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D-dimer plasmatic levels as a marker for diagnosis and prognosis of hepatocellular carcinoma patients with portal vein thrombosis

Authors Malaguarnera M, Latteri S, Bertino G, Madeddu R, Catania VE, Currò G, Borzì AM, Drago F, Malaguarnera G

Received 30 April 2018

Accepted for publication 20 June 2018

Published 3 October 2018 Volume 2018:11 Pages 373—380

DOI https://doi.org/10.2147/CEG.S172663

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Everson L.A. Artifon


Michele Malaguarnera,1,2 Saverio Latteri,3 Gaetano Bertino,4 Roberto Madeddu,5 Vito Emanuele Catania,3 Giuseppe Currò,6 Antonio Maria Borzì,2 Filippo Drago,1 Giulia Malaguarnera1

1Department of Biomedical and Biotechnological Science, University of Catania, Catania, Italy; 2Research Center “The Great Senescence”, University of Catania, Catania, Italy; 3Department of Medical, Surgical Sciences and Advanced Technologies “Gian Filippo Ingrassia”, University of Catania, Catania, Italy; 4Department of Experimental and Clinical Medicine, University of Catania, Catania, Italy; 5Department of Biomedical Sciences, University of Sassari, Sassari, Italy; 6Department of Human Pathology, University of Messina, Messina, Italy

Purpose: Portal vein thrombosis (PVT) is one of the severe complications of hepatocellular carcinoma (HCC). PVT deteriorates the liver, and its dysfunction increases the risk of bleeding, influencing the prognosis of patients with liver cirrhosis and HCC. The aim of our study was to investigate whether D-dimer testing could be a sensitive marker for the diagnosis and prognosis of HCC patients with PVT.
Patients and methods: Between June 2010 and December 2015, 118 HCC patients were admitted to Cannizzaro Hospital, Catania, and 50 controls were recruited from their relatives for health examinations. All enrolled patients were diagnosed and pathologically confirmed as having HCC. D-dimer was measured with an enzyme-linked immunosorbent assay using 2 monoclonal antibodies against nonoverlapping determinants of D-dimer.
Results: D-dimer levels in HCC patients with PVT were significantly higher vs HCC patients without PVT, P<0.002, and vs controls, P<0.001.
Conclusion: Plasma D-dimer is a sensitive marker of fibrin turnover and allows for the recognition of activated coagulation which may be manifested in HCC with PVT.

Keywords: hepatocellular carcinoma, D-dimer, portal venous thrombosis, coagulation, cancer, venous thromboembolism

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