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)(χ^(2)=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对不良预后的预测价值(Z=5.30,P=0.006)。结论结直肠癌病人接受完全治愈性切除术后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因素,对疾病复发具有较高的预测价值。
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 underwent complete curative resection at the Nanyang Second General Hospital from January 2016 to April 2018 were enrolled.Based on the 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 years postoperatively 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 infiltration 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)(χ^(2)=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%CI:(0.78,0.86)],the area under the curve for predicting poor prognosis for patients at 3 years postoperatively was 0.73[95%CI:(0.71,0.77)],and the predictive value of D-dimer for disease recurrence at 3 years postoperatively was higher than the predictive value for poor prognosis in patients(Z=5.30,P=0.006).Conclusion The D-dimer level at 1 week after complete curative resection in patients with colorectal cancer was an independent risk factor for disease recurrence and poor prognosis at
作者
宋宗工
SONG Zonggong(Minimally Invasive Surgery,Nanyang Second General Hospital,Nanyang,Henan 473000,China)
出处
《安徽医药》
CAS
2023年第9期1865-1869,共5页
Anhui Medical and Pharmaceutical Journal
关键词
结直肠肿瘤
D-二聚体
复发
生存率
Colorectal neoplasms
D-dimer
Recurrence
Survival rate
