D-Dimer: A Potential Solution to Problems of Cancer Screening, Surveillance, and Prognosis Assessment

Siddiqui, Nabeel; Malik, Mushrin; Fernando, Ransirini Wijeratne; Nair, Archana Sreekantan; Illango, Janan; Gor, Rajvi; Hamid, Pousette

doi:10.7759/cureus.15064

Cited by 15 publications

(14 citation statements)

References 38 publications

(39 reference statements)

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“…Therefore, accurate preoperative assessment of disease burden is essential to avoid nontherapeutic laparotomies in many patients or withholding of potentially beneficial therapy in others. The application value of D-Dimer in tumor has been confirmed by extensive researches [ 20 , 21 ]. In 2018, a meta-analysis included 13,001 patients, which found an elevated D-Dimer was markedly associated with poor overall survival (OS) and shorter progression-free survival (PFS) [ 22 ].…”

Section: Discussionmentioning

confidence: 97%

Preoperative plasma D-Dimer level is correlated with peritoneal cancer index of patients with pseudomyxoma peritonei

Feng

et al. 2022

BMC Surg

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Purpose Accurate assessment of preoperative tumor burden contribute to formulate a scientific surgical plan for patients with pseudomyxoma peritonei (PMP). Present study aimed to assess whether the preoperative plasma D-Dimer level could reflect tumor burden for PMP patients. Methods A total of 253 PMP patients were included between June 1, 2013 and March 1, 2022. According to the peritoneal cancer index (PCI), all participants were divided into extensive (PCI ≥ 28) and none-extensive (PCI < 28) subgroups. The D-Dimer and tumor markers were compared between the two subgroups. The correlation between the abovementioned biomarkers and PCI will be calculated, and further compared with each other. Two-sided P value less than 0.05 is considered statistically significant. Results The level of D-Dimer (ng/ml) between extensive and none-extensive subgroup were 600 (328, 1268) vs. 339 (128, 598), Z = -5.425, p < 0.001. The Spearman correlation between D-Dimer, carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA 125), CA 19 − 9 and PCI were 0.487, 0.509, 0.469, and 0.499, respectively (all p < 0.001). The correlation coefficients were compared with each other according to Meng, Rosenthal and Rubin’s method, however, there was no significant difference. Conclusion Preoperative plasma D-Dimer could moderately reflect tumor burden for PMP. In the future, a multivariate prediction model will be developed to help surgeons to formulate a more precise surgical plan for the PMP patients.

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Section: Discussionmentioning

confidence: 97%

Preoperative plasma D-Dimer level is correlated with peritoneal cancer index of patients with pseudomyxoma peritonei

Feng

et al. 2022

BMC Surg

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“…Prior studies have shown an elevated D-dimer levels among elderly patients 1 , 18 , 30 and in many co-morbidities including renal failure, 1 , 18 cancer, 1 , 4 – 6 and sepsis. 1 , 7 , 8 Recently, D-dimer was shown to be an important prognostic factor among COVID-19 patients.…”

Section: Discussionmentioning

confidence: 99%

“… 1 , 2 D-dimer was initially found to be a valuable marker for coagulation and fibrinolytic system activation, linked with various venous and arterial thrombotic events, as well as disseminated intravascular coagulation (DIC). 1 , 3 It was also shown to be an important prognostic factor in multiple diseases including various malignancies, 1 , 4 – 6 sepsis, 7 , 8 aortic dissection, 9 , 10 acute stroke, 11 , 12 and recently among COVID-19 patients. 13 – 15 Although robust data exists showing D-dimer to be a strong predictor for overall mortality among critically ill patients, 16 – 21 and although recent studies suggest a prognostic role among stable coronary patients 22 , 23 as well as among acute coronary syndrome (ACS) patients or after percutaneous coronary procedures, 24 – 26 data regarding its prognostic role among contemporary tertiary care intensive coronary care unit (ICCU) patients are scarce.…”

Section: Introductionmentioning

confidence: 99%

D-Dimer as a Prognostic Factor in a Tertiary Center Intensive Coronary Care Unit

Rav

Taha

Turyan

et al. 2022

Clin Appl Thromb Hemost

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Introduction D-dimer is a small protein fragment produced during fibrinolysis. High D-dimer levels were shown to have prognostic impact in critically ill patients. Nevertheless, data regarding D-dimer's prognostic impact among tertiary care intensive coronary care unit (ICCU) patients is scarce. Material and method All patients admitted to the ICCU between 1-12/2020 were prospectively included. Based on admission D-dimer level, patients were categorized into low and high D-dimer groups (< 500 ng/ml and ≥ 500 ng/ml) and also to age-adjusted D-dimer cutoff (500 ng/ml for ages ≤ 50 years old and age*10 for ages>50 years old). Results and discussion A total of 959 consecutive patients were included, including 296 (27.4%) and 663 (61.3%) patients with low and high D-Dimer levels, respectively. Patients with high D-dimer level were older compared with patients with low D-dimer level (age 70.4 ± 15 and 59 ± 13 years, p = 0.004) and had more comorbidities. The most common primary diagnosis on admission among the low D-dimer group was acute coronary syndrome (ACS) (74.3%), while in the high D-dimer group it was a combination of ACS (33.6%), cardiac structural interventions (26.7%) and various arrhythmias (21.1%). High D-dimer levels were associated with increased mortality rate, even after adjustment for age, gender, comorbidities and left ventricular ejection fraction (LVEF). High D-dimer levels were independently associated with increased overall 1-year mortality rate (HR = 5.8; 95% CI; 1.7-19.1; p = 0.004). Conclusion Elevated D-dimer levels on admission in ICCU patients is an independently poor prognostic factor for in-hospital morbidity and 1-year overall mortality rate following hospitalization.

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“…Moreover, activation of the coagulation system and fibrinolytic cascade may correlate with tumor growth, invasion, and metastasis, and plasma Ddimer is a procoagulation factor that may reflect micrometastases (15)(16)(17). A high D-dimer level is considered to reflect a poor prognosis for a variety of cancers (17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Monitoring of postoperative neutrophil-to-lymphocyte ratio, D-dimer, and CA153 in: Diagnostic value for recurrent and metastatic breast cancer

Ren

Yang²,

Ji³

et al. 2023

Front. Surg.

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ObjectiveThis stydy aims to assess the value of monitoring of postoperative neutrophil-to-lymphocyte ratio (NLR), D-dimer, and carbohydrate antigen 153 (CA153) for diagnosis of breast cancer (BC) recurrence and metastasis.Materials/MethodsA cohort of 252 BC patients who underwent surgery at the First Affiliated Hospital of Anhui Medical University between August 2008 and August 2018 were enrolled in this retrospective study. All patients were examined during outpatient follow-ups every 3 months for 5 years postoperation and every 6 months thereafter. Recurrence or metastasis was recorded for 131 patients but not for the remaining 121. Retrospective analysis of hematological parameters and clinicopathological characteristics allowed comparison between the two groups and evaluation of these parameters for the recurrent and metastatic patients.ResultsLymph node metastasis, higher tumor node metastasis (TNM) staging, and higher histological grade correlated with BC recurrence and metastasis (p < 0.05). Statistical differences were found in absolute neutrophil count (ANC), absolute lymphocyte count (ALC), CEA, CA153, D-dimer, NLR, platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) between the recurrent and metastatic and control groups (p < 0.05). Logistic regression analysis showed that CA153, D-dimer, NLR, and TNM staging were risk factors for BC recurrence and metastasis (p < 0.05). Combined values for the NLR, D-dimer, and CA153 had good diagnostic values, giving the highest area under the curve (AUC) of 0.913. High NLR, D-dimer, and CA153 values were significantly associated with recurrence and metastasis at multiple sites, lymph node metastasis, and higher TNM staging (p < 0.05). Patients with high CA153 were more likely to have bone metastases (p < 0.05), and those with high D-dimer were prone to lung metastasis (p < 0.05). With the increasing length of the postoperative period, the possibility of liver metastases gradually decreased, while that of chest wall recurrence gradually increased (p < 0.05).ConclusionMonitoring postoperative NLR, D-dimer, and CA153 is a convenient, practical method for diagnosing BC recurrence and metastasis. These metrics have good predictive value in terms of sites of recurrence and metastasis and the likelihood of multiple metastases.

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D-Dimer: A Potential Solution to Problems of Cancer Screening, Surveillance, and Prognosis Assessment

Cited by 15 publications

References 38 publications

Preoperative plasma D-Dimer level is correlated with peritoneal cancer index of patients with pseudomyxoma peritonei

Preoperative plasma D-Dimer level is correlated with peritoneal cancer index of patients with pseudomyxoma peritonei

D-Dimer as a Prognostic Factor in a Tertiary Center Intensive Coronary Care Unit

Monitoring of postoperative neutrophil-to-lymphocyte ratio, D-dimer, and CA153 in: Diagnostic value for recurrent and metastatic breast cancer

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