非鳞非小细胞肺癌患者血清D-二聚体水平与EGFR基因突变关系探讨

Correlation between Serum D-Dimer Level and EGFR Gene Mutation in Patients with Non-Squamous Non-Small Cell Lung Cancer

摘要: 目的：探讨非鳞状非小细胞肺癌患者血清D-二聚体水平与EGFR基因突变的关系及其临床意义。方法：回顾性纳入187例局部晚期或转移性非鳞NSCLC患者，根据EGFR状态分为突变组(n = 113)与野生组(n = 74)。比较两组基线D-二聚体水平，通过ROC曲线分析其预测EGFR突变的效能，并采用Kaplan-Meier法分析其与无进展生存期的关系。结果：EGFR突变组血清D-二聚体水平显著高于野生组[(1.27 ± 0.86) μg/mL vs (0.83 ± 0.61) μg/mL, P < 0.01]。ROC曲线显示，D-二聚体预测EGFR突变的AUC为0.682 (P < 0.01)，最佳截断值为0.94 μg/mL。在EGFR突变组中，D-二聚体高水平患者的中位PFS显著缩短(9.4个月 vs 13.7个月，P < 0.05)。结论：血清D-二聚体水平与EGFR基因突变显著相关，对突变状态具有一定的预测价值，且是EGFR突变患者预后的潜在评估指标。

Abstract: Objective: To explore the correlation between serum D-dimer level and EGFR gene mutation in patients with non-squamous non-small cell lung cancer (NSCLC) and its clinical significance. Methods: A total of 187 patients with locally advanced or metastatic non-squamous NSCLC were retrospectively enrolled and divided into the mutation group (n = 113) and the wild-type group (n = 74) according to EGFR status. The baseline D-dimer levels of the two groups were compared, the efficacy of D-dimer in predicting EGFR mutation was analyzed by ROC curve, and the relationship between D-dimer and progression-free survival (PFS) was evaluated by Kaplan-Meier method. Results: The serum D-dimer level in the EGFR mutation group was significantly higher than that in the wild-type group [(1.27 ± 0.86) μg/mL vs (0.83 ± 0.61) μg/mL, P < 0.01]. ROC curve analysis showed that the AUC of D-dimer for predicting EGFR mutation was 0.682 (P < 0.01), with the optimal cut-off value of 0.94 μg/mL. In the EGFR mutation group, the median PFS of patients with high D-dimer levels was significantly shorter than that of patients with low D-dimer levels (9.4 months vs 13.7 months, P < 0.05). Conclusion: Serum D-dimer level is significantly correlated with EGFR gene mutation, which has certain predictive value for EGFR mutation status and is a potential prognostic evaluation indicator for patients with EGFR mutations.