PLASMA D-DIMER IN PATIENTS WITH SOLID MALIGNANT TUMORS

Jumaa Qasim, Ban

	PLASMA D-DIMER IN PATIENTS WITH SOLID MALIGNANT TUMORS
IRAQI JOURNAL OF MEDICAL SCIENCES
Article 1, Volume 6, Issue 3, 2008, Pages 47-53
Author
Ban Jumaa Qasim
Abstract
Background: Cancer patients show increased susceptibility to thromboembolic disease, as compared with the general population, suggesting that disorders of coagulation are very common in this disease, although clinical symptoms occur less frequently. D-dimer test is simple and sensitive test to detect intravascular coagulation and fibrinolysis in patients with solid malignant tumors. Objective: To identify those patients suffering from solid malignant tumors complicated with intravascular coagulation and fibrinolysis (ICF) by use of D-dimer, and the interrelation of plasma D-dimer level with histologic type of the tumor and metastasis. Patients and methods: From January to July 2004, a total of 40 patients with solid malignant tumors of various tissues and of miscellaneous histopathologic type and grades. there were 26 were included in this study, males and 14 females, their age ranged from 36 to 73 years for males and from 38 to 70 years for females. Thirteen of all patients were admitted to Al-Yarmouk Teaching Hospital and the other 27 patients were seen in the Hospital of Radiation and Nuclear Medicine clinics. All patients were to have malignancy, and clinical information including full medical and surgical history as well as laboratory data were included from patients' files and formed the basis of this study. All patients were investigated for an "intravascular coagulation and fibrinolysis syndrome" (ICF) using D-dimer test on blood samples. Results: The results presented in this study were based on analysis of 40 patients with solid malignant tumors, 26 males (65%) and 14 females (35%),their age ranged from 36 to 73 years for males and from 38 to 70 years for females . D-dimer concentration in all healthy controls included in this study was negative(i.e. <0.5 μg/ml), and there was a statistically significant difference in the plasma D-dimer concentration between healthy control group and patients with solid malignant tumors (P value =0.002). All patients were screened for ICF by the use of plasma D-dimer. Twenty two patients (55%) were found to have D-dimer < 0.5 μg/ml (i.e no evidence of ICF syndrome) while 18 patients (45%) were found to have D-dimer ≥ 0.5 μg/ml (evidence of ICF syndrome). Regarding the rate of positivity of D-dimer,it was more with adenocarcinoma than other types of solid malignant tumors but the differences failed to reach the level of significance (P value 0.18). On the other hand, this rate was more in patients showing distant metastasis and this difference was statistically significant (P value ≤ 0.001). Conclusion: Plasma D-dimer test forms a good simple applicable test for assessment of ICF syndrome. Positive D-dimer test is higher in patients with solid malignant tumors compared to normal healthy controls and it is higher in patients with metastatic tumors compared to those with localized tumors and in adenocarcinoma in comparison with other histologic types.
Keywords
solid malignant tumors; intravascular coagulation and fibrinolysis; dimer

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