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Yu Z, Yuan M, Chen G. The clinical association between coagulation indexes, platelet-related parameters, and bone metastasis of newly diagnosed prostate cancer. Eur J Med Res 2023; 28:587. [PMID: 38093347 PMCID: PMC10720219 DOI: 10.1186/s40001-023-01562-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 11/30/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND At present, much evidence shows that many cancers have a high risk of thrombosis. Several studies have shown the prognostic value of platelet-related parameters and coagulation indexes in prostate cancer (PCa). However, the association between platelet-related parameters, coagulation indexes and bone metastasis of Pca is unclear. METHODS A total of 234 pathologically diagnosed patients with Pca were consecutively collected and stratified into the bone metastasis group and non-bone metastasis group according to the results of the bone scan. ROC curve analysis was used to explore the auxiliary predictive value of single and combined parameters for bone metastasis in Pca patients. Univariate and multivariate Logistic regression analyses were used to determine the relationship between platelet-related parameters, coagulation indexes, and bone metastasis of Pca. RESULTS Platelet count (PLT), fibrinogen (Fib), prostate-specific antigen (PSA), and D-dimer (DD) levels of the bone metastasis group were significantly higher than the non-bone metastasis group (P = 0.010, P < 0.001, P < 0.001, and P < 0.001, respectively). This study confirmed that PLT, PSA, DD and Fib have auxiliary predictive value for prostate cancer bone metastasis. After the combination of PLT, PSA, DD and Fib, the area under the curve, sensitivity and specificity increased significantly. The univariate logistic analysis demonstrated that PLT (OR: 1.008, P = 0.011), DD (OR: 2.690, P < 0.001), PSA (OR: 1.073, P < 0.001), Gleason score (OR: 7.060, P < 0.001), and Fib (OR: 2.082, P < 0.001) were significantly positively correlated with bone metastasis of Pca. Multivariate analysis showed that PSA (OR: 1.075, P < 0.001), DD (OR: 2.152, P < 0.001), Gleason score (OR: 2.904, P < 0.001), and Fib (OR: 1.706, P < 0.001) were independent risk factors for bone metastasis of Pca after adjusting for Age, BMI and other confounding factors. CONCLUSIONS Higher platelet, D-dimer, prostate-specific antigen, Gleason score, and fibrinogen levels may predict a worse prognosis in patients with Pca. PLT, DD, and Fib, as readily available and relatively inexpensive indicators, help predict bone metastasis of Pca. It is suggested that PLT, DD and Fib may be helpful in the risk stratification of Pca.
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Affiliation(s)
- Zhiwei Yu
- Department of Urology, Ji Ning Third People's Hospital, No. 99 Jianshexi Road, Yanzhou District, Jining, 272100, Shandong, China
| | - Mingxue Yuan
- Department of Breast and Thyroid, Ji Ning Third People's Hospital, No. 99 Jianshexi Road, Yanzhou District, Jining, 272100, Shandong, China
| | - Guojun Chen
- Qinghai University Affiliated Hospital, No. 29 Tongren Road, Xining, 810012, Qinghai, China.
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Ke CH, Liu CC, Wang SL, Lin CS. Paired Analysis of D-Dimer and Its Correlated Hemostatic Parameters in 30 Dogs with Neoplasms after Tumorectomy. Animals (Basel) 2023; 13:ani13060969. [PMID: 36978511 PMCID: PMC10044208 DOI: 10.3390/ani13060969] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/24/2023] [Accepted: 03/04/2023] [Indexed: 03/10/2023] Open
Abstract
Previous studies have reported that dogs with neoplasms had elevated D-dimer levels. However, few studies have addressed whether D-dimer could be an indicator of tumor burden. The clinical significance of paired analysis of pre- and post-operation of D-dimer levels in dogs has rarely been described. The present study investigated the values of D-dimer levels and their correlated hemostatic alterations in dogs with surgically removable benign and malignant tumors. This study analyzed 30 clinically healthy and 30 tumor-bearing dogs and evaluated the hemostatic functions including D-dimer, thromboelastography G (TEG G), fibrinogen, activated partial thromboplastin time (aPTT), prothrombin time, and platelet count. The median level of pre-treatment D-dimer was 0.8 µg/mL (range: 0.1–6.3 µg/mL), whereas the control dogs exhibited a median value of 0.1 µg/mL (range: 0.1–0.1 µg/mL, p < 0.0001). After tumorectomy, the median levels of D-dimer (p < 0.0001), fibrinogen (p < 0.0001), TEG G value (p < 0.01), and aPTT (p < 0.05) were significantly lower than those of the pre-treatment samples. However, further studies are needed to clarify the values of other hemostatic evaluations. The study revealed the clinical significance of D-dimer and its correlated hemostatic parameters by paired analysis in dogs with tumors. Though more cases are needed for solid confirmation, these values could be potential tumor biomarkers for dogs.
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Affiliation(s)
- Chiao-Hsu Ke
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan
| | - Cheng-Chi Liu
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan
| | - Shang-Lin Wang
- Graduate Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan
- Animal Cancer Center, College of Bioresources and Agriculture, National Taiwan University, Taipei 10617, Taiwan
- National Taiwan University Veterinary Hospital, College of Bioresources and Agriculture, National Taiwan University, Taipei 10672, Taiwan
| | - Chen-Si Lin
- Department of Veterinary Medicine, School of Veterinary Medicine, National Taiwan University, Taipei 10617, Taiwan
- Correspondence: ; Tel.: +886-2-33661286
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Dybowska M, Dybowski D, Szturmowicz M, Jóźwik A, Lewandowska K, Sobiecka M, Tomkowski W. D-Dimers Variability in the Perioperative Period of Breast Cancer Surgery Helps to Predict Cancer Relapse: A Single-Centre Prospective Study. Cancer Control 2023; 30:10732748231204713. [PMID: 37791647 PMCID: PMC10552458 DOI: 10.1177/10732748231204713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/30/2023] [Accepted: 07/10/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND The importance of D-dimers (DD) assessment in the diagnostic algorithm of venous thromboembolic (VTE) disease is well known. Increase of DD concentration may be also associated with neoplastic disease. Many studies documented that high concentration of DD before solid tumour surgery indicates more advanced disease and poor life expectancy. The prognostic value of the DD concentration variability in the perioperative period, in women undergoing breast cancer surgery, has not been analysed so far. Thus, the aim of the present prospective study was to assess whether the trend of DD concentration changes in the perioperative period may predict cancer recurrence in women undergoing breast cancer surgery. MATERIALS AND METHODS 189 consecutive women with histopathological diagnosis of breast cancer (BC) referred for surgical treatment were included. DD concentration was measured twice in each patient: at the time of admission to hospital and at the time of discharge home. Enoxaparin in standard dose of 40 mg daily s. c. was used as primary VTE prophylaxis in all of the patients. RESULTS The recurrence of BC, within 1 year observation time, occurred in 13 patients (6.8%), in 11 (5.8%) patients with DD increase after surgery and only in 2 (1.1%) without an increase in DD, P = .0179. Increase in DD concentration after BC surgery was an independent positive predictor of disease relapse (OR 8.600, LCI 1.451, UCI 96.80, P = .0371) together with the lack of postoperative radiotherapy (OR 6.009, LCI 1.305, UCI 31.95, P = .0245), whereas the lack of postoperative chemotherapy predicted no BC relapse (OR .07355, LCI .0056, UCI .58, P = .0245). CONCLUSIONS Increase of DD in the early postoperative period may be considered as additional independent predictor of recurrence of BC within 1 year.
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Affiliation(s)
- Małgorzata Dybowska
- 1 Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Dariusz Dybowski
- Oncological Surgery Department, Masovian Cancer Hospital, Wieliszew, Poland
| | - Monika Szturmowicz
- 1 Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Adam Jóźwik
- Faculty of Physics and Applied Informatics, Department of Computer Science, University of Łódź, Łódź, Poland
| | - Katarzyna Lewandowska
- 1 Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Małgorzata Sobiecka
- 1 Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
| | - Witold Tomkowski
- 1 Department of Lung Diseases, National Tuberculosis and Lung Diseases Research Institute, Warsaw, Poland
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Zhou BY, Zhang Q, Hu YC, Wang L, Zhang JX, Cong HL, Wang L. Association of D-dimer with long-term prognosis in type 2 diabetes mellitus patients with acute coronary syndrome. Nutr Metab Cardiovasc Dis 2022; 32:1955-1962. [PMID: 35752544 DOI: 10.1016/j.numecd.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 04/11/2022] [Accepted: 05/20/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Type 2 diabetes mellitus (DM) accounts for more and more individuals worldwide. D-dimer has been demonstrated to be associated with cardiovascular diseases. The aim is to study the potential impact of D-dimer on the long-term prognosis of acute coronary syndrome (ACS) in the special population with type 2 DM. METHODS AND RESULTS A total of 2265 consecutive patients with DM and ACS were eligible in the study. Patients were divided into four groups according to quartiles of D-dimer concentration. Univariate and multivariate Cox regression analysis were conducted to explore the prognostic value of D-dimer for future outcomes. Patients with higher level of D-dimer presented with higher percentage of major adverse cardiovascular events (MACEs) (23.7%), all-cause death (18.3%) and cardiovascular (CV) death (9.4%) in Quartile 4. In multivariate Cox regression analysis, D-dimer was demonstrated to be independently associated with MACEs, all-cause death and CV death. The prognostic value of D-dimer is still significant in subgroups of HbA1C <7% and ≥7%. In Kaplan-Meier analysis, higher D-dimer showed poorer prognosis in MACEs, all-cause death and CV death (all log rank p < 0.001). The area under the curve (AUC) by receiver operating characteristic (ROC) curve analysis is 0.609 for MACEs, 0.708 for all-cause death, 0.747 for CV death (p < 0.001). CONCLUSION The present study demonstrated the independent predictive value of D-dimer for outcomes in DM patients with ACS. In addition, for the first time, we explored the prognostic value in different glucose control status.
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Affiliation(s)
- Bing-Yang Zhou
- Department of Cardiology, Tianjin Chest Hospital, No 261 Tai'erzhuang South Road, Jinnan District, Tianjin, 300222, China
| | - Qi Zhang
- Department of Cardiology, Tianjin Chest Hospital, No 261 Tai'erzhuang South Road, Jinnan District, Tianjin, 300222, China
| | - Yue-Cheng Hu
- Department of Cardiology, Tianjin Chest Hospital, No 261 Tai'erzhuang South Road, Jinnan District, Tianjin, 300222, China
| | - Lin Wang
- Department of Cardiology, Tianjin Chest Hospital, No 261 Tai'erzhuang South Road, Jinnan District, Tianjin, 300222, China
| | - Jing-Xia Zhang
- Department of Cardiology, Tianjin Chest Hospital, No 261 Tai'erzhuang South Road, Jinnan District, Tianjin, 300222, China
| | - Hong-Liang Cong
- Department of Cardiology, Tianjin Chest Hospital, No 261 Tai'erzhuang South Road, Jinnan District, Tianjin, 300222, China.
| | - Le Wang
- Department of Cardiology, Tianjin Chest Hospital, No 261 Tai'erzhuang South Road, Jinnan District, Tianjin, 300222, China.
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Pu Y, Wang J, Wang J, Wang S. Association of Preoperative Plasma D-Dimer and Fibrinogen and Osteosarcoma Outcome. Front Oncol 2022; 12:699295. [PMID: 35463340 PMCID: PMC9024173 DOI: 10.3389/fonc.2022.699295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
Objective We aimed to evaluate the utility of preoperative D-dimer and plasma fibrinogen (PF) levels as useful markers for predicting the clinical value of patients with osteosarcoma. Methods 145 enrolled patients with osteosarcoma were studied retrospectively. We determined the critical values of D-dimer and PF by receiver operating characteristic curve analysis. Cox regression analysis was used to assess prognostic role of the D-dimer and PF levels among osteosarcoma patients. Results The critical values of D-dimer and PF were calculated to be 0.46 µg/mL and 3.34 mg/mL, respectively. Upregulation of D-dimer and PF showed positive correlations with a higher clinical stage, tumour metastasis and recurrence. Survival curve results confirmed that osteosarcoma patients with higher levels of D-dimer and PF predicted worse overall survival (OS) and progression-free survival (PFS). Moreover, only a high D-dimer level was associated with a shorter OS (P = 0.013) and PFS (P = 0.042) in both the univariate and multivariate analysis. Conclusion Elevated preoperative D-dimer levels are correlated with aggressive clinicopathological features and poor survival outcomes, which indicates that assessment of the D-dimer could be a useful prognostic marker in osteosarcoma.
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Affiliation(s)
- Yanchuan Pu
- Department of Orthopedics, Wuwei City People’s Hospital, Wuwei, China
- *Correspondence: Shizhong Wang, ; Yanchuan Pu,
| | - Jin Wang
- Department of Orthopedics, Wuwei City People’s Hospital, Wuwei, China
| | - Jianshu Wang
- Department of Bone Oncology, Gansu Cancer Hospital, Lanzhou, China
| | - Shizhong Wang
- Department of Orthopedics, Wuwei City People’s Hospital, Wuwei, China
- *Correspondence: Shizhong Wang, ; Yanchuan Pu,
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Chen W, Shan B, Zhou S, Yang H, Ye S. Fibrinogen/albumin ratio as a promising predictor of platinum response and survival in ovarian clear cell carcinoma. BMC Cancer 2022; 22:92. [PMID: 35062908 PMCID: PMC8780809 DOI: 10.1186/s12885-022-09204-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 01/17/2022] [Indexed: 02/06/2023] Open
Abstract
Background This study aims to evaluate the role of the fibrinogen/albumin ratio (FAR) in predicting platinum resistance and survival outcomes of patients with ovarian clear cell carcinoma (OCCC). Methods Coagulation function and D-dimer, serum albumin, CA125 and HE4 levels were measured before surgery in OCCC patients undergoing initial surgery in our institution. FAR was calculated as fibrinogen/albumin level. The correlation between these indicators and clinicopathological features, platinum response, and survival outcomes was further analyzed. The Kaplan-Meier method and multivariable Cox regression model were used to assess the effects of FAR on progression-free survival (PFS) and overall survival (OS). Results Advanced stage patients accounted for 42.1% of the 114 participants. Optimal cytoreductive surgery was achieved in 105 patients, and the complete resection rate was 78.1%. FAR was associated with tumor stage, residual tumor and platinum response. A receiver operating characteristic curve for predicting platinum response showed that the optimal cutoff point of the FAR was 12%. The sensitivity was 73.3% and the specificity was 68.2%. In multivariate analysis, FAR ≥12% (HR = 4.963, P = 0.002) was an independent risk factor for platinum resistance. In addition, FAR and D-dimer proved to be independent negative factors for outcomes including both PFS and OS. The median follow-up time was 52 months. A high FAR (≥ 12%) showed a stronger correlation with poor OS and PFS in the subgroup analysis of advanced and completely resected patients. Conclusions The FAR might be a potential preoperative biochemical marker for predicting treatment response and oncological outcomes in OCCC patients.
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Shen H, Wu S, Su R, Chen Y, He Y. A Nomogram Combining Neutrophil-to-Lymphocyte Ratio and D-Dimer Predicts Chemosensitivity of Oxaliplatin-Based First-Line Chemotherapy in Patients with Unresectable Advanced Gastric Cancer. Technol Cancer Res Treat 2022; 21:15330338221112741. [PMID: 35880288 PMCID: PMC9340318 DOI: 10.1177/15330338221112741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: No effective peripheral blood predictors have been
establoshed for first-line chemotherapy in patients with advanced gastric
cancer. In this study, a nomogram combining the neutrophil-to-lymphocyte
ratio/D-dimer with gender, number of metastases, and histological grade was
established to predict progression-free survival in patients with unresectable
advanced gastric cancer. Methods: We retrospectively collected
baseline clinical characteristics and blood parameters from 153 patients
diagnosed with advanced gastric cancer that underwent oxaliplatin-based
first-line chemotherapy. Kaplan–Meier analysis and Cox regression analysis were
used to determine the factors associated with progression-free survival. The
concordance index (C-index) and calibration curve were used to determine the
prediction accuracy and discriminative ability of the nomogram as a visual
complement to the prognostic score system. Results: Determined by
the X-tile software, the optimal cut-off points for the neutrophil-to-lymphocyte
ratio and D-dimer were 3.18 and 0.56 mg/L, respectively. Multivariate analysis
identified four independent prognostic factors: two or more metastatic organs
(HR: 1.562, 95% CI: 1.009-2.418, P = .046), poor
differentiation (HR: 0.308, 95% CI: 0.194-0.487, P < .001),
neutrophil-to-lymphocyte ratio >3.18 (HR: 1.427, 95% CI: 1.024-1.989,
P = .036), and D-dimer >0.56 mg/L (HR: 1.811, 95% CI:
1.183-2.773, P = .006). Receiver operating characteristic
curves showed that the combination of the neutrophil-to-lymphocyte ratio and
D-dimer in the prediction model exhibited the highest predictive performance
(area under the curve, 0.800). The prognostic nomogram yielded a C-index of
0.800. Decision curve analysis demonstrated that the prognostic nomogram was
clinically useful. A nomogram-based risk classification system was also
constructed to facilitate risk stratification of advanced gastric cancer for
optimal clinical management. Conclusion: We identified the
neutrophil-to-lymphocyte ratio and D-dimer level as independent prognostic
factors for advanced gastric cancer. The prognostic nomogram combining the
neutrophil-to-lymphocyte ratio and D-dimer level can be applied in the
individualized prediction of treatment outcome in patients with advanced gastric
cancer.
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Affiliation(s)
- Hao Shen
- 577141Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Shusheng Wu
- West Branch of the First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Rixin Su
- 577141Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Yaolin Chen
- West Branch of the First Affiliated Hospital of University of Science and Technology of China, Hefei, China
| | - Yifu He
- West Branch of the First Affiliated Hospital of University of Science and Technology of China, Hefei, China
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Prognostic Value of Albumin to D-Dimer Ratio in Advanced Gastric Cancer. JOURNAL OF ONCOLOGY 2021; 2021:9973743. [PMID: 34239566 PMCID: PMC8241521 DOI: 10.1155/2021/9973743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/17/2021] [Accepted: 06/01/2021] [Indexed: 12/18/2022]
Abstract
Gastric cancer (GC) is one of the most common malignancies worldwide. Notably, patients with advanced GC have a poor prognosis and quality of life, prompting the need for further studies on its prognostic markers. Among these, albumin and D-dimer are often used as prognostic factors in the prediction of a variety of tumors. Moreover, the albumin to D-dimer ratio (ADR) may be an improved predictor of chemotherapy effect and survival compared to albumin and D-dimer alone, but few studies have investigated this issue. Thus, we explored the relationship between pretreatment ADR and prognosis in advanced GC treated with first-line chemotherapy. A total of 247 advanced unresectable GC patients treated with first-line chemotherapy were retrospectively included. The cut-off value for ADR was determined using the receiver operating characteristic (ROC) curve. The ADR had a cut-off value of 41.64. Compared to albumin and D-dimer alone, ADR had the highest area under curve (AUC) value (AUC = 0.730), followed by albumin (AUC = 0.659) and D-dimer (AUC = 0.719). Additionally, we found that patients with a low ADR (<41.64) had a lower disease control rate (77.9% vs. 92.5%, P < 0.01), shorter overall survival (OS) (271 vs. 389 days), and shorter progression-free survival (PFS) (118 vs. 192 days) than patients with a high ADR (≥41.64). Similar results were also found on subgroup analysis, and ADR was found to be an independent advanced GC prognostic factor on multivariate analysis (all P < 0.001). Low ADR was found to be correlated with poor therapeutic effects of chemotherapy and shortened OS and PFS. Therefore, pretreatment ADR may be a useful tool for predicting the effect of chemotherapy and prognosis in advanced GC patients treated with first-line chemotherapy.
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