Study on D-dimer elevation in patients with colorectal cancer

Abstract

Objective To analyze the association of coagulation with clinical parameters in patients with colorectal cancer. Methods Clinical and pathological data in the patients with colorectal cancer and surgical treatment were collec-ted from August 2018 to December 2019 in the Department of Gastrointestinal Surgery in our hospital. Retrospective analysis was performed to study the related factors to hypercoagulability with preoperative D-dimer value as index. Results A total of 104 from 249 (41.8%) cases exhibited elevated D-dimer (>550 μg/ L) in serum preoperatively. Twenty-seven (10.8%) cases had a significant elevation of D-dimer(>1 650 μg/ L) three times higher than normal limit. There were 7 cases with venous thromboembolism(VTE) postoperatively. Multivariate analysis showed that the preoperative elevated D-dimer in serum was associated with far metastasis and intraluminal invasion. Elevated D-dimer was found 73.3% cases with metastasis and 37.6% cases without metastasis(P<0.01), and 51.9% cases with intraluminal invasion and 34.3% without intraluminal invasion (P<0.01). Far metastasis was seen 2.8% in cases with normal D-dimer, 6.5% with elevated D-dimer, and 22.2% with significantly elevated D-dimer, and intraluminal tumor invasion diagnosed pathologically 35.2%, 48.1% and 66.7% in patients with normal, elevated and significantly elevated D-dimer, respectively. The incidence of VTE was 0.7%, 3.9% and 11.1% in above three groups, which showed the statistical correlation of VTE with preoperative serum D-dimer level. Conclusions Far metastasis and intraluminal tumor invasion are important to induce hypercoagulability state in patients with colorectal cancer and to be as risk predictor of VTE.

Keywords

• |colorectal cancer|thromboembolism|venous thrombosis|metastasis|d-dimer