title: Combined use of D-dimer and P-selectin for the diagnosis of splenic or portal vein thrombosis following splenectomy.
abstract: To investigate the predictive value of combined use of D-dimer and P-selectin for splenic or portal vein thrombosis (SPVT) after splenectomy. A prospective study was carried out in 82 patients who had undergone splenectomy for portal hypertension secondary to hepatic cirrhosis. Plasma levels D-dimer and P-selectin were measured before and after the surgery.27 (30.1%) patients developed SPVT following the portal hypertension surgery. The post-operative D-dimer and P-selectin levels in patients with SPVT were significantly higher than in those without PVT (n=55, P<0.01). The receiver-operated characteristics curves (ROC) of D-dimer and P-selectin showed a significant predictive value in SPVT (D-dimer, Az=0.880, P<0.01; P-slectin, Az=0.933, P<0.01). The sensitivity and specificity of D-dimer (>500 microg/mL) in diagnosing SPVT were 88.9% and 78.2% respectively. P-selectin >90ng/mL had an 85.2% sensitivity and 85.5% specificity for SPVT. The combination of the D-dimer and P-selectin criteria yielded an 82.0% sensitivity and 97.6% specificity for SPVT. In Conclusion, there was a significant elevation in plasma D-dimer and P-selectin in patients with post-operative SPVT. A combination of plasma D-dimer and P-selectin may be used as biomarkers to screen or diagnose SPVT following splenectomy.
authors.affiliation: Department of General Surgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng 252000, Shandong Province, China.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Gui-Jie
authors.initials: GJ
authors.lastname: Liu
authors.forename: Yan-Xin
authors.initials: YX
authors.lastname: Chen
authors.forename: Huai-Ping
authors.initials: HP
authors.lastname: Dong
authors.forename: Yan-Qiang
authors.initials: YQ
authors.lastname: Zhang
authors.forename: Le-Xin
authors.initials: LX
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood*; D011169:Portal Vein; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013156:Splenectomy / Q000009:adverse effects*; D013162:Splenic Vein; D020246:Venous Thrombosis / Q000097:blood* / Q000175:diagnosis*
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D019007:P-Selectin; C036309:fibrin fragment D