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Preoperative D-dimers as an independent prognostic marker in cervical carcinoma

  • Research Article
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Tumor Biology

Abstract

Activation of coagulation and fibrinolysis has been observed in many tumors. Our study aimed to investigate the clinical and prognostic significance of various plasma coagulation tests in patients with cervical cancer. A total of 296 patients with cervical cancer were included in the analysis. Patients were followed up for at least 60 months until death. Pretreatment parameters including activated partial thromboplastin time, D-dimer, fibrinogen, prothrombin time, thrombin time, lactate dehydrogenase, and squamous cell carcinoma antigen were evaluated. Prothrombin time (hazard ratio = 1.825; P = 0.006) and plasma D-dimer levels (hazard ratio = 2.179; P = 0.036) were identified as significant independent predictors of overall survival. Patients with elevated D-dimer levels had a significantly shorter overall survival compared with those with low-D-dimer levels (<0.5 μg/ml) in the stage I subgroup (n = 98, P = 0.019) and stage II subgroup (n = 77, P = 0.044). D-dimer levels differed significantly according to mortality (P < 0.001), stage I versus stage II (P = 0.030), and stage I versus stage III/IV (P = 0.038). DD level of patients with chemotherapy and/or radiotherapy was higher than patients with other treatment (P < 0.001). Patients with a low-D-dimer level (<0.5 μg/ml) showed a significantly better 5-year overall survival (OS) compared with patients with an increased D-dimer level for different histological typing of squamous cell carcinoma (SCC) (P = 0.001) and non-SCC (P < 0.043). In conclusion, the pretreatment plasma D-dimer level is a potential prognostic factor for cervical cancer.

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Acknowledgments

We thank the Director of Clinical Laboratories, Sun Yat-sen University Cancer Center, Guangzhou, China, Prof. Wan-Li Liu, for providing support on research conditions in this study and making substantial contributions to its conception and design.

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    Authors and Affiliations

    1. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, China

      Yao-Ling Luo, Pei-Dong Chi, Xin Zheng, Lin Zhang, Xue-Ping Wang & Hao Chen

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    1. Yao-Ling Luo
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    2. Pei-Dong Chi
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    3. Xin Zheng
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    4. Lin Zhang
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    6. Hao Chen
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    Correspondence to Hao Chen.

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    Yao-Ling Luo and Pei-Dong Chi contributed equally to this work.

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    Luo, YL., Chi, PD., Zheng, X. et al. Preoperative D-dimers as an independent prognostic marker in cervical carcinoma. Tumor Biol. 36, 8903–8911 (2015). https://doi.org/10.1007/s13277-015-3650-5

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    • DOI: https://doi.org/10.1007/s13277-015-3650-5

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