began to stepwise descend and on the 14(th) day nearly returned to control level. The preoperative levels of D-dimer were significantly correlated with the lymph node metastasis and Dukes stage but had no association with tumor location and the degree of differentiation. A stepwise increase in the mean D-dimer levels was found with increase of the tumor stage. CONCLUSION: Hypercoagulation and higher fibrinolytic activities occur in patients with colorectal cancer. The operative trauma could enhance the fibrinolysis in the patients with colorectal cancer. The measurement of preoperative D-dimer levels is considered to be useful for predicting lymph node metastasis and stage of colorectal cancer.