Objective To explore the clinical significance of detection of plasma D-dimer in patients with cervical cancer,uterine cancer and ovarian cancer.Methods Total 35 cervical cancer patients,32 uterine cancer patients and 30 ovarian cancer patients were collected from Yunxiao Traditional Chinese Medicine Hospital of Zhangzhou city and the First Hospital of Zhangzhou China Merchants Economic and Technological Development Zone from October 2013 to July 2015.The plasma D-dimer was detected and compared with cervicitis,hysteromyoma,ovarian cyst and healthy control respectively.Relativity between the level of plasma D-dimer with the International Federation of Gynecology and Obstetrics (FIGO) staging was anslyzed.The diagnostic value of plasma D-dimer in cervical cancer,uterine cancer and ovarian cancer was assessed by receiver operating characteristic (ROC)curves.Results The level of plasma D-dimer in the cervical cancer group was significantly higher than that in the cervicitis group,the uterine cancer group was higher than that in the uterine leiomyoma group,and the ovarian cancer group was higher than that in the ovarian cyst group too (t=5.91 ～ 7.17,all P＜0.01).It was no significantly differentia compare with cervical cancer group,uterine cancer group and ovarian cancer group (F=0.10,P＞0.05).Plasma D-dimer level in cervicitis group,hysteromyoma group and ovarian cyst group was no significantly differentia (F=2.47,P＞0.05) but it was significantly high in cervicitis than hysteromyoma at post test (P＜0.05).Compared with healthy control group,the plasma D-dimer level was significantly rise in cervical cancer,uterine cancer,uterine cancer,cervicitis and ovarian cyst (t=2.43～7.53,P＜0.01～0.05),while no significantly differentia in hysteromyoma (t=1.04,P＞0.05).It was significantly differentia and increases as the FIGO staging in cervical cancer,uterine cancer and uterine cancer (F=15.06 ～ 19.02,all P＜0.01,r=0.625 ～ 0.855,all P＜0.01).The area under the ROC curve (AUC) of the three tumors diagnosed by D-dimer was 0.964,0.980 and 0.983,with sensitivity of 82.9 ％,90.6 ％ and 86.7 ％ respectively,and specificity of all 100％,which was of high diagnostic value.Conclusion There are hyperactivity of thrombosis and fibrinolysis in cervical cancer,uterine cancer and ovarian cancer.The plasma D-dimer levels can be used as the reference index of diagnosis and staging.%目的 探讨子宫颈癌、子宫癌和卵巢癌患者血浆D-二聚体水平检测的临床意义.方法 收集2013年10月～2015年7月在云霄县中医院和漳州开发区第一医院就诊的子宫颈癌患者35例,子宫癌患者32例,卵巢癌患者30例,测定血浆D-二聚体水平,分别与子宫颈炎、子宫肌瘤、卵巢囊肿患者和健康对照比较,并分析D-二-聚体水平与国际妇产科联盟(FIGO)分期的关系,采用受试者工作特征(ROC)曲线分析D-二聚体对3种恶性肿瘤的诊断价值.结果 子宫颈癌组D-二聚体水平高于子宫颈炎组,子宫癌组高于子宫肌瘤组,卵巢癌组高于卵巢囊肿组,差异均具有统计学意义(t=5.91～7.17,均P＜0.01).子宫颈癌、子宫癌与卵巢癌之间差异无统计学意义(F=0.10,P＞0.05).子宫颈炎组、子宫肌瘤组和卵巢囊肿组之间差异无统计学意义(F=2.47,P＞0.05),事后检验,子宫颈炎组高于子宫肌瘤组,差异具有统计学意义(P＜0.05).与健康对照组比较,子宫颈癌组、子宫癌组、卵巢癌组、子宫颈炎组和卵巢囊肿组明显增高,差异具有统计学意义(t=2.43～7.53,P＜0.01～0.05),子宫肌瘤组与健康对照组差异无统计学意义(t=1.04,P＞0.05).子宫颈癌、子宫癌和卵巢癌不同FIGO分期患者,血浆D-二聚体水平不同(F=15.06～19.02,P均＜0.01),与分期的升级呈正相关(r=0.625～0.855,P均＜0.01).D-二聚体诊断三种肿瘤的ROC曲线下面积(AUC)分别为0.964,0.980和0.983,灵敏度为82.9％,90.6％和86.7％,特异度均为100％,具有较高诊断价值.结论 子宫颈癌、子宫癌和卵巢癌均存在血栓形成和纤溶亢进,血浆D-二聚体水平可以作为诊断的参考指标.
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