Plasma D-dimer value as a predictor of malignant lymph node involvement in operable non-small cell lung cancer

Abstract

Fibrin deposition and remodelling of the extracellular matrix are important early steps in tumour metastasis. The D-dimer value is an indicator of intravascular fibrin formation and degradation. Thus, the D-dimer value may be a predictor of the malignant involvement of lymph nodes in operable non-small cell lung cancer (NSCLC) patients. The study comprised 142 highly suspected lung cancer patients scheduled to undergo pneumonectomy, lobectomy or wedge resection. Of the 142 patients, 124 were subsequently diagnosed as NSCLC, and 18 were subsequently diagnosed as benign lung disease by histological examination. Preoperative plasma D-dimer values were quantified, and the relationship between plasma D-dimer and clinical variables including tumour size, involvement of lymph nodes and clinical stage was examined using Spearman correlation coefficients and χ (2) tests. The median plasma D-dimer values were statistically higher in NSCLC patients with malignant lymph nodes than in those who suffered either benign lung disease or carcinoma in situ (Kruskal-Wallis test; P = 0.001). Plasma D-dimer values were significantly correlated with clinical stage (ANOVA; P = 0.009). An obvious relationship was observed between elevated D-dimer (>0.475 mg/L fibrinogen equivalent units) and malignant lymph node involvement (χ (2) test; P = 0.0000). This correlation suggests that the plasma D-dimer value is a clinically important predictor for the malignant involvement of lymph nodes in operable NSCLC.

The role of plasma D‐dimer levels for predicting lymph node and mediastinal lymph node involvement in non‐small cell lung cancer

“…In contrast, Fregoni et al found no correlation between plasma D‐dimer levels and lymph node involvement in 142 patients with operable breast cancer . In 2015, after a retrospective analysis of 124 patients with operable NSCLC, Chen et al reported a significant relationship between plasma D‐dimer levels and malignant lymph node involvement . In accordance with these findings, the current study demonstrated that preoperative plasma D‐dimer levels were a predictor of lymph node involvement in NSCLC patients undergoing radical lung resection with systemic lymph node dissection by thoracotomy or VATS.…”

Case of Thrombosis of Rare Localization in a Cancer Patient with Combined form of Thrombophilia

“…Fibrin fibers are always present in any tumor tissue, which is particularly characteristic of the active zone of proliferation of malignant cells. A powerful fibrin barrier is formed due to distortion of the processes of permanent stimulation of fibrinogenesis and concomitant fibrinolysis in the tumor zone [5,6]. From the side of tumor cells, the initiating effect on the components of the hemostasis system and the process of fibrin formation is mediated by macrophages present in the tumor zone, whose reaction to malignant cells is expressed by increased production of proinflammatory cytokines, such as TNFα, IL-1, IL-6, IL-8 and other active molecules [7,8].…”

Non-High Risk PE in the Patients with Acute or Exacerbated Respiratory Disease: The Value of the Algorithm Based on D-Dimer Evaluation and Revised Geneva Score

“…Fijałkowska et al found DD increase in the course of lung cancer in 75% of patients, with median value of 941 ng/ mL [23]. The histological type of neoplasm and the disease extension are probably influencing DD-concentration [23,29].…”