title: Plasma D-dimer measurement as a marker of gynecologic tumors: comparison with Ca 125.
abstract: BACKGROUND
  Fibrin is formed and degraded intra-abdominally in ovarian cancer, and the cross-linked fibrin degradation product, D-dimer (D-D), has been found in increased concentrations in the plasma of these patients.
  
  
  METHODS
  D-dimer and Ca 125 levels were determined simultaneously in 110 patients with gynecologic neoplasms. D-dimer and Ca 125 assays were performed using the Dimertest Stripwell EIA Kit (Ortho) and CA 125-II EIA assay (Roche), respectively.
  
  
  RESULTS
  D-dimer plasma and Ca 125 serum levels were significantly higher in patients with ovarian cancer (mean +/- SE = 894.2 +/- 173.7 ng/ml and 760.5 +/- 292.7 U/ml, respectively) than in those with uterine cancer (mean DD +/- SE = 109.7 +/- 23.5 ng/ml and mean Ca 125 +/- SE = 50.0 +/- 23.1 U/ml) or those with benign disease (mean D-D +/- SE = 70.5 +/- 5.5 ng/ml and mean Ca 125 +/- SE = 6.6 +/- 2.8 U/ml). The levels of both markers increased with regard to ovarian cancer disease status. Mean D-D +/- SE was 90.0 +/- 22.8 ng/ml and mean Ca 125 +/- SE was 2.1 +/- 1.2 U/ml in patients with complete remission; mean D-D +/- SE was 143.3 +/- 33.5 ng/ml and mean Ca 125 +/- SE was 26.2 +/- 13.6 U/ml in patients with partial remission. In active disease, both markers had very high levels: D-D mean +/- SE = 1021.6 +/- 173.0 ng/ml and Ca 125 mean +/- SE = 1154.7 +/- 458.1 U/ml. In all groups of ovarian cancer patients, D-dimer sensitivity was better than that of Ca 125. In advanced ovarian cancer patients, the D-dimer concentration in ascites was up to 100 fold that in plasma.
  
  
  CONCLUSIONS
  Our results suggest that D-dimer can serve as a sensitive indicator to monitor the extent and course of the disease in ovarian cancer patients. The patient follow-up is ongoing to establish the predictive value of D-dimer measurement with respect to prognosis.
authors.affiliation: Hemostasis and Hematology Laboratory, Oncology Institute, Bari, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Rella
authors.forename: M
authors.initials: M
authors.lastname: Coviello
authors.forename: N
authors.initials: N
authors.lastname: De Frenza
authors.forename: G
authors.initials: G
authors.lastname: Falco
authors.forename: E
authors.initials: E
authors.lastname: Chiuri
authors.forename: P
authors.initials: P
authors.lastname: Colavito
authors.forename: M
authors.initials: M
authors.lastname: Quaranata
authors.forename: A
authors.initials: A
authors.lastname: De Leonardis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D005833:Genital Neoplasms, Female / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D