The significance of plasma D-dimer level in predicting high risk factors of endometrial cancer

BACKGROUND: Activated clotting-fibrinolytic system is associated with poor outcome of cancer patients. This retrospective study aimed to evaluate the significance of plasma D-dimer level in predicting high risk factors of endometrial cancer (EC) patients. METHODS: Total 176 EC patients who underwent radiotherapy between January 2018 and June 2019 at Shanghai First Maternity and Infant Hospital were retrospectively analyzed. Their preoperative and postoperative plasma D-dimer levels were measured as routine assessment in our hospital, and analyzed for their association with clinicopathological data retrieved from medical records of the patients. RESULTS: High risk group had significantly higher 1st day postoperative D-dimer levels. The 1st day postoperative D-dimer predicted higher grade EC with the specificity of 63.7% and the sensitivity of 63.4%; predicted late stage EC with the specificity of 83.7% and the sensitivity of 58.6%; predicted deeper myoinvasion of EC with the specificity of 84.9% and the sensitivity of 43.3%; predicted lymphovascular space invasion positive EC with the specificity of 84.0% and the sensitivity of 50.0%; predicted lymph node metastasis of EC with the specificity of 50.9% and the sensitivity of 100%; and predicted cervical invasion of EC with the specificity of 82.1% and the sensitivity of 65.0%. CONCLUSIONS: Increased postoperative plasma D-dimer levels accurately predicted high risk factors in patients with EC.