Study on D-dimer elevation in patients with colorectal cancer

doi:10.16139/j.1007-9610.2021.04.015

Abstract

Abstract:

Objective To analyze the association of coagulation with clinical parameters in patients with colorectal cancer. Methods Clinical and pathological data in the patients with colorectal cancer and surgical treatment were collec-ted from August 2018 to December 2019 in the Department of Gastrointestinal Surgery in our hospital. Retrospective analysis was performed to study the related factors to hypercoagulability with preoperative D-dimer value as index. Results A total of 104 from 249 (41.8%) cases exhibited elevated D-dimer (>550 μg/ L) in serum preoperatively. Twenty-seven (10.8%) cases had a significant elevation of D-dimer(>1 650 μg/ L) three times higher than normal limit. There were 7 cases with venous thromboembolism(VTE) postoperatively. Multivariate analysis showed that the preoperative elevated D-dimer in serum was associated with far metastasis and intraluminal invasion. Elevated D-dimer was found 73.3% cases with metastasis and 37.6% cases without metastasis(P<0.01), and 51.9% cases with intraluminal invasion and 34.3% without intraluminal invasion (P<0.01). Far metastasis was seen 2.8% in cases with normal D-dimer, 6.5% with elevated D-dimer, and 22.2% with significantly elevated D-dimer, and intraluminal tumor invasion diagnosed pathologically 35.2%, 48.1% and 66.7% in patients with normal, elevated and significantly elevated D-dimer, respectively. The incidence of VTE was 0.7%, 3.9% and 11.1% in above three groups, which showed the statistical correlation of VTE with preoperative serum D-dimer level. Conclusions Far metastasis and intraluminal tumor invasion are important to induce hypercoagulability state in patients with colorectal cancer and to be as risk predictor of VTE.

Key words: Colorectal cancer, Thromboembolism, Venous thrombosis, Metastasis, D-dimer

CLC Number:

MAO Jieqi, XU Duogang, ZHANG Mili, XIAO Yunyu, MING Xu, LI Yuzhe, CAO Can, YU Liang, LI Jikun. Study on D-dimer elevation in patients with colorectal cancer[J]. Journal of Surgery Concepts & Practice, 2021, 26(04): 361-366.

Figures/Tables 6

References 16

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项目	远处转移组	无远处转移组	P值
例数	15（6.0）	234（94.0）
男/女	10（4.0）/5（2.0）	127（51.0）/107（43.0）	>0.05
年龄（岁）	59.7±11.5	62.6±11.2	>0.05
D-二聚体均值（μg/L）	1 651±1 991	637±636	<0.01
D-二聚体升高例数（>550 μg/L）	11（73.3）	88（37.6）	<0.01

项目	脉管内肿瘤侵犯组	脉管内无肿瘤侵犯组	P值
例数	106（42.6）	143（57.4）
男/女	61（24.5）/45(18.1）	76（30.5）/67（26.9）	>0.05
年龄（岁）	62.3±11.1	62.6±11.3	>0.05
D-二聚体均值（μg/L）	897±1 082	550±489	<0.01
D-二聚体升高例数（>550 μg/L）	55（51.9）	49（34.3）	<0.01
发生VIE例数	6（5.7）	1（0.7）	<0.01

项目	结肠癌组	直肠癌组	P值
例数	143（57.4）	106（42.6）
男/女	77（30.9）/66（26.5）	60（24.1）/46（18.5）	>0.05
年龄（岁）	62.8±12.0	61.9±10.0	>0.05
D-二聚体均值（μg/L）	820±987	532±445	<0.01
D-二聚体升高例数（>550 μg/L）	69（48.2）	35（33.0）	<0.01