Prognostic significance of plasma D-dimer levels in patients with lung cancer

Abstract

Abstractprotein components of the extracellular matrix, activate latent enzymes such as type IV colBackground -The peripheral blood concentrations of several proteases of the clot-lagenase, and dissolve tumour associated fibrin clots. 2 Circulating markers of the fibrinolysis ting system have been shown to predict survival in patients with malignancy. A system are raised in patients with lung cancer and they have been shown to correlate with study was undertaken to investigate the independent value of the plasma levels of tumour burden, clinical progression, and the response to chemotherapy. 3 The aim of this the D-dimer degradation product of fibrin before treatment for predicting prognosis study was to investigate the independent value of the pretreated plasma levels of -dimer fibrin in patients with lung cancer. Methods -The study comprised 70 patients degradation products for predicting prognosis in patients with lung cancer. with lung cancer (49 non-small cell lung cancer and 21 small cell lung cancer). Plasma levels of D-dimer were measured using an enzyme immunoassay kit. Multi-Methods variate statistical analysis was carried Seventy consecutive patients with lung cancer, out using the Cox's proportional hazards of median age 65 years (range 20-83), admitted model.to the Mie University Hospital from July 1990 Results -The median value of the plasma to December 1991 took part in the study. There level of D-dimer differentiated two groups were 49 cases with non-small cell lung cancer of patients with different outcomes: a (non-SCLC) and 21 with small cell lung cancer group with a D-dimer level of <150 ng/ml (SCLC). Clinical staging was performed ac-(low DD group) and those with D-dimer cording to the new international staging system. levels of [150 ng/ml (high DD group). Patients underwent curative surgery (n=20) Survival time was significantly better in or combination chemotherapy followed by patients in the low DD group than in those radiotherapy (n=50). Venous blood samples in the high DD group in all patients (haz-were taken 1-5 days (median two days) before ard ratio for high DD group=4.7; 95% starting any treatment and stored at −80°C confidence interval (CI) 1.8 to 11.7). The until needed. Plasma levels of -dimer were plasma levels of D-dimer predicted sur-determined using an enzyme immunoassay kit vival independently from the clinical stage (Dimertest, Agen, Mountain View, California, of disease, histological type, performance USA). -dimer levels were also measured in status, and tumour size (hazard ratio= blood samples from age matched healthy vo-3.9; 95% CI 1.6 to 9.2).lunteers (n=40) and from patients with benign Conclusions -These results suggest that pulmonary disease (n=25). There was a history plasma levels of D-dimer might be useful of smoking in 50 patients with lung cancer, in for predicting the clinical outcome in 15 with benign disease, and in 10 healthy patients with lung cancer. However, fur-subjects. The intra-assay and inter-assay prether prospective studies are needed in a cisio...

Plasma levels of D‐dimer in lung carcinoma

“…7 In addition, changes in the clotting/fibrinolytic system in lung carcinoma patients are common. 3,9,[11][12][13][14][15][16][17] Clinical and experimental evidence supports the idea that the activation of coagulation/fibrinolysis may play an important role in the invasiveness of cancer. 6,7 For example, Kwaan and Keer 6 demonstrated a correlation between coagulation changes and the natural history of malignancies.…”

“…32 As in many other human malignancies, [33][34][35][36][37][38] including lung carcinoma, DD might have prognostic significance. 12,15,39 In 1993, Seitz et al 12 reported that TAT and DD were significantly increased in patients with metastatic disease and that elevated TAT values at diagnosis might be prognostically significant. Taguchi et al 15 measured the plasma levels of DD in 70 lung carcinoma patients.…”

“…12,15,39 In 1993, Seitz et al 12 reported that TAT and DD were significantly increased in patients with metastatic disease and that elevated TAT values at diagnosis might be prognostically significant. Taguchi et al 15 measured the plasma levels of DD in 70 lung carcinoma patients. They found that low values of DD were significantly predictive of both good prognosis and longer survival times.…”

“…A thrombophilic state often is associated with a large tumor burden, clinical progression, low rates of response to chemotherapy, and a poor prognosis. 3,9,[11][12][13][14][15][16][17] The evidence, however, was derived from several small or medium studies, and no marker of hemostasis was identified, even in the most recent and expert review of lung carcinoma prognosis. 18 The purpose of the current study was to confirm the prognostic significance of hemostatic activation in lung carcinoma patients and to delineate the relationships between markers of hemostasis and other clinical and laboratory characteristics.…”

Plasma fibrin D-dimer levels correlate with tumour volume, progression rate and survival in patients with metastatic breast cancer

“…Tissue markers of fibrinolysis, mainly the levels of tissue-type (tPA) and urokinase-type (uPA) plasminogen activators, have prognostic significance in patients with localized and metastatic breast cancer (Solomayer et al, 1997). In patients with both non-small cell and small cell lung cancer, increased plasma D-dimer levels were shown to be predictive for a worse clinical outcome (Taguchi et al, 1997). Similarly in patients with primary colorectal cancer, D-dimers predicted for more advanced stage of disease and worse prognosis (Oya et al, 1998).…”