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Prognostic and predictive value of plasma d-dimer levels in patients with small-cell lung cancer

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Abstract

Background

To investigate the predictive value of plasma d-dimer levels for short-term therapeutic effect and progression-free survival (PFS) in patients with small-cell lung cancer (SCLC); and to analyze the correlation between baseline plasma d-dimer levels and other clinicopathological features. The aim of the study was to investigate whether the levels of plasma d-dimer could serve as a predictive and prognostic factor in patients with SCLC.

Methods

A retrospective review of the clinicopathological data of 160 patients with pathologically confirmed SCLC, who were treated at the Department of Thoracic Oncology of Tianjin Medical University Tumor Institute and Hospital between June 2011 and June 2016, was performed. At the same time, we collected 100 patients with benign pulmonary diseases as a control group. The correlations between baseline plasma d-dimer levels and other clinical features, therapeutic effect and PFS were analyzed statistically.

Results

The level of plasma d-dimer in patients with SCLC was significantly higher than that of patients with benign pulmonary diseases (P = 0.001). The PFS of patients with elevated d-dimer levels before therapy were significantly shorter than that of patients with normal d-dimer levels (6.0 versus 7.5 months, P = 0.013). The patients whose plasma d-dimer level always (before and after treatment) in the normal range have the best prognosis, and continuously elevated d-dimer carried out a poor prognosis (8.0 versus 5.0 months). According to multivariate analysis, elevated d-dimer level was confirmed to be an independent prognostic factor for worse survival (P = 0.029). The level of d-dimer was associated with tumor stage, the level of neuron-specific enolase, the presence of distant metastasis, hyponatremia, and the Karnofsky performance status score; and levels decreased when therapy was effective, but increased when the disease progressed.

Conclusions

High levels of baseline plasma d-dimer may indicate advanced disease stage and poor prognosis. Therefore, plasma d-dimer levels could serve as a predictive and prognostic factor in patients with SCLC.

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Author information

Author notes

  1. Cuicui Zhang and Yongsheng Jia contributed equally to this work.

Authors and Affiliations

  1. Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People’s Republic of China

    Cuicui Zhang, Yongsheng Jia, Yanan Jia, Xiaoling Zhang & Kai Li

  2. National Clinical Research Center for Cancer, Tianjin, 300060, People’s Republic of China

    Cuicui Zhang, Yongsheng Jia, Yanan Jia, Xiaoling Zhang & Kai Li

  3. Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, People’s Republic of China

    Cuicui Zhang, Yongsheng Jia, Yanan Jia, Xiaoling Zhang & Kai Li

  4. Tianin’s Clinical Research Center for Cancer, Tianjin, 300060, People’s Republic of China

    Cuicui Zhang, Yongsheng Jia, Yanan Jia, Xiaoling Zhang & Kai Li

  5. Department of Thoracic Oncology, Tianjin Medical University Cancer Institute and Hospital, Huanhuxi Rd, Tiyuanbei, Hexi District, Tianjin, People’s Republic of China

    Cuicui Zhang, Yanan Jia, Xiaoling Zhang & Kai Li

  6. Thyroid and Neck Department, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 300060, People’s Republic of China

    Yongsheng Jia

Authors
  1. Cuicui Zhang
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  2. Yongsheng Jia
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  3. Yanan Jia
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  4. Xiaoling Zhang
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  5. Kai Li
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Corresponding author

Correspondence to Kai Li.

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All the authors hereby declare that they do not have any competing interests with regard to the manuscript submitted here for review.

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Zhang, C., Jia, Y., Jia, Y. et al. Prognostic and predictive value of plasma d-dimer levels in patients with small-cell lung cancer. Int J Clin Oncol 23, 1070–1075 (2018). https://doi.org/10.1007/s10147-018-1320-5

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  • DOI: https://doi.org/10.1007/s10147-018-1320-5

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