"Increased D-dimer level was a poor predictor of neuroblastoma, especially in the high-risk group"

作者全名："Ma, Yue; Li, Changchun; Zhao, Zhenzhen; Yang, Chao; Zhou, Jianwu; Peng, Liang; Deng, Xiaobin; Wang, Shan"

作者地址："[Ma, Yue; Li, Changchun; Zhao, Zhenzhen; Yang, Chao; Zhou, Jianwu; Peng, Liang; Deng, Xiaobin; Wang, Shan] Chongqing Med Univ, Childrens Hosp, Engn Res Ctr, Minist Educ,Key Lab Pediatr Childrens Med Big Data, Chongqing 400014, Peoples R China"

通信作者："Wang, S (通讯作者)，Chongqing Med Univ, Childrens Hosp, Engn Res Ctr, Minist Educ,Key Lab Pediatr Childrens Med Big Data, Chongqing 400014, Peoples R China."

来源：WORLD JOURNAL OF SURGICAL ONCOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000949712300003

JCR分区：Q1

影响因子：2.5

年份：2023

卷号：21

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：D-dimer; Neuroblastoma; Prognosis; Risk stratification

摘要："PurposeD-dimer levels are associated with tumor progression and prognosis in various cancers. However, there are few research about the relationship between D-dimer and neuroblastoma (NB). This study assessed the relationships of D-dimer levels with clinical features and overall survival (OS) in patients with NB.MethodsInformation about the clinical features of 365 patients and the prognosis of 301 patients was collected. The relationship between D-dimer levels and clinical features or OS was analyzed. We constructed the risk score based on Cox regression analysis and verified the predictive efficacy of the model through ROC curve and calibration curve.ResultsThe results showed that D-dimer levels were significantly increased in patients with nonmediastinal tumor, tumor larger than 10 cm, stage 3-4 disease, bone marrow metastasis, unfavorable histology, bone metastasis, NMYC amplification, and the high-risk group (all P < 0.05). The Kaplan-Meier survival analysis showed that there were significant differences in 3- and 5-year OS (87.4% vs. 32.3%, 79.3% vs. 32.3%, P < 0.0001) between the low D-dimer and high D-dimer groups. In the high-risk group, the OS of high D-dimer was significantly lower than that of low D-dimer (P < 0.0001). All cases were divided into the training cohort (N = 211) and the validation cohort (N = 90). Multivariate analysis further suggested that D-dimer level, bone metastasis, and NMYC status were independent prognostic factors for OS (all P < 0.05). Based on the above three factors, we constructed the risk score in the training cohort. Survival analysis showed that compared with the other groups, the group with 11 scores had the worst prognosis (3-year OS 0%, P < 0.0001). The time-dependent ROC analysis and calibration curve indicated that the risk score had good accuracy.ConclusionsPatients with high D-dimer levels tended to have unfavorable clinical characteristics and poor prognosis."

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