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Tumor Biology

, Volume 36, Issue 12, pp 9201–9207 | Cite as

Plasma D-dimer value as a predictor of malignant lymph node involvement in operable non-small cell lung cancer

Research Article

Abstract

Fibrin deposition and remodelling of the extracellular matrix are important early steps in tumour metastasis. The D-dimer value is an indicator of intravascular fibrin formation and degradation. Thus, the D-dimer value may be a predictor of the malignant involvement of lymph nodes in operable non-small cell lung cancer (NSCLC) patients. The study comprised 142 highly suspected lung cancer patients scheduled to undergo pneumonectomy, lobectomy or wedge resection. Of the 142 patients, 124 were subsequently diagnosed as NSCLC, and 18 were subsequently diagnosed as benign lung disease by histological examination. Preoperative plasma D-dimer values were quantified, and the relationship between plasma D-dimer and clinical variables including tumour size, involvement of lymph nodes and clinical stage was examined using Spearman correlation coefficients and χ 2 tests. The median plasma D-dimer values were statistically higher in NSCLC patients with malignant lymph nodes than in those who suffered either benign lung disease or carcinoma in situ (Kruskal–Wallis test; P = 0.001). Plasma D-dimer values were significantly correlated with clinical stage (ANOVA; P = 0.009). An obvious relationship was observed between elevated D-dimer (>0.475 mg/L fibrinogen equivalent units) and malignant lymph node involvement (χ 2 test; P = 0.0000). This correlation suggests that the plasma D-dimer value is a clinically important predictor for the malignant involvement of lymph nodes in operable NSCLC.

Keywords

D-dimer Non-small cell lung cancer Lymph node Metastasis 

Notes

Conflicts of interest

None

References

  1. 1.
    Lyman GH, Khorana AA. Cancer, clots and consensus: new understanding of an old problem. J Clin Oncol. 2009;27:4821–6.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Khorana AA, Fine RL. Pancreatic cancer and thromboembolic disease. Lancet Oncol. 2004;5:655–63.CrossRefPubMedGoogle Scholar
  3. 3.
    Koldas M, Gummus M, Seker M, Seval H, Hulya K, Dane F, et al. Thrombin-activatable fibrinolysis inhibitor levels in patients with non-small-cell lung cancer. Clin Lung Cancer. 2008;9:112–5.CrossRefPubMedGoogle Scholar
  4. 4.
    Kawai K, Watanabe T. Colorectal cancer and hypercoagulability. Surg Today. 2014;44:797–803.CrossRefPubMedGoogle Scholar
  5. 5.
    Stavik B, Skretting G, Aasheim HC, Tinholt M, Zernichow L, Sletten M, et al. Downregulation of tfpi in breast cancer cells induces tyrosine phosphorylation signaling and increases metastatic growth by stimulating cell motility. BMC Cancer. 2011;11:357.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Bretz N, Noske A, Keller S, Erbe-Hofmann N, Schlange T, Salnikov AV, et al. Cd24 promotes tumor cell invasion by suppressing tissue factor pathway inhibitor-2 (tfpi-2) in a c-src-dependent fashion. Clin Exp Metastasis. 2012;29:27–38.CrossRefPubMedGoogle Scholar
  7. 7.
    Hron G, Kollars M, Weber H, Sagaster V, Quehenberger P, Eichinger S, et al. Tissue factor-positive microparticles: cellular origin and association with coagulation activation in patients with colorectal cancer. Thromb Haemost. 2007;97:119–23.PubMedGoogle Scholar
  8. 8.
    Bardos H, Juhasz A, Repassy G, Adany R. Fibrin deposition in squamous cell carcinomas of the larynx and hypopharynx. Thromb Haemost. 1998;80:767–72.PubMedGoogle Scholar
  9. 9.
    Palumbo JS, Kombrinck KW, Drew AF, Grimes TS, Kiser JH, Degen JL, et al. Fibrinogen is an important determinant of the metastatic potential of circulating tumor cells. Blood. 2000;96:3302–9.PubMedGoogle Scholar
  10. 10.
    Zhang PP, Sun JW, Wang XY, Liu XM, Li K. Preoperative plasma D-dimer levels predict survival in patients with operable non-small cell lung cancer independently of venous thromboembolism. Eur J Surg Oncol. 2013;39:951–6.CrossRefPubMedGoogle Scholar
  11. 11.
    Zhou YX, Yang ZM, Feng J, Shan YJ, Wang WL, Mei YQ. High plasma D-dimer level is associated with decreased survival in patients with lung cancer: a meta-analysis. Tumour Biol. 2013;34:3701–4.CrossRefPubMedGoogle Scholar
  12. 12.
    Silvestri GA, Gonzalez AV, Jantz MA, Margolis ML, Gould MK, Tanoue LT, et al. Methods for staging non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143:e211S–50.CrossRefPubMedGoogle Scholar
  13. 13.
    Beasley MB, Brambilla E, Travis WD. The 2004 World Health Organization classification of lung tumors. Semin Roentgenol. 2005;40:90–7.CrossRefPubMedGoogle Scholar
  14. 14.
    Detterbeck FC, Postmus PE, Tanoue LT. The stage classification of lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143:e191S–210.CrossRefPubMedGoogle Scholar
  15. 15.
    Harper PL, Theakston E, Ahmed J, Ockelford P. D-dimer concentration increases with age reducing the clinical value of the D-dimer assay in the elderly. Intern Med J. 2007;37:607–13.CrossRefPubMedGoogle Scholar
  16. 16.
    Caponnetto P, Russo C, Di Maria A, Morjaria JB, Barton S, Guarino F, et al. Circulating endothelial-coagulative activation markers after smoking cessation: a 12-month observational study. Eur J Clin Invest. 2011;41:616–26.CrossRefPubMedGoogle Scholar
  17. 17.
    Tas F, Kilic L, Serilmez M, Keskin S, Sen F, Duranyildiz D. Clinical and prognostic significance of coagulation assays in lung cancer. Respir Med. 2013;107:451–7.CrossRefPubMedGoogle Scholar
  18. 18.
    Fukumoto K, Taniguchi T, Usami N, Kawaguchi K, Fukui T, Ishiguro F, et al. The preoperative plasma D-dimer level is an independent prognostic factor in patients with completely resected non-small cell lung cancer. Surg Today. 2015;45:63–7.CrossRefPubMedGoogle Scholar
  19. 19.
    Yip CH, Taib NA, Tan GH, Ng KL, Yoong BK, Choo WY. Predictors of axillary lymph node metastases in breast cancer: is there a role for minimal axillary surgery? World J Surg. 2009;33:54–7.CrossRefPubMedGoogle Scholar

Copyright information

© International Society of Oncology and BioMarkers (ISOBM) 2015

Authors and Affiliations

  1. 1.Department of Clinical Laboratory, Cancer Institute and HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingPeople’s Republic of China

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