Serum D-dimer level may be a prognostic factor for survival in patients with gastric cancer

Year 2012, Volume: 20 Issue: 1, - , 01.04.2012

Saadettin Kılıçkap Turgut Kaçan Orhan Kırbıyık Nalan Akgül Babacan Birsen Yücel Mehmet Fuat Eren

https://doi.org/10.17940/endoskopi.74839

Abstract

Background and Aims: High serum D-dimer level associates with prognosis in patients with breast and colorectal cancer. The prognostic value of serum D-dimer level in gastric cancer is unclear. In this study, we evaluated the prognostic value of D-dimer level in gastric cancer. Materials and Methods: The patients' data were retrospectively obtained from the hospital records. The demographic parameters and pathological findings of the patients were recorded. Serum carcinoembryonic antigen and D-dimer levels at the time of diagnosis were categorized as normal or high. Results: A total of 44 patients were included in our study. At the time of diagnosis, the median carcinoembryonic antigen and D-dimer levels were 2.1 ng/dl (0.45-201) and 358 ng/dl (130-7361), respectively. High carcinoembryonic antigen was associated with stage and metastatic disease (p=0.001 and p=0.021). There were no associations between serum D-dimer level and sex, T and N status, stage, Eastern Cooperative Oncology Group performance status, or lymphovascular invasion. At the initial diagnosis, high serum D-dimer level was a prognostic factor for survival in patients with gastric cancer, but not serum carcinoembryonic antigen level (p=0.024). Conclusions: Elevated serum D-dimer levels may be a poor prognostic factor in gastric cancer.

Keywords

Gastric cancer, D-dimer, carcinoembryonic antigen, prognosis

Serum D-dimer düzeyi mide kanserli hastalarda sağkalım için prognostik bir faktör olabilir

Abstract

Giriş ve Amaç: Yüksek serum D-dimer seviyesi kolorektal ve meme kanserli hastalarda prognozla ilişkilidir. Mide kanserli hastalarda D-dimer düzeyinin prognostik önemi tartışmalıdır. Bu çalışmada tanı anındaki serum D-dimer düzeyinin mide kanseri için prognostik değeri araştırılmıştır. Gereç ve yöntem: Hasta verileri retrospektif olarak hastane kayıtlarından elde edildi. Demografik veriler ve patolojik bulgular kaydedildi. Karsinoembriyonik antijen ve D-dimer düzeyleri kategorize edildi. Bulgular: Toplam 44 hastanın verileri analiz edildi. Tüm hastalarda tanı anında ortanca karsinoembriyonik antijen 2,1 ng/dL (0,45-201) ve D-dimer 358 ng/dL (130-7361) idi. Yüksek karsinoembriyonik antijen düzeyi metastaz ve evre ile ilişkili idi (sırasıyla p=0,001 ve p=0.021). Tanı anındaki D-dimer ile cinsiyet, T ve N status, evre, Eastern Cooperative Oncology Group performans statusu ve lenfovasküler invazyon varlığı arasında bir ilişki bulunamadı. Başlangıç karsinoembriyonik antijen düzeyi sağkalım için prognostik bir faktör olarak bulunamazken, D-dimer yüksekliği mide kanserli hastalarda sağkalım için kötü prognostik bir faktördü (p=0,024). Tartışma: D-dimer yüksekliği mide kanserinde kötü prognostik bir faktör olabilir.

Keywords

Mide kanseri, d-dimer, karsinoembriyonik antijen, prognoz

References

• World Health Organization. The Global Burden of Disease: 2004 Upda- te. Geneva: World Health Organization; 2008.
• Yilmaz HH, Yazihan N, Tunca D, et al. Cancer trends and incidence and mortality patterns in Turkey. Jpn J Clin Oncol 2011;41:10-6.
• Ay C, Dunkler D, Pirker R, et al. High D-dimer levels are associated with poor prognosis in cancer patients. Haematologica 2012; 97: doi:10.3324/ haematol.2011.054718
• Oya M, Akiyama Y, Okuyama T, Ishikawa H. High preoperative plasma D-dimer level is associated with advanced tumor stage and short survi- val after curative resection in patients with colorectal cancer. Jpn J Clin Oncol 2001;31:388-94.
• Blackwell K, Hurwitz H, Liebérman G, et al. Circulating D-dimer levels are better predictors of overall survival and disease progression than car- cinoembryonic antigen levels in patients with metastatic colorectal carci- noma. Cancer 2004;101:77-82.
• Lyman GH, Khorana AA. Cancer, clots and consensus: new understan- ding of an old problem. J Clin Oncol 2009;27:4821-6.
• Kwon H, Oh SY, Lee S, et al. Plasma levels of prothrombin fragment F112, D-dimer and prothrombin time correlate with clinical stage and lymph node metastasis in operable gastric cancer patients. Jpn J Clin On- col 2008;8:2-7.
• Malik G, Knowles LM, Dhir R, et al. Plasma fibronectin promotes lung metastasis by contributions to fibrin clots and tumor cell invasion. Can- cer Res 2010;70:4327-34.
• Jain S, Harris J, Ware J. Platelets: linking hemostasis and cancer. Arteri- oscler Thromb Vasc Biol 2010;30:2362-7.
• Pabinger I, Ay C. Biomarkers and venous thromboembolism. Arteriosc- ler Thromb Vasc Biol 2009;29:332-6.
• Ay C, Vormittag R, Dunkler D, et al. D-dimer and prothrombin fragment 1 + 2 predict venous thromboembolism in patients with cancer: results from the Vienna Cancer and Thrombosis Study. J Clin Oncol 2009;27: 4124-9.
• Ay C, Pabinger I. Tests predictive of thrombosis in cancer. Thromb Res 2010;125 Suppl 2:S12-5.
• Blackwell K, Haroon Z, Broadwater G, et al. Plasma D-dimer levels in operable breast cancer patients correlate with clinical stage and axillary lymph node status. J Clin Oncol 2000;18:600-8.
• Batschauer AP, Figueiredo CP, Bueno EC, et al. D-dimer as a possible prognostic marker of operable hormone receptor-negative breast cancer. Ann Oncol 2010;21:1267-72.
• Chew HK, Wun T, Harvey D, et al. Incidence of venous thromboembo- lism and its effect on survival among patients with common cancers. Arch Intern Med 2006;166:458-64.
• Schutgens RE, Haas FJ, Biesma DH. Reduced efficacy of clinical proba- bility score and D-dimer assay in elderly subjects suspected of having de- ep vein thrombosis. Br J Haematol 2005;129:653-7.