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BMC Cancer
Published in: BMC Cancer 1/2014

Open Access 01-12-2014 | Research article

Elevated levels of plasma D-dimer predict a worse outcome in patients with nasopharyngeal carcinoma

Authors: Wen-Hui Chen, Lin-Quan Tang, Feng-Wei Wang, Chang-Peng Li, Xiao-Peng Tian, Xiao-Xia Huang, Shi-Juan Mai, Yi-Ji Liao, Hai-Xia Deng, Qiu-Yan Chen, Huai Liu, Lu Zhang, Shan-Shan Guo, Li-Ting Liu, Shu-Mei Yan, Chao-Feng Li, Jing-Ping Zhang, Qing Liu, Xue-Wen Liu, Li-Zhi Liu, Hai-Qiang Mai, Mu-Sheng Zeng, Dan Xie

Published in: BMC Cancer | Issue 1/2014

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Abstract

Background

Hemostatic alterations occur during the development of cancer. Plasma D-dimer is a hypercoagulability and fibrinolytic system marker that is increased in patients with various solid tumours. The aim of this study was to evaluate the hemostatic status of nasopharyngeal carcinoma (NPC) patients by assessing plasma D-dimer levels to investigate its value as a prognostic marker.

Methods

We retrospectively analysed 717 patients with nasopharyngeal carcinoma, and we applied Cox regression and log-rank tests to assess the association of D-dimer levels with disease-free survival (DFS), distant metastasis-free survival (DMFS), and overall survival (OS). D-dimer levels were measured using a quantitative D-dimer latex agglutination assay.

Results

Using the 3rd quartile values (0.8 μg/L) as the optimal cut-offs, we found that patients with high D-dimer levels have a shorter 3-year DFS, (79%, 95%CI (73.1–84.9)) vs. (69%, 95%CI (59.2–78.8)), DMFS (87%, 95%CI (83.1–90.9)) vs. (77%, 95%CI (69.2–84.8)), and overall survival (82%, 95%CI (76.1–87.9)) vs. (76%, 95%CI (66.2–85.8)). Multivariate analysis revealed that pre-treatment D-dimer levels and EBV DNA were significant independent factors for DFS, DMFS, and OS in NPC patients. Subgroup analyses indicated that the plasma D-dimer levels could effectively stratify patient prognosis for early cancer, advanced stage cancer, and patients with EBV DNA ≥4000 copies/ml.

Conclusions

High D-dimer levels were associated with poor disease-free survival, distant metastasis-free survival, overall survival, and increased risk of mortality in NPC patients. Prospective trials are required to assess the prognostic value of D-dimer levels.
Appendix
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Metadata
Title
Elevated levels of plasma D-dimer predict a worse outcome in patients with nasopharyngeal carcinoma
Authors
Wen-Hui Chen
Lin-Quan Tang
Feng-Wei Wang
Chang-Peng Li
Xiao-Peng Tian
Xiao-Xia Huang
Shi-Juan Mai
Yi-Ji Liao
Hai-Xia Deng
Qiu-Yan Chen
Huai Liu
Lu Zhang
Shan-Shan Guo
Li-Ting Liu
Shu-Mei Yan
Chao-Feng Li
Jing-Ping Zhang
Qing Liu
Xue-Wen Liu
Li-Zhi Liu
Hai-Qiang Mai
Mu-Sheng Zeng
Dan Xie
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2014
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-14-583

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