血清D-二聚体对非鳞非小细胞肺癌EGFR突变的预测价值研究

Study on Predictive Value of Serum D-Dimer in Predicting EGFR Mutation in Non-Squamous Non-Small Cell Lung Cancer

摘要: 目的：探讨血清D-二聚体水平对非鳞非小细胞肺癌患者EGFR基因突变的预测价值。方法：选取2024年12月至2026年6月于济宁医学院附属医院呼吸内科就诊、经病理确诊为局部晚期或晚期非鳞非小细胞肺癌且未经抗肿瘤治疗的患者，收集其临床资料、EGFR基因检测结果及首次血清D-二聚体数据，依据EGFR状态分为突变组与野生组，比较两组D-二聚体水平差异，并通过ROC曲线评估其预测效能。结果：共纳入300例患者，其中EGFR突变组186例(62.0%)，野生组114例(38.0%)。突变组血清D-二聚体水平显著高于野生组(P < 0.05)。ROC曲线分析显示，D-二聚体预测EGFR基因突变的AUC为0.609 (95% CI: 0.530~0.689)，最佳截断值为1.25 μg/ml，敏感度为71.9%，特异度为52.1%。结论：血清D-二聚体在EGFR突变患者中显著升高，可作为预测EGFR突变的潜在生物学指标。

Abstract: Objective: To investigate the predictive value of serum D-dimer level for epidermal growth factor receptor (EGFR) gene mutation in patients with non-squamous non-small cell lung cancer (NSCLC). Methods: Patients with pathologically confirmed locally advanced or advanced non-squamous NSCLC who were treatment-naive and admitted to the Department of Respiratory Medicine, Affiliated Hospital of Jining Medical University from December 2024 to June 2026 were enrolled. Clinical data, EGFR gene test results, and initial serum D-dimer levels were collected. Patients were divided into EGFR mutant group and wild-type group. The difference in D-dimer levels between the two groups was compared, and the predictive efficacy was evaluated by receiver operating characteristic (ROC) curve. Results: A total of 300 patients were included, with 186 cases (62.0%) in the EGFR mutant group and 114 cases (38.0%) in the wild-type group. Serum D-dimer level was significantly higher in the mutant group than in the wild-type group (P < 0.05). ROC curve analysis showed that the area under the curve (AUC) of D-dimer for predicting EGFR mutation was 0.609 (95%CI: 0.530~0.689), with an optimal cutoff value of 1.25 μg/ml, a sensitivity of 71.9%, and a specificity of 52.1%. Conclusion: Serum D-dimer is significantly elevated in patients with EGFR mutation and can be used as a potential biomarker for predicting EGFR mutation.