血浆D-二聚体与109例膀胱癌中发生31例转移的关联性分析

doi:10.6040/j.issn.1671-7554.0.2020.1440

摘要/Abstract

摘要： 目的探讨血浆D-二聚体与膀胱癌发生转移的相关性。方法回顾性分析2018年11月至2020年10月于天津医科大学第二医院泌尿外科住院的膀胱癌患者109例。根据影像学检查及术后病理检查结果是否发现淋巴结和/或远处转移,将患者分为转移组(31例)和非转移组(78例)。收集患者同期血液常规检验结果并比较其差异。采用多因素Logistic回归模型分析膀胱癌转移的独立危险因素,绘制受试者工作(ROC)曲线,评价血浆D-二聚体对膀胱癌转移的诊断效能。结果转移组D-二聚体中位水平为1.37 mg/L,非转移组为0.53 mg/L。多因素Logistic回归结果显示,膀胱癌患者血浆D-二聚体水平升高可能是肿瘤转移的独立危险因素［OR(95%CI)为9.542(3.521,25.935),P<0.05］。以D-二聚体为变量对膀胱癌转移诊断效能的ROC曲线下面积为0.857(P<0.05),最大约登指数对应的D-二聚体临界值为1.16mg/L。D-二聚体对膀胱癌转移的诊断灵敏度65%、特异度94%、假阴性35%、假阳性6%。结论血浆D-二聚体水平升高可能是膀胱癌转移的独立危险因素。

关键词: D-二聚体, 膀胱肿瘤, 转移, 相关性

Abstract: Objective To explore the correlation between plasma D-dimer and metastasis of bladder cancer. Methods The clinical data of 109 patients with bladder cancer admitted to the Urology Department of The Second Hospital of Tianjin Medical University during Nov. 2018 and Oct. 2020 were respectively analyzed. The patients were divided into metastatic group(n=31)and non-metastatic group(n=78 cases)based on the presence of lymph nodes and/or distant metastasis detected by imaging and pathological examinations. Results of routine blood tests were also collected and analyzed. The independent risk factors of metastasis were analyzed with multivariate Logistic regression model. The diagnostic efficacy of plasma D-dimer of metastasis was evaluated with receiver operating characteristic(ROC)curve. Results The median level of D-dimer was 1.37 mg/L in the metastatic group and 0.53 mg/L in the non-metastatic group. Multivariate Logistic regression showed that elevated plasma D-dimer level might be an independent risk factor of metastasis ［OR(95%CI): 9.542(3.521, 25.935), P<0.05］. The area under the ROC curve was 0.857(P<0.05), and the cut-off point of plasma D-dimer under the maximum Youden index was 1.16 mg/L. The sensitivity, specificity, false negative value and false positive value of D-dimer of bladder cancer metastasis were 65%, 94%, 35% and 6%, respectively. Conclusion Elevated plasma D-dimer level may be an independent risk factor of metastasis of bladder cancer.

Key words: D-dimer, Bladder cancer, Metastasis, Correlation

中图分类号:

R737.14

高金梅,张向莲,刘铁菊. 血浆D-二聚体与109例膀胱癌中发生31例转移的关联性分析[J]. 山东大学学报 (医学版), 2021, 59(3): 98-102.

GAO Jinmei, ZHANG Xianglian, LIU Tieju. Correlation between plasma D-dimer and metastasis in 109 cases of bladder cancer[J]. Journal of Shandong University (Health Sciences), 2021, 59(3): 98-102.

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