Correlation between clinical stage of solid tumor and D dimer as a marker of coagulation activation.

AIM to examine the relationship between clinical stage of solid cancers and plasma D dimer value. METHODS patients with solid cancer treated in Sanglah hospital who met study ctiteria were consecutively recruited and studied in order to examine the relationship between clinical stage of solid cancers and plasma D dimer value. Plasma D dimer was measured by ELISA (Nycocard) and TNM system to assign each patient into stage I,II,III and IV according to American Joint Committee on Cancer. Rank Spearman analysis was used to determine the relationship and one way Anova to compare the mean difference of D dimer between group of clinical stages. RESULTS there were 79 patients included, mostly female (72,2%) and 57% was in age group of 40-59 years old. Level of D dimer >500 ng/ml were found in 60 patients and 19 patients with D dimer <500 ng/ml. The most frequent cancer was cervix (32.9%) then followed by nasopharyng cancer (16.5%). Clinical stage I,II,III, and IV were 6.3%, 16.5%, 53.2% and 24.1% respectively. Thrombocytosis (>400.103/uL) was found 50.6% as well as leukocytosis 62%. Although the differences of mean D dimer in each type of solid cancers were big enough but it was not statistically significant (p = 0.156). Plasma D dimer was positively correlated with clinical stage of solid cancers (r = 0.367; p = 0.001). CONCLUSION plasma D dimer level was positively correlated with clinical stage of solid cancers. High plasma D dimer could be a marker for advanced stage of a patient with solid cancer.