Circulating D-dimer level correlates with disease characteristics in hepatoblastoma patients

Medicine (Baltimore). 2017 Nov;96(47):e8798. doi: 10.1097/MD.0000000000008798.

Abstract

Objectives: Hepatoblastoma (HB) is the most common pediatric liver malignancy, typically affecting children within the first 4 years of life. However, only a few validated blood biomarkers are used in clinical evaluation. The current study explored the clinical application and significance of D-dimer levels in patients with HB.

Method: Forty-four patients with HB were included in this retrospective study. D-dimer and plasma fibrinogen levels were examined, and their correlation with other clinical features was analyzed. D-dimer and plasma fibrinogen levels were examined between HB and other benign hepatic tumors.

Results: D-dimer levels were significantly associated with high-risk HB features, such as advanced stage and high α-fetoprotein (AFP) levels. Higher D-dimer levels were observed in stage 4 patients compared with stage 1/2/3 patients (P = .028). Higher D-dimer levels were also observed in patients with higher AFP levels before chemotherapy compared with patients with lower AFP levels after chemotherapy (P< 0.001). In addition, higher D-dimer levels were observed in HB compared with other benign hepatic tumors such as hepatic hemangioma and hepatocellular adenoma (P = .012). No significant difference in D-dimer levels was found between sex (P = .503) and age (≥12 vs <12 months, P = .424). There was no significant difference in plasma fibrinogen levels between sex or age and high-risk HB features, such as advanced stage and high AFP levels.

Conclusions: Elevated D-dimer levels could be a useful determinant biomarker for high-risk features in patients with HB. This finding also supports the clinical application of D-dimer in HB.

Publication types

  • Evaluation Study

MeSH terms

  • Biomarkers, Tumor / blood
  • Child
  • Child, Preschool
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis*
  • Fibrinogen / analysis
  • Hepatoblastoma / blood*
  • Humans
  • Infant
  • Infant, Newborn
  • Liver Neoplasms / blood*
  • Male
  • Retrospective Studies
  • alpha-Fetoproteins / analysis

Substances

  • Biomarkers, Tumor
  • Fibrin Fibrinogen Degradation Products
  • alpha-Fetoproteins
  • fibrin fragment D
  • Fibrinogen