Application of an elevated plasma D-dimer cut-off value improves prognosis prediction of advanced non-small cell lung cancer

Abstract

Background: Tumor-related coagulation dysfunction has been reported to be closely associated with poor prognosis. The present study is aimed to evaluate the prognostic prediction of an elevated plasma D-dimer cut-off value in advanced non-small cell lung cancer (NSCLC).Methods: A total of 233 patients initially diagnosed with advanced NSCLC were retrospectively analyzed, an elevated plasma cut-off value 981 ng/mL of D-dimer, which was instead of the clinical cut-off value 500 mg/mL, was used to determine the high and low. Univariate analysis using the Kaplan-Meier method and log-ranking test, and the multivariate analysis using the Cox proportional hazard regression model were performed.Results: Results showed when using the D-dimer value of 500 ng/mL as an evaluation standard, there was no significant difference in gender, age, smoking status, histopathology and overall survival rate between normal D-dimer (≤500 ng/mL) and high D-dimer (>500 ng/mL) group. However, when the evaluation standard for plasma D-dimer was set at 981 ng/mL, the age distribution of the high D-dimer (>981 ng/mL) group was significantly different from the normal D-dimer (≤981 ng/mL) group. Moreover, the overall survival rate in the high D-dimer (>981 ng/mL) group was significantly lower than that in the normal D-dimer (≤981 ng/mL) group. Conclusions:The present study implied that increasing the plasma D-dimer cut-off value to 981 ng/mL is more beneficial to prognosis prediction in advanced NSCLC.

Prognostic value of plasma D-dimer levels in advanced non-small cell lung cancer patients treated with immune checkpoint inhibitors: a retrospective study

“…Chen et al found that increasing the threshold value of D-dimer from 0.5 to 0.981 µg/mL was statistically significant across different age groups ( 54 ). They concluded that the cut-off value of 0.5 µg/mL could not reflect the correlation between age and D-dimer.…”

Coagulation parameters in lung cancer patients: A systematic review and meta‐analysis

“…The tumor microenvironment constituted by immune cells and stromal cells with other “niche” cells leads to cancer patients' tumor‐associated coagulation abnormalities, which increases plasma D‐dimer concentration, one of the fibrin degradation products. Furthermore, D‐dimer is associated with lymph node metastases in NSCLC 37 . This meta‐analysis points out that the plasma D‐dimer value was significantly higher in lung cancer patients (SMD 3.10; 95% CI 2.08–4.12; p = 0.000) when compared with the control group using seven studies.…”

“…Furthermore, D-dimer is associated with lymph node metastases in NSCLC. 37 This meta-analysis points out that the plasma D-dimer value was significantly higher in lung cancer patients (SMD 3.10; 95% CI 2.08-4.12; p = 0.000) when compared with the control group using seven studies. The single-arm meta-analysis on seven studies with a total of 1488 lung cancer patients and 328 control groups revealed that the pooled D-dimer was 275.99 (95% CI:172.9-11735.9) as compared with the control group 0.2 (95% CI:0.20-0.37).…”

The Prognostic Value of Preoperative Serum D-dimer Levels After Surgical Resection of Thymic Epithelial Tumors

“…D-dimer and fibrinogen levels were the coagulation indicators that correlated with cancer prognosis; they also correlate with patient prognosis in non-small cell lung cancer, 19 esophageal cancer, 20 and gastrointestinal cancer. 21 However, this has not been adequately studied in thymic epithelial tumors.…”

“…16 Conventional biochemical markers, such as LDH and CRP, have been reported to be valuable prognostic biomarkers in thymic epithelial tumors 17,18 ; however, the prognostic value of other biochemical markers related to liver function has not been demonstrated. D-dimer and fibrinogen levels were the coagulation indicators that correlated with cancer prognosis; they also correlate with patient prognosis in non-small cell lung cancer, 19 esophageal cancer, 20 and gastrointestinal cancer. 21 However, this has not been adequately studied in thymic epithelial tumors.…”