术前血浆D-二聚体水平及血小板计数与局部晚期食管鳞癌临床病理特征的关系

目的:探讨术前D-二聚体(D-dimer)和血小板(PLT)计数与局部晚期食管鳞状细胞癌(esophageal squamous cell carcinoma,ESCC)临床病理特征的相关性及预后价值。方法:测定99例局部晚期ESCC患者(食管癌组)及30例健康体检者(对照组)血浆D-dimer和PLT水平并进行比较,并分析其与ESCC临床病理因素之间关系及预后价值。结果:食管癌组血浆D-dimer、PLT水平高于健康对照组(P0.05)。食管癌组D-dimer与淋巴结转移、TNM分期有关,而PLT与ESCC临床病理特征无关。单因素分析提示D-dimer、淋巴结转移、TNM分期与无疾病进展时间(disease free survival,DFS)和总体生存时间(overall survival,OS)相关,而多因素分析仅提示D-dimer是局部晚期ESCC患者的独立危险预后因素。结论:D-dimer增高与淋巴结转移和TNM分期有关,D-dimer可作为评判局部晚期ESCC预后的独立指标,为ESCC个体化治疗提供参考价值。

Clinical Significance of Preoperative Plasma D-dimer and Platelet in Esophageal Squamous Cell Carcinoma

ABSTRACT Objective: To investigate the correlation of D-dimer and platelet counts with the clinicopathological features of locally advanced esophageal squamous cell carcinoma (ESCC) and its prognostic value. Methods: The plasma levels of D-dimer and PLT were measured in 99 patients with esophageal cancer (esophageal cancer group) and 30 healthy subjects (control group), and their relationship with clinical pathological factors and prognosis value were analyzed. Results: The levels of plasma D-dimer and PLT in esophageal can- cer group were higher than those in healthy control group (P<0.05). And D-dimer was related to lymph node metastasis and TNM stage in esophageal cancer group. But the PLT was not related to clinicopathological features. Univariate analysis showed that D-dimer, lymph node metastasis and TNM stage was related to disease free survival (DFS) and overall survival (OS) time. Multivariate analysis revealed that only D-dimer was an independent risk factor of locally advanced ESCC patients. Conclusion: The increased D-dimer is associated with lymph node metastasis and TNM stage. The D-dimer can be used as an independent factor for the prognosis of locally advanced ESCC and may provide a certain value for its individualized therapy.