Clinical Significance Of Tumor Markers Combined With D-dimer In The Diagnosis Of HCC With PVTT

Objective:To investigate the clinical significance of tumor markers combined with D-dimer in the diagnosis of hepatocellular carcinoma with portal vein tumor thrombus.Methods:The object of study were 71 patients who had imaging diagnosis or pathologic diagnosis of HCC with or without PVTT in First Affiliated Hospital of Zhejiang University School of Medicine from January 2015 to December 2016.The clinical data were retrospectively analyzed.We used SPSS software to do statistical analysis.Chi square test was used to compare the data of each group.We used the ROC curve to analyze the sensitivity and specificity in order to determine the cut-off value of portal vein tumor thrombus.P<0.05 can be considered statistically significant.Results:In this study,4 factors that may be of clinical significance in the diagnosis of HCC combined with PVTT were collected.The ROC curve area of AFP was 0.827,the data of AFP was divided into positive group(?725.85 ?g/L)and negative group(<725.85 ?g/L)and its sensitivity was 0.773,specificity was 0.893,data of the two groups had significant difference(P =0.000);The ROC curve area of D-dimer was 0.833,the data of D-dimer was divided into positive group(? 535.50 ?g/L)and negative group(<535.50 ?g/L)and its sensitivity was 0.933,specificity was 0.750,data of the two groups had significant difference(P = 0.000);The ROC curve area of CA125 was 0.769,the data of CA125 was divided into positive group(? 20.90 U/mL)and negative group(<20.90 U/mL)and its sensitivity was 0.667,specificity was 0.821,data of the two groups had significant difference(P = 0.001);The ROC curve area of CA19-9 was 0.713,the data of CA19-9 was divided into positive group(? 8.25 U/mL)and negative group(<8.25 U/mL)and its sensitivity was 0.800,specificity was 0.589,data of the two groups had significant difference(P = 0.012).Serial testing of AFP combined with D-dimer(AFP>725.85 ?g/L and D-dimer ?535.50 ?g/L are positive,others are negative):the sensitivity was 0.733,the specificity was 0.982,chi square test data suggested that the two groups had significant difference(P = 0.000)and parallel testing of AFP combined with D-dimer(AFP ? 725.85?g/L or D-dimer ? 535.50?g/L are positive,others are negative):the sensitivity was 0.933,specificity was 0.661,chi square test in two groups the data suggested significant difference(P = 0.000);Serial testing of AFP combined with CA125(AFP>725.85?g/L and CA125 ? 20.90 U/mL are positive,others are negative):the sensitivity was 0.600,specificity was 0.982,chi square test data suggested that the two groups had significant difference(P = 0.000)and parallel testing of AFP combined with CA125(AFP ? 725.85?g/L or CA125 ? 20.90 U/mL are positive,others are negative):the sensitivity was 0.800,specificity was 0.732,chi square test data suggested that the two groups had significant difference(P=0.001);Serial testing of CA125 and D-dimer(CA125 ? 20.90 U/mL and D-dimer ? 535.50?g/L are positive,others are negative):the sensitivity was 0.667,specificity was 0.875,chi square test data suggested that the two groups had significant difference(P=0.000)and parallel testing of CA125 and D-dimer(CA125 ?20.90 U/mL or D-dimer ? 535.50?g/L are positive,others are negative):the sensitivity was 0.933,specificity was 0.696,chi square test data suggested that the two groups had significant difference(P=0.000).Conclusion:AFP,CA125,CA19-9,D-dimer are of clinical significance in diagnosis with portal vein tumor thrombus in patients with hepatocellular carcinoma independently,especially AFP,CA125,D-dimer.Tumor markers combined with D-dimer can be used in the diagnosis of HCC patients with or without portal vein tumor thrombus.The combined detection of tumor markers and D-dimer can improve the early detection rate of portal vein tumor thrombus for HCC patients.