Study On The Relationship Between D-dimmer, Fibrinogen And Response Of Advanced Non-small Lung Cancer Patients Undergoing Chemotherapy

ObjectiveDo research on the change of the level of D-dimmer and fibrinogen before and after first-line chemotherapy, to examine the significance of the two index in predicting the response and progression of NSCLC.MethodsA retrospective review of the clinical data of 53 NSCLC patients in our hospital from January 2013 to June 2014 was performed. We recorded the D-dimer and fibrinogen level before (BO) and after one(B1) and two(B2) cycles of chemotherapy of the patients and analyzed the relationship between the levels and response and PFS. Then use the software SPSS 17.0 to do some analysis, to examine the significance of the two index in predicting the response and progression of NSCLC.30 healthy people were control group.Results1.The NSCLC patients’s medians of the plasma D-dimmer and fibrinogen level are 0.97mg/L and 4.35g/L, in the control group are 0.485mg/L and 3.85g/L, It is obvious that the control group is lower than the patient group.(P=0.000,P=0.004).2.After two rounds of chemotherapy, the plasma D-dimmer and fibrinogen level medians of effective group (PR+SD) are 0.69mg/L and2.75g/L, and the invalid group are 1.75mg/L and 4.63g/L. It is obvious that the effective group is lower than the invalid group. (P=0.000, P=0.001)3. The positive of plasma D-dimmer and fibrinogen level doesn’t correlate to the age, sex, tumor stage and pathology, P>0.05.4. The patients’s PFS median is 5.6 months (95% confidence interval is 5.2-7.5 months),.The patients with positive plasma D-dimmer and fibrinogen level have a shorter PFS than the negative ones.(P=0.002,P=0.001).In the single variable analysis of COX regression, plasma D-dimmer and fibrinogen level have significant correlation with the PFS(P=0.001,P=0.003), and they are independent predictors. And the age, sex, tumor stage and pathology doesn’t correlate to the PFS.5.Compared the D-dimmer level before and after the two round chemotherapy, the medians are 0.69mg/L、0.58 mg/L、0.51 mg/L,we can see that the latter are lower than the former (P=0.153, P=0.228), but there is no significant difference. The result is as same as the fibrinogen(P=0.124,P=0.219).Conclusions1. The plasma D-dimmer and fibrinogen levels before the first chemotherapy are higher than the control, for the people who didn’t have abnormal coagulation related diseases, the positive of the two indexes can be taken as proves of a malignant lung tumor. The D-dimmer and fibrinogen levels can be used as predictors of tumor progression and first-line chemotherapy response.2. For the new diagnosis NSCLC patients, the group with lower plasma D-dimmer and fibrinogen levels before the first chemotherapy would have a better chemotherapy response, and the negative ones have a longer PFS. The two index can predict the response and PFS.3. This research give us a tip that when the new diagnosis NSCLC patient have an abnormal level of the two indexes, we should be alerted that the patient may have a worse response. Then more attention should be paid on him. We could give him a frequent reexamination such as imagine examination. It could be helpful for us to find the worse response and progressive patients.