| 宋宗工.结直肠癌术后 D-二聚体水平对癌症复发和不良预后的影响及预测价值[J].安徽医药,2023,27(9):1865-1869. |
| 结直肠癌术后 D-二聚体水平对癌症复发和不良预后的影响及预测价值 |
| Influence and predictive value of D-dimer level on cancer recurrence and poor prognosis after colorectal cancer surgery |
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| DOI：10.3969/j.issn.1009-6469.2023.09.038 |
| 中文关键词: 结直肠肿瘤 D-二聚体 复发 生存率 |
| 英文关键词: Colorectal neoplasms D-dimer Recurrence Survival rate |
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| 中文摘要: |
| 目的检测结直肠癌术后 D-二聚体水平，分析其对癌症复发和不良预后的影响及预测价值。方法收集 2016年 1月至 2018年 4月在南阳市第二人民医院接受完全治愈性切除结直肠癌病人 132例，男 75例，女 57例，年龄( 67.3±8.4)岁。根据术后 1周 D-二聚体平均值 3.1 mg/L，将病人分为 D-二聚体低水平组( <3.1 mg/L)和 D-二聚体高水平组( ≥3.1 mg/L)，比较两组间的临床病理特征、术后 1、3年疾病无进展生存率和生存率。分析影响术后 1、3年疾病无进展生存率和生存率的危险因素。结果D-二聚体高水平组与低水平组间 TNM分期、 T分期、 N分期、神经侵犯、脉管浸润和肿瘤长径比较差异有统计学意义( P<0.05)。 D-二聚体高水平组术后 3年疾病无进展生存率和生存率分别为 62.2%(46/74)、 70.3%(52/74)均低于 D-二聚体低水平组 79.3%(46/58)、 86.2%(50/58)(χ2=4.35、4.63，P=0.037、0.032)。 D-二聚体为影响术后 3年疾病无进展生存率和生存率的独立危险因素( P<0.05)。 D-二聚体预测病人术后 3年复发的曲线下面积为 0.82［95%CI:(0.78，0.86)］预测病人术后 3年不良预后的曲线下面积为 0.73［95%CI:(0.71，0.77)］D-二聚体对病人术后 3年疾病复发的预测价值高于良预后的预测价值(Z=5.30， P=0.006)。结论结直肠癌病人接受完愈性切除术后 1周 D-二聚体水平为病人术后 3年疾病复发和不良预后的独立危险对不，全治，因素，对疾病复发具有较高的预测价值。 |
| 英文摘要: |
| Objective To measure the level of D-dimer after colorectal cancer surgery and analyze its impact and predictive value on cancer recurrence and poor prognosis.Methods A total of 132 patients, 75 males and 57 females, aged 67.3±8.4 years old, who un-derwent complete curative resection at the Nanyang Second General Hospital from January 2016 to April 2018 were enrolled. Based onthe mean value of D-dimer at 1 week postoperatively, patients were divided into a low-level D-dimer group (<9.6 mg/L) and a high-level D-dimer group (≥9.6 mg/L). The clinicopathological characteristics, disease progression-free survival and survival rates at 1 and 3 yearspostoperatively were compared between the two groups. Risk factors affecting disease progression-free survival and survival rate at 1 and 3 years postoperatively were analyzed.Results The differences in TNM stage, T stage, N stage, nerve invasion, vascular infiltra- tion and tumor length diameter between the high-level D-dimer group and the low-level group were statistically significant(P < 0.05). The 3-year disease progression-free survival rate and survival rate in the high-level D-dimer group were 62.2% (46/74) and 70.3% (52/ 74), respectively, which were lower than those in the low-level D-dimer group, 79.3% (46/58) and 86.2% (50/58) (χ2=4.35, 4.63, P = 0.037, 0.032). D-dimer was an independent risk factor affecting the disease progression-free survival rate and survival rate after 3 years postoperatively (P < 0.05). The area under the curve for D-dimer to predict patient recurrence at 3 years postoperatively was 0.82 [95% |
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