The D-dimer level predicts the prognosis in patients with lung cancer: a systematic review and meta-analysis

• Published in: Journal of cardiothoracic surgery Vol. 16; no. 1; pp. 243 - 11
• Main Authors: Ma, Mingsheng, Cao, Run, Wang, Wei, Wang, Biying, Yang, Yichen, Huang, Yunchao, Zhao, Guangqiang, Ye, Lianhua
• Format: Journal Article
• Language: English
• Published: London BioMed Central 28.08.2021; BioMed Central Ltd; BMC
• Subjects: Analysis; Bias; Biomarkers, Tumor; Cancer patients; Cardiac Surgery; Coagulation; Confidence intervals; D-dimer; Development and progression; Dimers; Fibrin Fibrinogen Degradation Products; Fibrinolysis; Humans; Localization; Lung cancer; Lung Neoplasms - diagnosis; Medical prognosis; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Meta-analysis; Patients; Plasma; Prognosis; Proportional Hazards Models; Review; Subgroups; Survival; Systematic review; Thoracic Surgery; Thrombosis; Tumors; Asia; Europe; Oceania; D-dimer; Lung cancer; Prognosis
• ISSN: 1749-8090; 1749-8090
• DOI: 10.1186/s13019-021-01618-4

Objective Although the significance of increased plasma D-dimer levels in activating coagulation and fibrinolysis has been reported, it is still controversial whether it can be used to predict the prognosis of lung cancer patients. This meta-analysis was performed to explore the beneficial role of plasma D-dimer as a prognostic factor in lung cancer patients according to a larger sample capacity. Materials and methods MEDLINE, EMBASE, and Cochrane Central databases were searched from inception to January 2021. The data are mainly hazard ratio(HR) with 95% confidence interval (CI) and Kaplan–Meier survival curves. The publication bias was examined by Egger’s test. Results Finally, a total of 28 studies, enrolling 8452 patients were included in the current meta-analysis. Our results showed that the OS (HR = 1.742, 95%CI:1.542–1.969, P  < 0.001) and PFS (HR = 1.385, 95%CI:1.169–1.641, P  = 0.003) in the high D-dimer group were significantly lower than those in the low D-dimer group. Subgroup analysis suggested that localization, detection methods and disease stage had an important effect on the prognosis. Conclusion This meta-analysis revealed that the high plasma D-dimer level leads to lower survival than in the low D-dimer level, which might provide an important clue for high plasma D-dimer level as an independent factor of poor prognosis in patients with lung cancer.