Prognostic Correlations Between Peripheral PLT,FIB And D-D Levels In Patients With NSCLC

Background and Objective:With a high incidence and high case fatality rate,lung cancer is divided into small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC),with NSCLC being the most common,the etiology of which is complex,the pathogenesis is unclear,and the pathological types,molecular classification,and staging all have different effects on prognosis,at present,simple and accurate indicators for prognosis determination are lacking.Although primary prevention of lung cancer has achieved certain achievements,it still has a long way to go,low-dose chest spiral CT screening plays an important role in the early detection and early diagnosis of lung cancer,meanwhile,more and more attention has been paid to the role of tumor biomarkers and peripheral blood coagulation indicators in cancer diagnosis,prognosis determination and recurrence monitoring.Some scholars have found that the development and metastasis of malignant tumors are closely related to the hypercoagulable state that exists in their peripheral blood,especially in lung cancer patients,whose hypercoagulable state in peripheral blood is more obvious than that in other malignant tumors.The hypercoagulable state is reflected by changes in platelet(PLT),fibrinogen(FIB)and D-Dimer(D-dimer)levels in the peripheral blood.This study aimed to retrospectively investigate the levels of preoperative peripheral blood PLT,FIB,D-D and the combination of all three assays in different TNM stages of lung cancer in patients with NSCLC,and thus to analyze their value as a simple indicator for determining the prognosis and trends of NSCLC patients.Methods:(1)Clinical data of 127 NSCLC patients were collected and retrospectively reviewed,who were referred for surgery between January 2017 and December 2020 at the Second Affiliated Hospital of Zhengzhou University.The collected clinical data included patients’ gender,age,smoking history,history of underlying diseases(including hypertension,diabetes and coronary heart disease),clinical TNM stage,pathological classification,examination results of PLT,FIB and D-D within 1 week before operation.In addition,78 healthy subjects were collected as control group.(2)Statistical analyses were performed using SPSS 21.0,and measurements were made using the mean±Standard deviation((?)±s)Denotes,comparison between groups was by t test;The chi square test was used for comparison of count data.The area under the ROC curve(AUC)and the cut-off values were obtained by plotting the ROC curve with single parameter detection(the ROC plot corresponds to the point closest to the upper left corner,which corresponds to the value with the highest sensitivity and specificity),and the cut-off value was used as the judgment cut-off point,the variable continuity variable was used as a categorical variable,and the combined analysis of multiple parameters was performed using logistic regression and ROC curve.Take α=0.05 as the inspection level.Result:(1)The levels of all three preoperative PLT,D-D and FIB were higher in NSCLC patients than in healthy controls(P < 0.05).(2)Higher levels of PLT,D-D and FIB in NSCLC patients predicted later clinical stages(P < 0.05).(3)Single parameter studies of each index,PLT,D-D and FIB,were of adjuvant value(AUC > 0.5)in determining the prognosis of NSCLC,although they were small because of their small area under the curve.However,the area under the curve of the combined detection of the three indicators was larger,so it was of more adjuvant value to determine the prognosis of NSCLC.Conclusions:The elevated levels of PLT,D-D,and Fib in the peripheral blood before surgery suggested a poor prognosis in NSCLC,and the combination of all three assays has the potential to be used as one of the decision-making markers for the prognosis of NSCLC.