• 1.天津市第一中心醫(yī)院移植外科（天津300197）;;
  • 2.首都醫(yī)科大學(xué)附屬北京友誼醫(yī)院外科（北京100050）;

【摘要】目的分析肝癌肝移植術(shù)前血漿D-二聚體水平升高在瘤栓形成及微血管侵犯中的評(píng)估意義以及與肝癌Pittsburgh TNM分期的相關(guān)性。
方法采用金標(biāo)法定量檢測(cè)了120例肝癌肝移植患者術(shù)前血漿D-二聚體水平； 根據(jù)全肝切除后病理分析主支血管內(nèi)瘤栓形成、微血管侵犯情況，對(duì)患者病情進(jìn)行Pittsburgh TNM分期、ChildPugh分級(jí)，運(yùn)用統(tǒng)計(jì)軟件SPSS 9.0行分層χ2檢驗(yàn)、多因素方差分析及q檢驗(yàn)。
結(jié)果在Child-Pugh A、 B、C級(jí)主支血管內(nèi)有瘤栓形成者與無(wú)血管侵犯者血漿D-二聚體水平的差異有顯著性意義（P＜0.05）； 在ChildPugh B、C級(jí)有微血管侵犯者與無(wú)血管侵犯者血漿D-二聚體水平差異有顯著性意義（P＜0.01），在ChildPugh A級(jí)上差異無(wú)顯著性意義（P gt;0.05）； 腫瘤TNM分期 Ⅰ、Ⅱ 期與Ⅲ期和Ⅳ期間D-二聚體水平差異有顯著性意義（P＜0.05），Ⅲ期與Ⅳ期間差異無(wú)顯著性意義（P gt;0.05）。
結(jié)論血漿D-二聚體水平隨Pittsburg TNM分期升高而升高，對(duì)肝癌肝移植術(shù)前微血管侵犯及瘤栓形成的評(píng)估有參考價(jià)值，且隨著血管侵犯進(jìn)展和Child-Pugh分級(jí)增高而其相關(guān)性增高。

引用本文： 吳迪,高東宸. 肝癌肝移植術(shù)前血漿D-二聚體水平與血管侵犯及肝癌分期的相關(guān)性. 中國(guó)普外基礎(chǔ)與臨床雜志, 2005, 12(1): 59-62. doi: 復(fù)制

1. Hemming AW, Cattral MS, Reed AI, et al. Liver transplantation for hepatocellular carcinoma [Ｊ]. Ann Surg, 2001; 233(5)∶652.
2. Herrero JI, Sangro B, Quiroga J, et al. Influence of tumor characteristics on the outcome of liver transplantation among patients with liver cirrhosis and hepatocellular carcinoma [Ｊ]. Liver Transpl, 2001; 7(7)∶631.
3. Blackwell K, Haroon Z, Broadwater G, et al. Plasma Ddimer levels in operable breast cancer patients correlate with clinical stage and axillary lymph node status [Ｊ]. J Clin Oncol, 2000; 18(3)∶600.
4. Oya M, Akiyama Y, Okuyama T, et al. High preoperative plasma Ddimer level is associated with advanced tumor stage and short survival after curative resection in patients with colorectal cancer [Ｊ]. Jpn J Clin Oncol, 2001; 31(8)∶388.
5. Hu KQ, Yu AS, Tiyyagura L, et al. Hyperfibrinolytic activity in hospitalized cirrhotic patients in a referral liver unit [Ｊ]. Am J Gastroenterol, 2001; 96(5)∶1581.
6. Costantini V, De Monte P, Cazzato AO, et al. Systemic thrombin generation in cancer patients is correlated with extrinsic pathway activation [Ｊ]. Blood Coagul Fibrinolysis, 1998; 9(1)∶79.
7. Gordon SG, Chelladurai M. Nontissue factor procoagulants in cancer cells [Ｊ]. Cancer Metastasis Rev, 1992; 11(3-4)∶267.
8. Marsh JW, Dvorchik I, B onham CA, et al. Is the pathologic TNM staging system for patients with hepatoma predictive of outcome? [Ｊ]. Cancer, 2000; 88(3)∶538.
9. Gandolfo GM, Conti L, Vercillo M. Fibrinolysis components as prognostic markers in breast cancer and colorectal carcinoma [Ｊ]. Anticancer Res, 1996; 16(4B)∶2155.
10. von Tempelhoff GF, Dietrich M, Hommel G, et al. Blood coagulation during adjuvant epirubicin/cyclophosphamide chemotherapy in patients with primary operable breast cancer [Ｊ]. J Clin Oncol, 1996; 14(9)∶2560.
  1. 1. Hemming AW, Cattral MS, Reed AI, et al. Liver transplantation for hepatocellular carcinoma [Ｊ]. Ann Surg, 2001; 233(5)∶652.
  2. 2. Herrero JI, Sangro B, Quiroga J, et al. Influence of tumor characteristics on the outcome of liver transplantation among patients with liver cirrhosis and hepatocellular carcinoma [Ｊ]. Liver Transpl, 2001; 7(7)∶631.
  3. 3. Blackwell K, Haroon Z, Broadwater G, et al. Plasma Ddimer levels in operable breast cancer patients correlate with clinical stage and axillary lymph node status [Ｊ]. J Clin Oncol, 2000; 18(3)∶600.
  4. 4. Oya M, Akiyama Y, Okuyama T, et al. High preoperative plasma Ddimer level is associated with advanced tumor stage and short survival after curative resection in patients with colorectal cancer [Ｊ]. Jpn J Clin Oncol, 2001; 31(8)∶388.
  5. 5. Hu KQ, Yu AS, Tiyyagura L, et al. Hyperfibrinolytic activity in hospitalized cirrhotic patients in a referral liver unit [Ｊ]. Am J Gastroenterol, 2001; 96(5)∶1581.
  6. 6. Costantini V, De Monte P, Cazzato AO, et al. Systemic thrombin generation in cancer patients is correlated with extrinsic pathway activation [Ｊ]. Blood Coagul Fibrinolysis, 1998; 9(1)∶79.
  7. 7. Gordon SG, Chelladurai M. Nontissue factor procoagulants in cancer cells [Ｊ]. Cancer Metastasis Rev, 1992; 11(3-4)∶267.
  8. 8. Marsh JW, Dvorchik I, B onham CA, et al. Is the pathologic TNM staging system for patients with hepatoma predictive of outcome? [Ｊ]. Cancer, 2000; 88(3)∶538.
  9. 9. Gandolfo GM, Conti L, Vercillo M. Fibrinolysis components as prognostic markers in breast cancer and colorectal carcinoma [Ｊ]. Anticancer Res, 1996; 16(4B)∶2155.
  10. 10. von Tempelhoff GF, Dietrich M, Hommel G, et al. Blood coagulation during adjuvant epirubicin/cyclophosphamide chemotherapy in patients with primary operable breast cancer [Ｊ]. J Clin Oncol, 1996; 14(9)∶2560.