摘要
Abstract
Objective To investigate the optimal cut-off value of plasma D-dimer for lung cancer with pulmonary embolism.Methods The enrolled participants were 100 lung cancer patients suspected with low or intermediate probability of having a pulmonary embolism (PE) from the First Affiliated Hospital of Nanchang University between January 2011 and August 2017.A11 of them underwent multi-slice spiral CT pulmonary angiography (CTPA) and D-dimer test.We collected and compared the clinical data,type of lung cancer,lung cancer staging,age-adjusted plasma D-dimer level between those with PE and those without.ROC curve of age-adjusted plasma D-dimer level for identifying PE in lung cancer patients was drew,and the optimal cut-off value was determined,the corresponding sensitivity,specificity,positive predictive value,negative predictive value and accuracy rate were calculated.Results Lung cancer patients with PE presented higher median age-adjusted D-dimer level compared with those without [5 811.8 (17 095.7) μ g/L vs 730.0 (1 050.9) μ g/L] (P＜0.001).Lung adenocarcinoma patients demonstrated higher median age-adjusted D-dimer level compared with those with other types of lung cancer [1 493.7 (6 343.5) μ g/L vs 785.2 (1 448.9) μ g/L] (P＜0.05).Stage Ⅰ-Ⅱ lung cancer patients showed lower median age-adjusted D-dimer level compared with stage Ⅲ-Ⅳ lung cancer patients [469.3 (1 602.7) μ g/L vs 1110.0 (4 750.9) μ g/L] (P＜0.05).The AUC of age-adjusted D-dimer level for the identification of PE was 0.796 [95％CI (0.696,0.896)],the optimal cut-off value was 2 835 μ g/L,corresponding sensitivity,specificity,positive predictive value,negative predictive value,accuracy rate and Youden's index were 62.9％,92.3％,81.5％,82.3％,82.0％,0.552,respectively.Conclusion The age-adjusted plasma D-dimer of 2 835 μ g/L plays an important role in the identification of PE in lung cancer patients.关键词
肺肿瘤/肺栓塞/D-二聚体/灵敏度/特异度Key words
Lung neoplasms/Pulmonary embolism/D-dimer/Sensitivity/Specificity分类
医药卫生
