Plasma D-dimer Levels In Breast Cancer Patients Correlate With Axillary Lymph Node Status

ObjectiveThe purpose of this study is to explore the relationship between plasma D-dimer level and axillary lymph node metastasis of breast cancer, and to provide the basis for predicting axillary lymph node metastasis. The study may help breast cancer patients to avoid unnecessary axillary lymph node remove. Methods1. Collecting 159 cases of female patients, who visited to the Affiliated Hospital of Yan’an university during May 2013 to January 2015, and we divided it into three groups:①73 cases of breast cancer, they have not received relevant anti-tumor treatment before operation;②36 cases of benign breast disease;③50 cases of normal control, they are no related diseases of healthy women. Collect three groups of patients with venous blood, which is breast cancer group(preoperative a week),benign breast disease group and normal control group. Plasma D-dimer levels were quantitated using a commercially available immunoassay kit(SYSMEX; TOA Medical Electronics, Kobe, Janpan).2. Patient characteristics(age and menstrual status, etc.), histopathologic variables(tumor size, pathological type, lymph node metastasis, number of lymph node metastasis, etc.) were classified and analyzed systematically.3. Statistical analysis was performed by using SPSS22.0 software package. Using single factor analysis of variance among multiple comparisons. Using T test between two groups comparisons and Spearman correlation analysis between the relationship of variables. Logistic regression analysis was used in multivariate analysis as well. P<0.05 was considered statistically significant. Results1. Plasma D-dimer levels in breast cancer patients are higher than those in benign breast disease group and normal control group, and the differences are statistically significant(P<0.01). The levels differences of D-dimer in benign breast disease group and normal control group are not statistically significant(P>0.05).2. Plasma D-dimer levels in the positive axillary lymph node metastasis group is higher than the negative axillary lymph node metastasis group, and the differences are statistically significant(P<0.01).3. In breast cancer patients, Axillary lymph node metastasis are related with tumor size, pathological type and D-dimer level. The tumor size is bigger, the axillary lymph node metastasis is easier(P<0.05). The pathological types are worse, the axillary lymph node metastasis rate is higher(P<0.01).4. Menstrual status, tumor size, pathological type, the plasma D-dimer levels are associated with the number of axillary lymph node metastasis. Except menstrual status, other three points are associated with the number of axillary lymph node metastasis significantly(P<0.01).5. Multivariate analysis showed that: pathological type and plasma D-dimer levels are independent influential factors in axillary lymph node metastasis(OR=7.464、6.470,P<0.05).6. In the diagnosis of axillary lymph node metastasis of breast cancer, the AUC of D-dimer is 0.689, with the best cutoff value is 0.455ug/ml, and the sensitivity is 52.3%, specificity is 86.2%. Conclusion1. Plasma D-dimer levels in breast cancer patients are higher than those in benign breast disease group and normal control group.2. The level of D-dimer in breast cancer patients are associated with axillary lymph node metastasis status. Plasma D-dimer levels in the positive axillary lymph node metastasis group is higher than the negative axillary lymph node metastasis group.3. Plasma D-dimer levels in breast cancer and the number of axillary node metastasis are positively correlated.4. Tumor size, pathological type and D- dimer levels was positively correlated with axillary lymph node metastasis, and associated with axillary lymph node metastasis number also.5. Pathological type and plasma D-dimer levels are independent influential factors in axillary lymph node metastasis.6. Plasma D-dimer levels to judge the axillary lymph node metastasis status of breast cancer has certain value.7. There are no relationship between the expression of ER, PR,Her-2 and axillary lymph node metastasis.