전이성 위암 환자에서 예후 및 치료반응의 예측인자로서 D-dimer의 임상적 의미
iv, 26 p.
stage IV gastric cancer D-dimer thrombosis CEA prognostic value;
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Background/Aims: The identification of prognostic factors may be helpful in predicting and improving outcomes in patients with stage IV gastric cancer. Systemic activation of hemostasis is frequently observed in cancer patients, even in the absence of thrombosis. Moreover, this activation has been implicated in tumor progression, angiogenesis, and metastatic spread. Elevated D-dimer levels indicate the activation of coagulation and fibrinolysis. Thus, we sought to determine the role of D-dimer levels in the prognosis and prediction of response for patients with stage IV gastric cancer. We also investigated the correlation between the pretreatment D-dimer and carcinoembryonic antigen (CEA) levels. Methods: We conducted a retrospective study of 46 stage IV gastric cancer patients who received palliative chemotherapy between January 2002 and December 2013. Pretreatment D-dimer levels, D-dimer levels at the first response evaluation after chemotherapy, and CEA levels were evaluated. Variables including age, sex, differentiation, metastatic organs, median cycle of the first line chemotherapy, embolic event, and median overall survival were recorded. Database management and all statistical analyses were performed using SPSS package (version 21.0). Survival curves were constructed by the Kaplan-Meier method and compared by the Log-rank test. Results: Forty-six patients with stage IV gastric cancer were included. The median age was 58 years old (range, 36 to 78 years) and there were 36 (78.3%) males and 10 (21.7%) females. Tumor differentiations were differentiated (34.8%) and undifferentiated (65.2%). Metastatic organs were only lymph node (19.6%), liver (37.0%), peritoneal seeding (37.0%), and the other organs (37.0%). The median cylce of the first line chemotherapy was five. Embolic event during the first line chemotherapy occurred in seven patients (15.2%). The median overall survival (OS) of the patients was 8.2 months. The D-dimer levels were positively correlated with the OS. The OS of patients with pretreatment D-dimer levels