Clinical significance of the changes in plasma D-dimer levels in HCC patients after receiving TACE / 介入放射学杂志

ABSTRACT

Objective To discuss the clinical significance of the changes in plasma D-dimer levels in patients with primary hepatic carcinoma (PHC) after receiving transcatheter arterial chemoembolization (TACE).Methods The clinical data of 69 PHC patients were collected.According to mRECIST criteria,the patients were divided into disease-controlled group,i.e.(CR+PR+SD) patients,(group A,n=41) and disease progression group,i.e.PD patients,(group B,n=28).The plasma D-dimer levels were determined before and after TACE in all patients.The differences in plasma D-dimer levels were determined with ranksum test,and receiver operating characteristic (ROC) curve was used to evaluate the potency of D-dimer levels in judging TACE efficacy.Results The pre-TACE and post-TACE plasma D-dimer levels in group A were 124.00 μg/L (88.00-212.00 μg/L) and 190.00 μg/L (75.00-273.00 μg/L) respectively,the difference was not statistically significant (P＞0.05),while those in group B were 261.50 μg/L (138.25-559.50 μg/L) and 554.50 μg/L (398.25-1 080.00 μg/L) respectively.The pre-TACE plasma D-dimer level in group B was significantly higher than that in group A (P＜0.05),besides,in group B the plasma D-dimer level showed a further rise after TACE,the difference was statistically significant when compared with the pre-TACE level (P＜0.05).ROC curve analysis showed that the areas under ROC of pre-TACE and post-TACE plasma D-dimer levels used to determine the postoperative efficacy were 0.737 and 0.907 respectively.When taking 181.5 μg/L and 339.0 μg/L as the cut-off values,the sensitivity and specificity for judging the postoperative efficacy were 71.4％,70.7％ and 85.7％,87.8％,respectively.Conclusion The changes in plasma D-dimer levels have certain value in assessing PHC patient's condition as well as in evaluating the curative effect of TACE.The increase in plasma D-dimer level means that the patient's condition is serious and TACE efficacy will be poor.