Study on D-dimer elevation in patients with colorectal cancer

Abstract

Abstract:

ObjectiveTo analyze the association of coagulation with clinical parameters in patients with colorectal cancer.MethodsClinical 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.ResultsA 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.ConclusionsFar 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/Tables6

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

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