The Role of Plasma D-dimer Level Measurement to Assist Breast Cancer Histopathological Grading
DOI:
https://doi.org/10.3889/oamjms.2022.8490Keywords:
Breast cancer, D-dimer, Histopathological gradingAbstract
BACKGROUND: The histopathological grades identification is unquestionably essential to determine the most effective approach in oncologic management, specifically in breast cancer (BC) as the most common malignancy diagnosed worldwide. Complex and micro-level alterations of coagulation function of the host may occur at some point since the reactivity of the tumor cells byproduct will dysregulate its physiologic function; as represented by the higher rate of fibrinolysis which in turn increase the D-dimer level.
AIM: The study aims to provide the correlation between the level of d-dimer and histopathological grades in BC patients.
METHODS: A total of 111 females with confirmed BC were included in this study, which was conducted from March to September 2021 at the teaching hospital of Universitas Sumatera Utara. After thorough clinical information analysis, the histopathological examination (HPE) was conducted to confirm the malignancy and graded based on the Bloom-Richardson grading system; therefore, the HPEs were classified into slow/moderate or poorly differentiated. The D-dimer value of >0.5 mg/L was indicated as an elevated level.
RESULTS: From the 102 eligible patients to be included in the final evaluation, it was observed that 46.1% and 52.9% of the participants were presumed with elevated D-dimer level and high-grade carcinoma, respectively. The elevated D-dimer level results percentage was substantially more common in high-grade BC (72.3%, the positive predictive value analysis. Other parameters, for example, sensitivity (63.0%), specificity (72.9%), and negative predictive value (63.6%) were found to be statistically accurate (p < 0.001).
CONCLUSION: The influence of tumor cells differentiation toward coagulation system or fibrin metabolism dysfunction is observable in this study. Hence, the role D-dimer level measurement should be investigated further to assist the BCs’ grading determination workup.
Downloads
Metrics
Plum Analytics Artifact Widget Block
References
Ay C, Dunkler D, Pirker R, Thaler J, Quehenberger P, Wagner O, et al. High D-dimer levels are associated with poor prognosis in cancer patients. Haematologica. 2012;97(8):1158-64. https://doi.org/10.3324/haematol.2011.054718 PMid:22371182 DOI: https://doi.org/10.3324/haematol.2011.054718
Dai H, Zhou H, Sun Y, Xu ZH, Wang S, Feng T, et al. D-dimer as a potential clinical marker for predicting metastasis and progression in cancer. Biomed Rep. 2018;9(5):453-7. https://doi.org/10.3892/br.2018.1151 PMid:30402229 DOI: https://doi.org/10.3892/br.2018.1151
Kaçan T, Yucel B, Bahar S, Celasun G, Seker MM, Babacan N, et al. Tedavi öncesi yüksek d-dimer düzeylerinin venöz tromboembolisi olmayan non-metastatik meme kanserli hastalardaki prognostik önemi. Uluslararasi Hematol Derg. 2016;26(3):136-44. https://doi.org/10.4999/uhod.161266 DOI: https://doi.org/10.4999/uhod.161266
Li W, Tang Y, Song Y, Chen SH, Sisliyan N, Ni M, et al. Prognostic role of pretreatment plasma D-dimer in patients with solid tumors: A systematic review and meta-analysis. Cell Physiol Biochem. 2018;45(4):1663-76. https://doi.org/10.1159/000487734 PMid:29490291 DOI: https://doi.org/10.1159/000487734
Siddiqui NA, Malik M, Fernando RW, Nair AS, Illango J, Gor R, et al. D-Dimer: A potential solution to problems of cancer screening, surveillance, and prognosis assessment. Cureus. 2021;13(5):4-9. https://doi.org/10.7759/cureus.15064 PMid:34141508 DOI: https://doi.org/10.7759/cureus.15064
Lu Y, Zhang LY, Zhang QH, Zhang YJ, Chen DB, Lou JJ, et al. The association of D-dimer with clinicopathological features of breast cancer and its usefulness in differential diagnosis: A systematic review and meta-analysis. PLoS One. 2019;14(9):e0221374. http://doi.org/10.1371/journal.pone.0221374 PMid:31487295 DOI: https://doi.org/10.1371/journal.pone.0221374
Chaari M, Ayadi I, Rousseau A, Lefkou E, Van Dreden P, Sidibe F, et al. Impact of breast cancer stage, time from diagnosis and chemotherapy on plasma and cellular biomarkers of hypercoagulability. BMC Cancer. 2014;14(1):991. https://doi.org/10.1186/1471-2407-14-991 PMid:25535397 DOI: https://doi.org/10.1186/1471-2407-14-991
Ghadhban BR. Plasma d-dimer level correlated with advanced breast carcinoma in female patients. Ann Med Surg. 2018;36(1):75-8. https://doi.org/10.1016/j.amsu.2018.10.025 PMid:30416724 DOI: https://doi.org/10.1016/j.amsu.2018.10.025
Harish S, Sringeri R, Chandra S. Role of plasma D-dimer levels in breast cancer patients and its correlation with clinical and histopathological stage. Indian J Surg Oncol. 2018;9(3):307-11. https://doi.org/10.1007/s13193-017-0682-x PMid:30287988 DOI: https://doi.org/10.1007/s13193-017-0682-x
Diao D, Wang Z, Cheng Y, Zhang H, Guo Q, Song Y, et al. D-dimer: Not just an indicator of venous thrombosis but a predictor of asymptomatic hematogenous metastasis in gastric cancer patients. PLoS One. 2014;9(7):e101125. https://doi.org/10.1371/journal.pone.0101125 PMid:24983619 DOI: https://doi.org/10.1371/journal.pone.0101125
Van Den Berg YW, Osanto S, Reitsma PH, Versteeg HH. The relationship between tissue factor and cancer progression: Insights from bench and bedside. Blood. 2012;119(4):924-32. https://doi.org/10.1182/blood-2011-06-317685 PMid:22065595 DOI: https://doi.org/10.1182/blood-2011-06-317685
Nakamura K, Nakayama K, Ishikawa M, Katagiri H, Minamoto T, Ishibashi T, et al. High pre-treatment plasma d-dimer level as a potential prognostic biomarker for cervical carcinoma. Anticancer Res. 2016;36(6):2933-8. PMid:27272807
Labelle M, Begum S, Hynes RO. Direct signaling between platelets and cancer cells induces an epithelial-mesenchymal-like transition and promotes metastasis. Cancer Cell. 2011;20(5):576-90. https://doi.org/10.1016/j.ccr.2011.09.009 PMid:22094253 DOI: https://doi.org/10.1016/j.ccr.2011.09.009
Ma M, Cao R, Wang W, Wang B, Yang Y, Huang Y, et al. The D-dimer level predicts the prognosis in patients with lung cancer: A systematic review and meta-analysis. J Cardiothorac Surg. 2021;16(1):1-11. https://doi.org/10.1186/s13019-021-01618-4 DOI: https://doi.org/10.1186/s13019-021-01618-4
Kalkan S, Caliskan S. High D-dimer levels are associated with prostate cancer. Rev Assoc Med Bras. 2020;66(5):649-53. https://doi.org/10.1590/1806-9282.66.5.649 DOI: https://doi.org/10.1590/1806-9282.66.5.649
Batschauer AP, Figueiredo CP, Bueno EC, Ribeiro MA, Dusse LM, Fernandes AP, et al. D-dimer as a possible prognostic marker of operable hormone receptor-negative breast cancer. Ann Oncol. 2009;21(6):1267-72. https://doi.org/10.1093/annonc/mdp474 PMid:19880435 DOI: https://doi.org/10.1093/annonc/mdp474
Downloads
Published
How to Cite
License
Copyright (c) 2022 Dedy Hermansyah, Naufal Nandita Firsty, Rifwanul Basir Nasution, Cut Aryfa Andra, Anggia Chairuddin Lubis (Author)
![Creative Commons License](http://i.creativecommons.org/l/by-nc/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0