D-Dimer与胰腺癌Ⅳ期患者生存期及预后的相关性研究

摘要

目的：探讨Ⅳ期胰腺癌患者血浆中D-二聚体(D-Dimer)水平与患者预后的相关性。方法：本研究回顾性分析了2001年1月至2015年12月在首都医科大学附属北京友谊医院治疗的胰腺癌住院患者90例，分析其入院时血浆D-Dimer、纤维蛋白原(fibrinogen，Fbg)含量与临床特征及总生存时间的关系。结果：Ⅳ期胰腺癌患者中D-Dimer水平升高、Fbg含量降低者生存期相对较短，体能状态评分相对较差。ECOG≥3分患者D-Dimer[(5.40±3.19) mg/L]显著高于ECOG≤2分患者[(2.42±2.33)mg/L](P<0.01)。D-Dimer水平正常者OS为9.82个月(95% CI，8.42~11.26个月)，D-Dimer水平异常者OS为3.76个月(95% CI，3.11~4.40个月)，二者差异有统计学意义(P<0.05)。D-Dimer水平为胰腺癌患者预后独立危险因素。结论：D-Dimer可作为Ⅳ期胰腺癌患者预后判断的实验室指标，其异常升高提示患者预后较差。%Objective: To examine the association of plasma D-Dimer levels and the prognosis of stageⅣ pancreatic cancer patients.Methods:Retrospectively analysed 90 stageⅣ pancreatic cancer patients hospitalized in Beijing Friendship Hospital Affliated Capital Medical University from January 2001 to December 2015, the correlation between plasma D-Dimer levels, the content of Fbg with clinical features and overall survival were analysed. Results: In stageⅣ pancreatic cancer patients’ D-Dimer levels increased, Fbg levels decreased, relatively the survival period was short and patients had poor physical status; D-Dimer in patients with ECOG ≥3 [(5.40±3.19) mg/L] was significantly higher than those with ECOG ≤2 [(2.42±2.33) mg/L] (P<0.01). The OS of patients with normal D-Dimer level was 9.82 months (95% CI, 8.42~11.26 months), with abnormal was 3.76 months (95% CI, 3.11~4.40 months) (P<0.05). Multivariate analysis revealed that D-Dimer was a signiifcant independent factor for OS in stageⅣ pancreatic cancer.Conclusion:D-Dimer could be the laboratory indexes of judging the prognosis of patients with stageⅣ pancreatic cancer, which abnormally elevated prompted patients with poor prognosis.