Laryngeal And Hypopharyngeal Cancer Patients Undergoing Surgery Of Plasma D-dimer Dynamic Changes And Clinical Significance

Objective:To investigate the dynamic variation of plasma D-dimer level during perioperation and clinical importants in patients with laryngeal carcinomas and hypolaryngeal carcinomas. And evaluate the value of plasma D-dimer to detection pulmonary embolism in suspicious patients.Methods:A total of 42 cases of laryngeal carcinomas and hypolaryngeal carcinomas were diagnosed,including 32 cases of laryngeal carcinomas and 10 cases of hypopharyngeal carcinomas.All the patients are male,the average age is (59.7±8.0) years; The laryngeal carcinomas contain 3 cases of supraglottic carcinomas,29 cases of glottis carcinomas;Stage I 4 cases,stage II 13 cases,stageⅢ10 cases, stageⅣ5 cases, T1N0M04cases,T2N0M013 cases,T2N1M02 cases,T3N0M05 cases,T3N1M03 cases,T4N1M02 cases,T4N2M02 cases,T4N3M01 case; The hypolaryngeal carcinomas contains 10 cases,stageⅢ4 cases, stage IV 6 cases, T2N1M02 cases,T2N2M01 case,T3NoM01 case,T3N1M01 case,T3N2M03 cases,T4N2Mo2 case。Control groups contains 18 cases of benign lesions in larynx,including vocal cord polyps,epiglottic cysts,the average age is (53.5±7.5)years. The laryngeal/hypolarygeal carcinoma group were hemostixed on an empty stomach before operation and at the 1st,3rd,7th,10th day after operation.All the samples were transfered and detected within 1 hour at room temperature. The control group were only hemostixed before operation.The ELLISA method were used in D-dimer detection,all the conditions were the same to the above.Results:In this study,the preoperation plasma D-dimer results between the laryngeal/hypolarygeal carcinoma group and the control group is statistically significant (p=0.017).In the laryngeal/hypolarygeal carcinoma group,the preoperation plasma D-dimer results between laryngeal carcinomas and hypopharyngeal carcinomas is no significantly different (t= 1.036, P= 0.11>0.05); The postoperative plasma D-dimer results of laryngeal/hypolaryngnx carcinomas is no significantly different from the preoperative (q=3.3917-7.4354,P<0.05-0.01);The pre-operation plasma D-dimer results between cases with and without cardiovascular system diseases in the laryngeal/ hypolarygeal carcinoma group is statistically significant different,and also the 7th day after operation,10th after operation (t=.376- 3.023, P=0.000-0.050≤0.05); The pre-operation plasma D-dimer results between cases with and without diabetes in the laryngeal/hypolarygeal carcinoma group is statistically significantly different,and also the 1th day after operation,10th day after operation(t=1.247-1.725,P=0.005 -0.009 <0.05);The D-dimer results is not statistically significant between groups whether performed neck dissection or not.The D-dimer results is not statistically significantly difference between groups whether lymph node metastatic or not. The D-Dimer results of the 7th day after operation is statistically significantly difference between cases in stageⅠ,Ⅱand stageⅢⅣ(t=0.797,p=0.047<0.05); All the preoperative plasma D-Dimer results is correlation with ages.Conclusion:①The preoperative plasma D-Dimer levels in laryngeal and hypolarygeal carcinoma patients is high.②From the 1st day to 10th day after operation,the plasma D-Dimer levels in laryngeal and hypolarygeal carcinoma patients is even high compared with preoperation, plasma D-dimer test can be a measure to detection pulmonary embolism in suspicious patients of laryngeal and hypolarygeal carcinoma.③The preoperative plasma D-Dimer levels in laryngeal and hypolarygeal carcinoma patients accompany with cardiovascular system diseases and diabetes are even high.