摘要目的 探究D二聚体水平在肝母细胞瘤患儿中的临床意义.方法 总结2013年7月至2017年1月我院39例肝母细胞瘤患儿的D二聚体水平.分析肝母细胞瘤患儿的D二聚体水平在不同年龄段、不同性别中有无明显差异;分析化疗后AFP水平明显下降的患儿中化疗前后的D二聚体水平是否有明显差异;分析D二聚体水平在不同PRETEXT分级中是否有差异;以及D二聚体水平在肝母细胞瘤和良性肝肿瘤中有无明显差异.并对化疗前D二聚体和AFP水平行相关性分析.结果 PRETEXTⅣ期患儿的D二聚体水平明显高于Ⅰ、Ⅱ、Ⅲ期的患儿(P=0.048);PRE-TEXTⅢ、Ⅳ期患儿的D二聚体水平明显高于Ⅰ、Ⅱ期的患儿(P=0.011);化疗后AFP水平明显下降的患儿中化疗前后的D二聚体水平有明显差异(P＜0.001);肝母细胞瘤患儿的D二聚体水平明显高于其他肝脏良性肿瘤患儿的D二聚体水平(P=0.010);D二聚体水平在不同性别的肝母细胞瘤患儿中差异无统计学意义(P=0.590);D二聚体水平在不同年龄段的肝母细胞瘤患儿中差异亦无统计学意义(≥12个月龄比＜12个月龄,P=0.646).化疗前D二聚体水平和AFP水平呈正相关(r=0.340,P=0.034).结论 高水平的D二聚体可能是肝母细胞瘤患儿的高危因素之一,D二聚体水平测定方便、快捷,可快速应用于临床.

abstractsObjective As one of the most common pediatric liver malignancies,hepatoblastoma (HB) typically affects children within the first four years of life.However,few blood biomarkers are validated for clinical evaluations.The current study explored the clinical application and significance of D-dimer levels in HB patients.Methods Thirty-nine HB children were recruited retrospectively.D-dimer levels were examined and correlations with other clinical features analyzed.D-dimer levels were compared between HB and other benign hepatic tumors.The correlation of prior to chemotherapy D-dimer and AFP level was analyzed by Pearson's correlation.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 Ⅳ patients compared with stage Ⅰ / Ⅱ/Ⅲ patients (P =0.048).Higher D-dimer levels were observed in stage 3/4 patients compared with stage 1/2 patients (P =0.011).Higher D-dimer levels were observed in patients with higher AFP levels prior to chemotherapy than those with lower AFP levels after chemotherapy (P＜0.001).Higher D-dimer levels were also observed in HB compared with other benign hepatic tumors such as hepatic hemangioma and hepatocellular adenoma (P =0.010).No significant difference existed between gender (P=0.590) or age (≥12 months vs ＜12 months,P =0.646).The level of D-dimer was positively correlated with AFP level prior to chemotherapy (r =0.502;P =0.169).Conclusions Elevated level of D-dimer may become a useful determinant biomarker for high-risk HB patients.This finding also supports the clinical application of D-dimer in HB.