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 3 years after surgery and had a high predictive value for disease recurrence.
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
