CAJ | 학술논문

目的：探讨术前血浆D－二聚体水平与浆液性卵巢癌一线化疗疗效及预后的相关性。方法：回顾性分析天津医科大学肿瘤医院2008年1月至2010年5月143例浆液性卵巢癌患者的术前血浆D-二聚体水平，并依据血浆D-二聚体正常水平分为血浆D-二聚体水平（≤0.3 mg/L）正常组（100例）和血浆D-二聚体水平（>0.3 mg/L）升高组（43例），比较血浆D-二聚体不同水平与临床病理因素、化疗疗效及预后的相关性。结果：血浆D-二聚体水平与FIGO分期、残余病灶大小、恶性腹水、术前CA125水平及新辅助化疗密切相关。化疗后血浆D-二聚体水平升高组的完全缓解率34.88%（15/43）明显低于血浆D-二聚体正常组73.00%（73/100），两者比较差异具有统计学意义（P<0.001）。血浆D-二聚体水平升高组的无进展生存率与总生存率明显低于血浆D-二聚体正常组（25.58%vs.50.00%与32.56%vs.65.00%），两者比较差异具有统计学意义（P<0.05）。Cox多因素分析显示血浆D－二聚体水平是患者预后的独立预测因素。结论：术前血浆D-二聚体水平可作为有效预测浆液性卵巢癌一线化疗疗效及预后的生物学指标。
목적：탐토술전혈장D－이취체수평여장액성란소암일선화료료효급예후적상관성。방법：회고성분석천진의과대학종류의원2008년1월지2010년5월143례장액성란소암환자적술전혈장D-이취체수평，병의거혈장D-이취체정상수평분위혈장D-이취체수평（≤0.3 mg/L）정상조（100례）화혈장D-이취체수평（>0.3 mg/L）승고조（43례），비교혈장D-이취체불동수평여림상병리인소、화료료효급예후적상관성。결과：혈장D-이취체수평여FIGO분기、잔여병조대소、악성복수、술전CA125수평급신보조화료밀절상관。화료후혈장D-이취체수평승고조적완전완해솔34.88%（15/43）명현저우혈장D-이취체정상조73.00%（73/100），량자비교차이구유통계학의의（P<0.001）。혈장D-이취체수평승고조적무진전생존솔여총생존솔명현저우혈장D-이취체정상조（25.58%vs.50.00%여32.56%vs.65.00%），량자비교차이구유통계학의의（P<0.05）。Cox다인소분석현시혈장D－이취체수평시환자예후적독립예측인소。결론：술전혈장D-이취체수평가작위유효예측장액성란소암일선화료료효급예후적생물학지표。
Objective:To investigate the correlation of plasma D-dimer levels with the response to first-line chemotherapy and the prognosis of patients with serous ovarian cancer (SOC). Methods:The preoperative plasmic D-dimer levels of 143 patients with prima-ry SOC were retrospectively evaluated. The patients were admitted to Tianjin Medical University Cancer Institute and Hospital between January 2008 and May 2010. The patients were divided into two groups on the basis of plasmic D-dimer levels. Group A consisted of 100 patients with a normal plasmic D-dimer level of≤0.3 mg/L. Group B included 43 patients with an increased plasmic D-dimer level of>0.3 mg/L. The correlations of the different plasmic D-dimer levels with clinicopathological features, therapeutic effects, and surviv-al outcomes were further analyzed. Results:The plasmic D-dimer levels were positively correlated with the staging of the Federation of International Gynecology and Obstetrics, residual tumor size, presence of malignant ascites, preoperative serum CA125 level, and neo-adjuvant chemotherapy. Group B exhibited a significantly lower (P<0.001) complete response (CR) rate of 34.88%(15/43) than group A, which yielded a CR rate of 73.00%(73/100). The progression-free survival and overall survival rates of group B were significantly lower than those of group A (25.58%vs. 50.00%and 32.56%vs. 65.00%;P<0.05). Multivariate analysis revealed that the plasmic D-di-mer level is an independent prognostic factor associated with unfavorable prognosis. Conclusion:Increased preoperative plasmic D-di-mer levels may be a potential biomarker of weak responses to first-line chemotherapy and poor clinical outcomes in patients with SOC.