晚期结直肠癌患者化疗前后血浆 D-二聚体和脂蛋白测定的临床意义

摘要

Objective To explore the clinical significance of detection of plasma D-dimer and lipoproteins levels before and after chemotherapy in patients with advanced colorectal cancer .Methods The plasma levels of D-dimer, high-density lipoprotein ( HDL ) , lipoprotein ( a ) were detected in 96 patients with advanced colorectal cancer who were subdivided into valid chemotherapy group and invalid chemotherapy group and 112 healthy subjects ( control group ) .These parameters were detected before chemotherapy and 4 treatment courses after chemotherapy in patients with advanced colorectal cancer,and the therapeutic effects were evaluated according to RECIST criterion .Results As compared with those in control group,the plasma levels of D-dimer and LP ( a) were significantly increased in patients with advanced colorectal cancer ( P <0.01),however,HDL levels were significantly decreased ( P <0.01).The plasma levels of D-dimer and LP (a) in valid chemotherapy group were significantly decreased after chemotherapy ( P <0.05 ), however, the levels of HDL were significantly increased ( P <0.01).In contrast to that,the plasma levels of D-dimer and LP (a) were significantly increased in invalid chemotherapy group ( P <0.05),however,HDL levels were significantly decreased ( P <0.01).Concluison The plasma levels of D-dimer and lipoproteins may provide basis for evaluating therapeutic effects before and after chemotherapy in patients with advanced colorectal cancer .%目的：检测晚期结直肠癌患者化疗前后血浆D-二聚体和脂蛋白｛包括高密度脂蛋白（ high-density lipo-protein，HDL）和脂蛋白（a）[lipoprotein（a）]｝水平，探讨两者在疗效评价中的价值。方法选择晚期结直肠癌患者96例和健康体检者112例，采用胶乳增强免疫比浊法测定D-二聚体水平，直接法测定HDL、LP（ a）水平。对于结直肠癌癌患者分别测定化疗前和4周期化疗结束后1周以内以上指标水平，并参照RECIST评价标准进行疗效评价。结果与健康体检者相比，晚期结直肠癌患者的血浆D-二聚体、LP（a）水平明显升高（ P ＜0．001），HDL水平明显降低（ P ＜0．01）。化疗有效组化疗后D-二聚体和LP（a）水平明显降低（ P分别为0．036和0．031），HDL水平明显升高（ P ＝0．01），差异具有统计学意义。化疗无效组化疗后血浆 D-二聚体和 LP（a）水平明显升高（ P 值分别为0．025和0．034），HDL明显降低（ P ＝0．01）。结论晚期结直肠癌患者化疗前后血浆D-二聚体和脂蛋白的水平可为疗效评价提供依据。