直肠癌根治术患者术前外周血D-二聚体水平检测的临床意义及预后预测价值

目的:探讨直肠癌根治术患者术前外周血D-二聚体（D-dimer,DD）水平检测的临床意义及预后预测价值。方法:检测309例直肠癌根治性切除患者术前外周血DD、癌胚抗原（carcinoembryonic antigen,CEA）水平，分析DD水平与CEA水平、患者临床病理特征及预后的相关性。结果:术前外周血DD水平与患者年龄、TNM分期、T分期、N分期及分化程度相关；根据NNE法计算的DD水平临床界值分析其与患者3年总生存（overall survival,OS）及无病生存（disease free survival,DFS）的相关性，结果显示，高水平组（DD≥0.53 μg/mL）3年OS及DFS明显低于低水平组（DD<0.53 μg/mL），差异有统计学意义（P<0.05）。结论:术前外周血DD水平可以作为直肠癌根治术后患者病理分期、分化程度的预测性生物标志物，同时可作为判断预后的有效生物标志物。

Clinical significance and prognostic value of preoperative peripheral blood D-dimer level detection in patients with rectal cancer undergoing radical operation

Objective:To investigate the clinical significance and prognostic value of preoperative peripheral blood D-dimer（DD） level detection in patients with rectal cancer radical operation.Methods:The levels of peripheral blood D-dimer and carcinoembryonic antigen(CEA) were detected in 309 patients with radical rectal cancer resection.To analyze the correlation between DD level and CEA level,clinicopathological features and prognosis of patients.Results:Preoperative peripheral blood DD level was correlated with TNM stage,T stage,N stage and differentiation degree of patients.The correlation between DD level and 3-year overall survival(OS) and disease free survival(DFS) was analyzed according to the clinical boundary value calculated by NNE method.The results showed that the 3-year OS and DFS in the high level group（DD≥0.53 μg/mL） were significantly lower than those in the low level group（DD<0.53 μg/mL）,and the difference was statistically significant（P<0.05）.Conclusion:Preoperative peripheral blood DD level can be used as a predictive biomarker of pathological staging and differentiation degree of patients with rectal cancer after radical resection,it can also be used as an effective biomarker for prognosis.