D-dimer levels as marker of deep vein thrombosis in patients with cervical cancer: A study of a northern Nigerian patient population

ABSTRACT

Background: Cervical cancer is the most common genital tract malignancy in Nigeria and an important cause of cancer­related death in women. Patients with advanced cervical cancer are often victims of deep venous thrombosis (DVT) that increases morbidity and mortality. Strategies at screening and early diagnosis enable prompt treatment which improves quality of life. Objectives: The objective of this study is to determine the plasma D­dimer level in patients with cervical cancer and its relationship to the presence of DVT,Well's score, and stage of malignancy. Materials and Methods: It is a prospective cross-sectional descriptive study of patients with histological diagnosis of cervical cancer in a Nigerian population. Patients' clinical, laboratory, and radiological data were obtained, and their body mass index (BMI) was calculated. Well's chart 17 was used to categorize patients using a cutoff of 2. Plasma D­dimer was quantified by immunoturbidimetric method and interpreted as significant if >0.099 g/dl.High­resolution ultrasound with 5­10 MHZ linear probe was used to evaluate the lower limbs veins of the patients. Data were analyzed with SPSS version 20. The test of association was done using Chi­square with a P < 0.05 considered statistically significant. Results: A total of 77 patients were enrolled, but 67 patients had complete data. The mean age was 54.7 ± 11.2 years. The average parity was 7.5 ± 3.1. Majority (47.8%) had normal BMI. D­dimer was positive in 58 (87%). Of the 17 (25%) with both elevated D­dimer and high probability of DVT, 5 (29%) had DVT. The incidence of DVT among our study population was 7.5%. There was statistically significant relationship between stage of diseaseand an elevated D­dimer value (χ2 = 5.82, α = 0.016, 95% confidence interval). Conclusion: Deep vein thrombosis occurred only in patients with high D­dimer and high Well's score, which makes their combination relevant in early diagnosis. Advanced age, high parity advanced stage of disease was the main associated risk factors. All cases with DVT occurred in patients with squamous cell cancer