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World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2017

Open Access 01-12-2017 | Research

Evaluation of serum D-dimer, fibrinogen, and CA19-9 for postoperative monitoring and survival prediction in resectable pancreatic carcinoma

Authors: Junli Cao, Zhanzhao Fu, Liming Gao, Xin Wang, Shaohui Cheng, Xiuchao Wang, He Ren

Published in: World Journal of Surgical Oncology | Issue 1/2017

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Abstract

Background

We sought to investigate the efficacy of serum D-dimer, fibrinogen, and CA19-9 for postoperative monitoring and prediction of survival in patients with resectable pancreatic carcinoma (PC).

Methods

One hundred and nineteen patients with resectable PC were enrolled. Serum D-dimer, fibrinogen, and CA19-9 values were analyzed before surgery and at the stages of relapse-free and progression disease.

Results

D-dimer, fibrinogen, and CA19-9 were significantly higher at the active stage of PC than those at the relapse-free stage [1059.2 (1690.1) ng/ml vs 485.18 (289.84) ng/ml, (3.71 ± 0.83) g/l vs (2.75 ± 0.52) g/l, 207.2 (681.8) U/ml vs 24.5 (30) U/ml, respectively, p < 0.01]. Patients with elevated preoperative D-dimer had significantly shorter overall survival (18.9 ± 1.9 months vs 29.2 ± 2.6 months, p < 0.01) and progression-free survival (10.6 ± 1.2 months vs 20.4 ± 2.4 months, p < 0.01) than did those with low D-dimer. The correlation between CA19-9 values and survival depended on the threshold value of CA19-9: when the threshold value was 37 U/ml, there was no correlation between CA19-9 and survival; when the threshold value was 253.8 U/ml (median CA19-9 for the enrolled patients), patients with elevated preoperative CA19-9 had significantly shorter overall survival (19.9 ± 2. 1 months vs 29.0 ± 2. 7 months) and progression-free survival (11.5 ± 1.5 months vs 21.0 ± 2. 6 months) than did the patients with low CA19-9 (p < 0.01); when the threshold value was 1000 U/ml, the overall survival was 15.5 ± 2.3 months vs 28.0 ± 2.0 months and the progression-free survival 8.9 ± 1.9 months vs 19.1 ± 1.9 months (p < 0.01). There was no correlation between fibrinogen and overall survival (25.8 ± 2.1 months vs 21.2 ± 2.9 months; p = 0.096) and progression-free survival (17.8 ± 2.1 months vs 12.7 ± 1.7 months; p = 0.168).

Conclusions

For postoperative monitoring of patients with resectable PC, D-dimer, fibrinogen, and CA19-9 may be used as markers for monitoring disease relapse, but only preoperative D-dimer could predict survival.
Literature
1.
2.
3.
Herreros-Villanueva M, Bujanda L. Non-invasive biomarkers in pancreatic cancer diagnosis: what we need versus what we have. Ann Transl Med. 2016;4:134.CrossRefPubMedPubMedCentral
4.
Guo J, Xie K, Zheng S. Molecular biomarkers of pancreatic intraepithelial neoplasia and their implications in early diagnosis and therapeutic intervention of pancreatic cancer. Int J Biol Sci. 2016;12:292–301.CrossRefPubMedPubMedCentral
5.
6.
7.
Le N, Sund M, Vinci A. Prognostic and predictive markers in pancreatic adenocarcinoma. Dig Liver Dis. 2016;48:223–30.CrossRefPubMed
8.
Luo YL, Chi PD, Zheng X, Zhang L, Wang SP, Chen H. Preoperative D-dimers as an independent prognostic marker in cervical carcinoma. Tumour Biol. 2015;36:8903–11.CrossRefPubMed
9.
Ma X, Li Y, Zhang J, Huang J, Liu L. Prognostic role of D-dimer in patients with lung cancer: a meta-analysis. Tumor Biol. 2014;35:2103–9.CrossRef
10.
Chen F, Wang MJ, Li J, Yan CE, Han XH, Wu ZY, et al. Plasma D-dimer value as a predictor of malignant lymph node involvement in operable non-small cell lung cancer. Tumour Biol. 2015;36:9201–7.CrossRefPubMed
11.
Guo Q, Zhang B, Dong X, Xie Q, Guo E, Huang H, et al. Elevated levels of plasma fibrinogen in patients with pancreatic cancer: possible role of a distant metastasis predictor. Pancreas. 2009;38:e75–9.CrossRefPubMed
12.
Liu P, Zhu Y, Liu L. Elevated pretreatment plasma D-dimer levels and platelet counts predict poor prognosis in pancreatic adenocarcinoma. Onco Targets Ther. 2015;8:1335–40.CrossRefPubMedPubMedCentral
13.
Qi Q, Geng Y, Sun M, Chen H, Wang P, Chen Z. Hyperfibrinogen is associated with the systemic inflammatory response and predicts poor prognosis in advanced pancreatic cancer. Pancreas. 2015;44:977–82.CrossRefPubMed
14.
Tas F, Karabulut S, Bilgin E, Kılıc L, Ciftci R, Duranyildiz D. Clinical significance of coagulation assays in metastatic pancreatic adenocarcinoma. J Gastrointest Cancer. 2013;44:404–9.CrossRefPubMed
15.
Palumbo JS, Talmage KE, Massari JV, La Jeunesse CM, Flick MJ, Kombrinck KW, et al. Platelets and fibrin (ogen) increase metastatic potential by impeding natural killer cell-mediated elimination of tumor cells. Blood. 2005;105:178–85.CrossRefPubMed
16.
Thaler J, Ay C, Mackman N, Bertina RM, Kaider A, Marosi C, et al. Microparticle-associated tissue factor activity, venous thromboembolism and mortality in pancreatic, gastric, colorectal and brain cancer patients. J Thromb Haemost. 2012;10:1363–70.CrossRefPubMed
17.
Fukumoto K, Taniguchi T, Usami N, Kawaguchi K, Fukui T, Ishiguro F, et al. The preoperative plasma D-dimer level is an independent prognostic factor in patients with completely resected non-small cell lung cancer. Surg Today. 2015;45:63–7.CrossRefPubMed
18.
Palumbo JS, Kombrinck KW, Drew AF, Grimes TS, Kiser JH, Degen JL, et al. Fibrinogen is an important determinant of the metastatic potential of circulating tumor cells. Blood. 2000;96:3302–9.PubMed
19.
Stender MT, Larsen AC, Sall M, Thorlacius-Ussing O. D-dimer predicts prognosis and non-resectability in patients with pancreatic cancer: a prospective cohort study. Blood Coagul Fibrinolysis. 2016;27:597–601.CrossRefPubMed
20.
Durczynski A, Kumor A, Hogendorf P, Szymanski D, Grzelak P, Strzelczyk J. Preoperative high level of D-dimers predicts unresectability of pancreatic head cancer. World J Gastroenterol. 2014;20:13167–71.CrossRefPubMedPubMedCentral
21.
Durczynski A, Kumor A, Hogendorf P, Szymanski D, Poznanska G, Grzelak P, et al. D-dimers revisited: a new marker of pancreatic cancer. Am J Clin Oncol. 2014;37:642.CrossRefPubMed
22.
Sun W, Ren H, Gao CT, Ma WD, Luo L, Liu Y, et al. Clinical and prognostic significance of coagulation assays in pancreatic cancer patients with absence of venous thromboembolism. Am J Clin Oncol. 2015;38:550–6.CrossRefPubMed
23.
Wang H, Gao J, Bai M, Liu R, Li H, Deng T, et al. The pretreatment platelet and plasma fibrinogen level correlate with tumor progression and metastasis in patients with pancreatic cancer. Platelets. 2014;25(5):382–7.CrossRefPubMed
24.
Ballehaninna UK, Chamberlain RS. The clinical utility of serum CA 19-9 in the diagnosis, prognosis and management of pancreatic adenocarcinoma: an evidence based appraisal. J Gastrointest Oncol. 2012;3:105–19.PubMedPubMedCentral
25.
Matsumoto I, Murakami Y, Shinzeki M, Asari S, Goto T, Tani M, et al. Proposed preoperative risk factors for early recurrence in patients with resectable pancreatic ductal adenocarcinoma after surgical resection: a multi-center retrospective study. Pancreatology. 2015;15:674–80.CrossRefPubMed
26.
Chung KH, Ryu JK, Lee BS, Jang DK, Lee SH, Kim YT. Early decrement of serum carbohydrate antigen 19-9 predicts favorable outcome in advanced pancreatic cancer. J Gastroenterol Hepatol. 2016;31:506–12.CrossRefPubMed
27.
Scarà S, Bottoni P, Scatena R. CA 19-9: biochemical and clinical aspects. Adv Exp Med Biol. 2015;867:247–60.CrossRefPubMed
Metadata
Title
Evaluation of serum D-dimer, fibrinogen, and CA19-9 for postoperative monitoring and survival prediction in resectable pancreatic carcinoma
Authors
Junli Cao
Zhanzhao Fu
Liming Gao
Xin Wang
Shaohui Cheng
Xiuchao Wang
He Ren
Publication date
01-12-2017
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2017
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-017-1104-9

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