血浆D-dimer 在预测及评估恶性黑色素瘤转移中临床应用分析

Objective: Metastasis is the main cause of tumor treatment failure. Although the incidence of malignant melanoma is low in China, it is characterized by high degree of malignancy and easy metastasis. In this study, by building a malignant melanoma animal model, plasma D-dimer significantly increased in the presence of blood metastasis. By detecting D-dimer and FIB in malignant melanoma patients' blood samples and imaging results, we compared their efficiency of diagnosis and assessed the clinical value of D-dimer in the diagnosis of blood metastasis of malignant melanoma. Methods: The lung metastasis model was first constructed by the common cell line B16/F10 of highly invasive malignant melanoma. After two weeks of tail vein injection, lung metastasis was observed and changes in plasma D-dimer level were detected. We retrospectively analyzed the blood samples and pathological data of 78 patients with malignant melanoma admitted to our hospital from January 2009 to January 2019. Results: Plasma D-dimer (1.04±0.15)mg/L was significantly higher in the B16/F10 group than in the PBS control group (0.56±0.11)mg/L (P<0.001). Furthermore, in the follow-up patients in our hospital, the median plasma D-dimer level of 25/78 patients with metastasis was 1.0 mg/L, while in non-metastasis patients the median level was 0.5 mg/L. Plasma D-dimer was significantly increased in patients with metastatic malignant melanoma (P<0.001). The area under the ROC curve for the diagnosis of distant metastasis by D-dimer was 0.831 (P<0.001) and the 95% confidence interval was 0.726-0.936. Conclusion: As a non-invasive, inexpensive and rapid detection method, D-dimer may provide a basis for its application in blood metastasis and routine screening of malignant melanoma through this study.