消化道肿瘤化疗前后D-二聚体与疗效的研究

目的:探讨消化道肿瘤患者血浆D-二聚体水平与化疗疗效及临床分期的关系。方法:80例入组的消化道肿瘤患者(其中男48例,女32例),采用免疫散射比浊方法、日本CA-7000全自动监测仪测定化疗前后血浆D-二聚体的含量。结果:化疗前消化道肿瘤进展期(Ⅲ、Ⅳ期)D-二聚体含量分别为(1.15±0.48)mg/L、(1.98±0.77)mg/L;早期(Ⅱ期)D-二聚体含量(0.28±0.09)mg/L;三者间比较,D-二聚体差异有统计学意义(P<0.01)。化疗后37例疗效达(CR+PR)组与治疗前D-二聚体差值为(-0.41±0.19)mg/L;25例疗效为稳定(SD)组血浆D-二聚体治疗前后差值为(0.09±0.11)mg/L;18例疗效进展(PD)组血浆D-二聚体差值(0.84±0.32)mg/L;且进展期(Ⅲ、Ⅳ期)化疗后有效组(CR+PR)D-二聚体含量显著低于化疗前,有统计学差异(P<0.01);化疗后进展组明显高于化疗前(P<0.05);化疗后稳定组(SD)无统计学差异。结论:血浆D-二聚体水平高低可作为消化道肿瘤观察临床分期、判断预后及化疗疗效的一个临床指标。

D-dimer and efficacy of gastrointestinal tumors before and after chemotherapy

Objective: To evaluate the association and predictive value of D-dimer levels with chemotherapy response in digestive cancer patients.Methods: 80 patients were evaluated and analysed;77 patients were at an advanced stage.D-dimer levels were measured before after 2 cycles of combination chemotherapy.D-dimer was measured with immunoturbidimetric assay method in Sysmex CA-7000 Automatic analyzer.Results: There was significant difference in blood plasma D-dimer between the group of digestive system tumor metastasis group and that of not metastasized.The D-dimer value showed significant different before and after chemotherapy(P<0.01).D-dimer levels were significantly different between 11I and IV stage digests cancer.After chemotherapy,the D-dimer of indigest patients with PR/CR was markly reduced(P<0.01),but increased in PD cases(P<0.05),and not changed in SD patients.conclusion: Levels of plasma D-dimer Can be residented as a potential predictor in metastatic gastric cancer.