Background: More and more patients with small pulmonary nodules (SPN) can be found along with the developing of chest low-dose computed tomography (LDCT). With current examinations not all the SPN can be diagnosed to be benign or malignant and not all the malignant nodules can be diagnosed to be lymphatic metastasis. We need to study the correlation between plasma D-dimer count of patients before surgery with pathology features of non-small cell lung cancer (NSCLC).
Methods: The study comprised 567 highly suspected lung cancer patients. Preoperative plasma D-dimer were qualified, and the relationship between plasma D-dimer with pathology features including benign or malignant nodules, tumor size and involvement of lymph nodes was examined using Kruskal-Wallis test and Spearman correlation coefficients.
Results: The median plasma D-dimer values were statistically higher in NSCLC patients than in those who suffered from benign lung nodules (P<0.001). The median plasma D-dimer values in NSCLC patients with malignant lymph nodes were statistically higher than in those without malignant lymph nodes (P<0.001). An obvious relationship was observed between elevated D-dimer with number of malignant lymph nodes involvement and tumer size. An obvious relationship was observed between elevated D-dimer (>112.5 ng/mL) and malignant lymph node involvement in stage T1 lung cancer.
Conclusions: The plasma D-dimer maybe useful for early diagnosis, staging and prognosis of the patients with NSCLC. The plasma D-dimer can be one of the indicator to identify what kind of patients need mediastinal lymph node cleaning.
【中文题目：术前血浆D-二聚体水平与非小细胞肺癌的 相关性分析】 【中文摘要：背景与目的 随着低剂量螺旋计算机断层扫描（computed tomography, CT）等筛查手段的普及，肺部小结节患者可以早期发现和治疗，但现有的检查手段对于肺小结节良恶性和肺癌淋巴结转移情况的预测均有一定局限性。本研究旨在分析术前血浆D-二聚体水平与非小细胞肺癌（non-small cell lung cancer, NSCLC）患者病理特征的相关性，从而探讨在早期肺癌患者术中进行常规系统性淋巴结清扫的必要性。方法 回顾性分析567例肺部结节手术患者资料，使用Kruskal-Wallis检验、Spearman相关系数检测和绘制受试者操作特征曲线（receiver operator characteristic curve, ROC）等统计学方法分析患者术前D-二聚体水平与肺部结节良恶性、肺癌胸膜侵犯、肿瘤最大径、淋巴结转移情况等的相关性。结果 术前D-二聚体的水平：肺癌患者显著高于肺部良性结节患者（P<0.001）；肺癌伴淋巴结阳性患者显著高于淋巴结阴性患者（P<0.001）；肺癌伴胸膜侵犯阳性患者显著高于胸膜侵犯阴性患者（P<0.001）。肺癌患者的术前D-二聚体水平与淋巴结转移个数呈正相关（Spearman Correlation=0.264, P<0.001），与肿瘤最大径呈正相关（Spearman Correlation=0.333, P<0.001）。术前血浆D-二聚体水平对T1期NSCLC是否伴有淋巴结转移的最佳诊断指标为112.5 ng/mL。结论 血浆D-二聚体水平对NSCLC患者的早期诊断、临床分期和预后判断有非常重要的临床意义，并且可以作为术中是否进行淋巴结清扫的参考指标之一。】 【中文关键词：肺肿瘤；淋巴结；D-二聚体】.
Keywords: D-dimer; Lung neoplasms; Lymph node.