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

J Cardiothorac Surg. 2021 Aug 28;16(1):243. doi: 10.1186/s13019-021-01618-4.

Abstract

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.

Keywords: D-dimer; Lung cancer; Prognosis.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Biomarkers, Tumor
  • Fibrin Fibrinogen Degradation Products*
  • Humans
  • Lung Neoplasms* / diagnosis
  • Prognosis
  • Proportional Hazards Models

Substances

  • Biomarkers, Tumor
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D