| Backgroung:Although non-small cell lung cancer(NSCLC)patients with venous thrombolism(VTE)have a higher overall risk,and VTE is a recognized cancer complicatio,However,the risk identification and prediction of venous thromboembolism in non-small cell lung cancer is limited。Venous thrombolism associated with lung cancer consists mainly of deep venous thrombolism(DVT)and pulmonary thrombolism(PE).The product of crosslinked fibrin degradation is D-dimer level.The increase of D-dimer level indicates the full activation of coagulation and fibrinolysis.Although D-dimer is specific for secondary hyperfibrinolysis,the clinical diagnosis of thrombus formation is not specific for the secondary hyperfibrinolysis system caused by various reasons,i.e.the result of hyperfibrinolysis is not necessarily obvious thrombus.In the course of clinical development of various diseases,through various mechanisms to initiate endogenous and exogenous coagulation pathway,the coagulation system was activated to produce a large number of crosslinked fibrin,further leading to the activation of the fibrinolysis system.The next major molecule,the crosslinked fibrin,will be degraded by fibrinolytic enzyme,which is activated without a clinically significant thrombus.Therefore,even if the body did not form thrombus,also can produce a large number of fibrin degradation products,plasma D-dimer? Purpose:The increased level of D-dimer indicates the increased risk of thrombus.The aim of this study was to study the predictive effect of plasma D-dimer on venous thromboembolism associated with non-small cell lung cancer(NSCLC),and to explore the medical determination of the levels of D-dimer test.,In order to provide clinical reference for clinical intervention(anticoagulant therapy)in Non-small cell lung cancer patients with elevated D-dimer.Design and methods:In this study,205 patients with non-small cell lung cancer(NSCLC)from January 2017 to December 2017 in Department of Respiratory Medicine,Central Hospital of Taian City,were selected as study subjects.These include 94 cases of squamous cell carcinoma confirmed by pathology and 111 cases of adenocarcinoma.According to the International Union against cancer(The Union for International Cancer Control,UICC)Eighth Edition TNM staging standard,There were 31 patients with stage Ⅰ-Ⅱ lung cancer and 174 patients with stage Ⅲ-Ⅳ lung cancer.According to whether the patients were complicated with venous thromboembolism,they were divided into venous thromboembolism group(71 cases)and non-venous thromboembolism group(134 cases).Plasma D-dimer was detected by enzyme linked immunosorbent assay(Elisa).It includes D-dimer increasing group(n=100)and D-dimer not increasing group(n=105).The sex,age,basic disease,pathology,stage and treatment of cancer of non-small cell lung cancer were retrospect-ively analyzed.Multiple risk factors including plasma D-dimer level were analyzed,and the main influencing factors were studied by multivariate unconditioned logistic regret-ssion.Results:Single factor analysis shows,Advanced age,complicated with cardiovascular and cerebrovascular diseases,high plasma level of D-dimer,adenocarcinoma,advanced lung cancer and so on have statistical correlation with venous thromboembolism in patients with non-small cell lung cancer.Multivariate analysis suggested that plasma levels of D-dimer were high,and adenocarcinoma was an independent risk factor for venous thromboembolism in patients with non-small cell lung cancer(NSCLC).Conclusion:Plasma high D-dimer level can independently predict the occurrence of VTE in patients with NSCLC.The next step is to quantify the level of D-dimer elevation,To evaluate the risk of VTE in patients with NSCLC,to provide objective basis for clinical preventive anticoagulant therapy,and to reduce the risk of secondary VTE in patients with lung cancer. |
