Significance Of Plasma D-dimer Detection And The Therapeutic Effect Of Radiotherapy In Elderly Non-small-cell Lung Cancer Patients

Objective: The incidence rate of lung cancer is the highest amongmalignant tumors in the whole globe,elderly lung cancer accounts for a largeproportion. Elderly patients often combined with other diseases, such asDiabetes Mellitus, Hypertension,cardiac-cerebral vascular disease and soon.While accompanied with hemodynamic changes in microcirculation, moreeasier with coagulation anticoagulation fibrinolytic system is more easierchanged, often in a high condensation state.In literature reports, the plasmaD-dimer (D-D), fibrinogen (FIB) levels are associated with prognosis. There isfew reports in meaning of Plasma D-dimer and fibrinogen for elderly patientswith lung cancer and the relationship between D-dimer and fibrinogen withradiation therapy.This study is to investigate the relationship between plasmaD-dimer,fibrinogen and curative effect of radiotherapy in elderly lung cancer,and provide the basis of progression and prognosis experiment for elderlypatients with lung cancer.Methods:1Collect124elderly patients with non-small-cell lung cancer treated inHebei Province People’s Hospital, from January2009to December2012,57patients received radiotherapy alone, the rest of the67patients receivedchemotherapy, radiochemical resynchronization therapy and generalsupportive therapy;The mean age of the patients (86males/38females) was72.51±6.77years, of which46cases were squamous cell carcinoma,56caseswere adenocarcinoma, the other22cases were adeno-squamous carcinoma;Detect the level of D-dimer, Fibrinogen, and then compared with the datadetected from the60healthy controls. 2Immune turbidimetric method was used to detect plasma D-dimer;solidification method was used to detect fibrinogen.To investigate thecorrelation of plasma D-dimer and fibrinogen levels wish the pathologictype,stage,Karnofsky scoring,performance status and conditions of prognosisin elderly patients with lung cancer.And To investigate the impact of radio-therapy on blood coagulation.3Then take57patients from the124elderly patients with lung cancer,who were treated with radiotherapy as a mere radiotherapy group; Detect thelevel of D-dimer and Fibrinogen in before and after radiotherapy.4Using SPSS16.0statistical software package for analysis.Using ttest,x2test,Spearman rank test and Kaplan Meier-survival analysis accordingto different statistical data, P <0.01or P <0.05was statistically significant.Results:1The significant of d-dimer and fibrinogen in elderly patients wish lungis higher than that in healthy controls(P<0.05)(Tab.5);2The level of D-dimer and Fibrinogen have nothing to do with the s-ex, pathological type(P＞0.05)(Tab.6,Tab.8); The plasma levels of d-dimerand fibrinogen in elderly patients with lung cancer was associated withpathologic stage.The higher plasma d-dimer concentration was associatedmore closely with advanced stage compared with early stage(P＜0.05)(Tab.9),with a trend towards a similar association for fibrinogen; The plasma levels ofd-dimer and fibrinogen in patients with elderly lung cancer was associatedwith age and performance status and prognosis (P＜0.05)(Tab.7)、(Tab.10、11), while negatively correlated to the survival span (D-D r=-0.612, P<0.01,FIB r=-0.399, P <0.01); the higher level of D-D and FIB,the lower survivalrate (Fig.1);3Radiotherapy can decrease the level of d-dimer, while increase thelevel of fibrinogen（P＜0.05）(Tab.12)(Fig.2); the average survival time ofmere radiotherapy group and un-simple radiotherapy group has no obviousdifference change（P>0.05）(Fig.3); the higher level of D-D and FIB,the lowersurvival rate in mere radiotherapy group (P <0.05)(fig.4). Conclusions：1The level of elderly patients with non-small-cell lung cancer d-dimerand fibrinogen is higher than the healthy people，Hypercoagulability state andfibrinolytic hyperfunction exists in them.2Elderly patients with non-small cell lung cancer, the greater the age,later installments, the worse performance status score the higher the plasmacontent of DD, FIB, the shorter survival. D-dimer, fibrinogen content hasnothing to do with gender, pathological type. Radiotherapy can decrease thefibrinolytic hyperfunction, while increase the hypercoagulability state；lowerlevel of the D-D and FIB can prolong the survival period.