Serial D-dimer levels in the assessment of tumor mass and clinical outcome in ovarian cancer.
D-dimer (DD)--an end product of fibrinolysis--was measured in serum by enzyme immunoassay using a monoclonal antibody to the gamma gamma crosslink in patients with ovarian cancer, before primary surgery and during chemotherapy for 12 months or more. Serial DD levels were found to have a high sensitivity for the detection of tumor in patients with subclinical disease (91%) as well as for predicting progression of disease (100%). As determined by a careful second-look laparotomy in patients with complete clinical remission the DD marker was highly predictive of tumors less than 1 cm. The negative predictive value (82%) was higher than the positive predictive value (69%). However, there were 31% of the patients who showed a false-positive result; a close examination of the clinical data of these 9 patients failed to reveal an explanation for the positive DD levels. Despite the lack of specificity (50% in the present series), the findings support the use of DD in the assessment of patients with ovarian cancer, especially those with subclinical disease.
Khoo
S K
SK
University of Queensland Department of Obstetrics and Gynaecology, Royal Brisbane Hospital, Queensland Radium Institute, Australia.
Rylatt
D B
DB
Parsons
P
P
Wilson
K
K
Webb
M J
MJ
Dickie
G
G
Kearsley
J
J
Mackay
E V
EV
D000911:Antibodies, Monoclonal; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D007813:Laparotomy; D010051:Ovarian Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D011863:Radioimmunoassay
D000911:Antibodies, Monoclonal; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D