Value of D-dimer and protein S for diagnosis of portal vein thrombosis in patients with liver cirrhosis

• Published in: Journal of international medical research Vol. 41; no. 3; pp. 664 - 672
• Main Authors: Zhang, Dong-Lei, Hao, Jian-Yu, Yang, Ning
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.06.2013; Sage Publications
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Biomarkers - blood; Blood and lymphatic vessels; Cardiology. Vascular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Fibrin Fibrinogen Degradation Products - metabolism; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Liver - diagnostic imaging; Liver - metabolism; Liver - pathology; Liver Cirrhosis - blood; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - pathology; Liver Function Tests; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Pharmacology. Drug treatments; Portal Vein - diagnostic imaging; Portal Vein - metabolism; Portal Vein - pathology; Protein S - metabolism; Radiography; Severity of Illness Index; Venous Thrombosis - blood; Venous Thrombosis - diagnosis; Venous Thrombosis - diagnostic imaging; Venous Thrombosis - pathology; D-dimer; diagnosis; protein S; Portal vein thrombosis; liver cirrhosis; Human; Liver; Cardiovascular disease; Hepatic disease; Protein; Venous disease; Vascular disease; Cirrhosis; Digestive diseases; Venous thrombosis; Diagnosis
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/0300060513483413

Objective To investigate the value of D-dimer and protein S plasma concentrations for diagnosis of portal vein thrombosis (PVT) in patients with liver cirrhosis. Methods D-dimer and protein S were quantified, PVT was diagnosed by dynamic enhanced computed tomography and liver function was classified using the Child–Pugh system. Receiver operating curve analysis was performed. Results D-dimer increased, and protein S decreased, with decreasing liver function in the total study population (n = 188). D-dimer concentrations were significantly higher and protein S concentrations were significantly lower in patients with (n = 51) than those without PVT (n = 137). D-dimer had high specificity and negative predictive value (NPV) in Child–Pugh class A or B patients (cut-off values>0.56 mg/l and >1.18 mg/l, respectively). In class C patients>0.77 mg/l D-dimer had high sensitivity and NPV. Protein S had high sensitivity but low specificity in class A or B patients (cut-off values < 17.4 mg/l and <19.2 mg/l, respectively). Conclusion Plasma D-dimer and protein S are potential biomarkers for PVT diagnosis in patients with cirrhosis. PVT can be excluded when D-dimer is low and protein S is elevated.