The D-dimer level predicts the postoperative prognosis in patients with non-small cell lung cancer

• Published in: PloS one Vol. 14; no. 12; p. e0222050
• Main Authors: Shiina, Yuki, Nakajima, Takahiro, Yamamoto, Takayoshi, Tanaka, Kazuhisa, Sakairi, Yuichi, Wada, Hironobu, Suzuki, Hidemi, Yoshino, Ichiro
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 26.12.2019; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Aged, 80 and over; Anticoagulants; Biology and Life Sciences; Biomarkers, Tumor - blood; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - surgery; CAT scans; Clinical outcomes; Coagulation; Computed tomography; Diagnostic imaging; Dimers; Disease-Free Survival; Female; Fibrin Fibrinogen Degradation Products - analysis; Fibrin Fibrinogen Degradation Products - metabolism; Fibrin Fibrinogen Degradation Products - physiology; Fibrinolysis; Hard disk drives; Health risk assessment; Humans; Levels; Lung cancer; Lung carcinoma; Lung diseases; Lung Neoplasms - pathology; Male; Medical prognosis; Medical research; Medical schools; Medicine; Medicine and Health Sciences; Middle Aged; Multivariate analysis; Neoplasm Staging; Non-small cell lung cancer; Non-small cell lung carcinoma; Opacity; Patients; Physical Sciences; Plasma; Plasmin; Postoperative Period; Prognosis; Research and Analysis Methods; Retrospective Studies; Small cell lung cancer; Small cell lung carcinoma; Solid tumors; Surgery; Survival; Thoracic surgery; Thrombosis; Tomography; Tomography, X-Ray Computed; Treatment Outcome; Tumors; University graduates; Chiba Japan; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0222050

Carcinoma cells often modulate coagulation and fibrinolysis among cancer patients. Plasma dimerized plasmin fragment D (D-dimer) has been reported as a prognostic marker of various types of malignancies, including non-small cell lung cancer (NSCLC). However, the associations between the plasma D-dimer level and peripheral small NSCLC remain unclear. Three hundred and sixty-two patients with NSCLC who underwent radical surgery were retrospectively reviewed. Patients who received anticoagulation therapy before surgery or who lacked preoperative D-dimer data were excluded. The other 235 patients were divided into a high D-dimer (over 1.0 μg/mL) group (HDD group, n = 47) and a normal D-dimer group (NDD group, n = 188) and investigated for their clinical characteristics, computed tomography (CT) findings, pathological findings, and clinical outcomes. The mean D-dimer levels was 2.49±2.58 μg/ml in the HDD group and 0.42±0.23 μg/ml in the NDD group. The HDD group was characterized by a predominance of male gender, older age, pure solid appearance on chest CT, vascular invasion in pathology, and a large solid part of the tumor. The HDD group showed a worse overall survival, disease-free survival, and disease-specific survival than the NDD group (p<0.001, <0.001, <0.001, respectively). These survival features were also observed in p-Stage IA disease. There was no marked survival difference when tumors showed ground-glass opacity on CT. In NSCLC patients with a solid tumor appearance on CT, high D-dimer levels predict a poor survival and early recurrence.