Prognostic value of preoperative D-dimer and careinoembryonic antigen levels in patients undergoing intended curative resection for colorectal cancer: a prospective cohort study

摘要

Careinoembryonic antigen (CEA) is the most commonly studied biomarker in colorectal cancer (CRC). Currently, CEA is recommended as a supplement approach in monitoring CRC recurrence, whereas its value as an isolated prognostic marker is limited [1-4].D-dimer (DD), a degradation product of cross-linked fibrin, correlates with tumour stage and prognosis in CRC, as well as other malignancies, and has been proposed as a potential prognostic marker [5-14]. In particular, cancer-induced coagulation activation has been proposed as the primary mechanism leading to these observations [15].Studies of DD as a prognostic marker in CRC have mainly been based on a mix of patients with metastatic and non-metastatic disease. Recently, we evaluated the impact of preoperative DD levels predicting short-term survival among 157 CRC patients with the absence of venous thromboembolism (VTE), including 35 patients with distant metastases [6]. This study demonstrated a greater than three-fold increase in 1-year mortality among patients with elevated preoperative DD levels. However, as a short-term and long-term prognostic marker in CRC patients with non-metastatic disease, DD remains to be evaluated.