title: Serial D-dimer levels in the assessment of tumor mass and clinical outcome in ovarian cancer.
abstract: 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.
authors.affiliation: University of Queensland Department of Obstetrics and Gynaecology, Royal Brisbane Hospital, Queensland Radium Institute, Australia.
authors.forename: S K
authors.initials: SK
authors.lastname: Khoo
authors.forename: D B
authors.initials: DB
authors.lastname: Rylatt
authors.forename: P
authors.initials: P
authors.lastname: Parsons
authors.forename: K
authors.initials: K
authors.lastname: Wilson
authors.forename: M J
authors.initials: MJ
authors.lastname: Webb
authors.forename: G
authors.initials: G
authors.lastname: Dickie
authors.forename: J
authors.initials: J
authors.lastname: Kearsley
authors.forename: E V
authors.initials: EV
authors.lastname: Mackay
mesh_terms: 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
chemical_list: D000911:Antibodies, Monoclonal; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D