D-二聚体与胃癌合并2型糖尿病临床病理特征相关性分析及对其预后的影响

  目的  探讨胃癌合并2型糖尿病（type 2 diabetes mellitus，T2DM）患者与单纯胃癌患者血浆D-二聚体水平的变化，血浆D-二聚体水平与胃癌合并T2DM患者临床病理特征的关系及对其预后的影响。  方法  回顾性收集2010年9月至2018年10月于郑州大学第一附属医院就诊的996例胃癌患者的临床资料。根据是否合并T2DM对患者进行分组，其中合并组190例，单纯胃癌组806例。采用Kaplan-Meier法及Cox比例模型进行生存分析。  结果  胃癌合并T2DM组患者血浆D-二聚体水平高于单纯胃癌组（P < 0.05）。胃癌合并T2DM组中D-二聚体水平与TNM分期、远处转移、肿瘤最大直径相关（P < 0.05）。D-二聚体水平为影响胃癌合并T2DM患者总生存期（overall survival，OS）的独立因素。胃癌合并T2DM组中血浆D-二聚体水平较高的患者的死亡风险高于正常的患者（HR=1.958，95%CI:1.028~3.728；P < 0.05）。  结论  胃癌合并T2DM患者处于高凝状态。D-二聚体水平可以为胃癌合并T2DM组患者病情的临床监测及预后判断提供思路。 

Correlation of D-dimer level with clinicopathological characteristics and prognosis in gastric cancer conbined with type 2 diabetes mellitus

Objective:To explore the difference in D-dimer levels in patients with single gastric cancer(GC)and GC combined with type 2 diabetes mellitus(T2DM).In addition,the association of plasma D-dimer level with clinicopathological characteristics and prognosis in patients with T2DM were investigated.Methods:The clinical and follow-up data of 996 patients diagnosed with GC at The First Affiliated Hospital of Zhengzhou University between September 2010 and October 2018 were retrospectively analyzed using relevant statistical methods.The patients were grouped according to whether they were complicated with T2DM or not,and included 190 cases in the combined group and 806 cases in the single group.The Kaplan-Meier method and Cox regression were used for survival analyses.Results:Compared with the single group,the combined group had significantly higher D-dimer levels(P<0.05).In the combined group,D-dimer levels were significantly associated with TNM stage,distant metastasis,and tumor size(P<0.05).Multivariate analysis further revealed that D-dimer levels remained an independent prognostic risk factor for the survival of patients with GC with T2DM(P<0.05),and the difference in overall survival between patients in the D-dimer level sub-groups was statistically significant with a HR of 1.958(95%CI:1.028-3.728).Conclusions:Patients with GC combined with T2DM are hypercoagulable.D-dimer levels can be useful for the clinical monitoring and prognosis of patients with GC combined with T2DM.