【Abstract】Objective To evaluate the prognostic value of plasma D-dimer level in cancer thrombosis and vascular invasion assessment and to analyze the correlation between plasma D-dimer level and the Pittsburgh modified TNM staging in patients with hepatocellular carcinoma for orthotopic liver transplantation.
MethodsThe plasma D-dimer level was quantitated using Golden method in 120 patients with hepatocellular carcinoma for orthotopic liver transplantation. Cancer thrombosis in trunk vein and microvascular invasion was diagnosed by pathology. The relationship between plasma D-dimer level in different Child-pugh’s classification patients and vascular invasion as well as the Pittsburgh modified TNM staging was analyzed with χ2 test, factorial analysis of variance and q test by microsoft SPSS 9.0.
ResultsIn ChildPugh’s A, B and C patients, the difference of plasma D-dimer level between patients with trunk vein cancer thrombosis and patients without vascular invasion was significant (P＜0.05). The differences of plasma D-dimer level between patients with microvascular invasion and patients without vascular invasion were significant (P＜0.01) in Child-Pugh’s B and C patients but was insignificant in Child-Pugh’s A patients (P gt;0.05). The differences of plasma D-dimer level between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅲ tumor, and between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅳ tumor were significant (P＜0.05), but the differences of plasma D-dimer level between patients with the Pittsburgh modified TNM Ⅲ tumor and patients with TNM Ⅳ tumor were insignificant (P gt;0.05).
ConclusionPlasma D-dimer level, which increasing as upgrade of the Pittsburgh TNM staging, is useful in the vascular invasion and cancer thrombosis assessment in patients with hepatocellular carcinoma for liver transplantation, and the correlation was more significant as progression of vascular invasion and upgrade of Child-pugh’s classification.
Citation：
WU Di,GAO Dongchen.. Correlation Between Plasma D-Dimer Level and Vascular Invasion as well as the Pittsburgh Modified TNM Staging in Patients with Hepatocellular Carcinoma for Orthotopic Liver Transplantation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2005, 12(1): 59-62. doi:
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- 1. Hemming AW, Cattral MS, Reed AI, et al. Liver transplantation for hepatocellular carcinoma [Ｊ]. Ann Surg, 2001; 233(5)∶652.
- 2. Herrero JI, Sangro B, Quiroga J, et al. Influence of tumor characteristics on the outcome of liver transplantation among patients with liver cirrhosis and hepatocellular carcinoma [Ｊ]. Liver Transpl, 2001; 7(7)∶631.
- 3. Blackwell K, Haroon Z, Broadwater G, et al. Plasma Ddimer levels in operable breast cancer patients correlate with clinical stage and axillary lymph node status [Ｊ]. J Clin Oncol, 2000; 18(3)∶600.
- 4. Oya M, Akiyama Y, Okuyama T, et al. High preoperative plasma Ddimer level is associated with advanced tumor stage and short survival after curative resection in patients with colorectal cancer [Ｊ]. Jpn J Clin Oncol, 2001; 31(8)∶388.
- 5. Hu KQ, Yu AS, Tiyyagura L, et al. Hyperfibrinolytic activity in hospitalized cirrhotic patients in a referral liver unit [Ｊ]. Am J Gastroenterol, 2001; 96(5)∶1581.
- 6. Costantini V, De Monte P, Cazzato AO, et al. Systemic thrombin generation in cancer patients is correlated with extrinsic pathway activation [Ｊ]. Blood Coagul Fibrinolysis, 1998; 9(1)∶79.
- 7. Gordon SG, Chelladurai M. Nontissue factor procoagulants in cancer cells [Ｊ]. Cancer Metastasis Rev, 1992; 11(3-4)∶267.
- 8. Marsh JW, Dvorchik I, B onham CA, et al. Is the pathologic TNM staging system for patients with hepatoma predictive of outcome? [Ｊ]. Cancer, 2000; 88(3)∶538.
- 9. Gandolfo GM, Conti L, Vercillo M. Fibrinolysis components as prognostic markers in breast cancer and colorectal carcinoma [Ｊ]. Anticancer Res, 1996; 16(4B)∶2155.
- 10. von Tempelhoff GF, Dietrich M, Hommel G, et al. Blood coagulation during adjuvant epirubicin/cyclophosphamide chemotherapy in patients with primary operable breast cancer [Ｊ]. J Clin Oncol, 1996; 14(9)∶2560.
