title: Value of D-dimer and protein S for diagnosis of portal vein thrombosis in patients with liver cirrhosis.
abstract: OBJECTIVE
  To investigate the value of D-dimer and protein S plasma concentrations for diagnosis of portal vein thrombosis (PVT) in patients with liver cirrhosis.
  
  
  METHODS
  D-dimer and protein S were quantified, PVT was diagnosed by dynamic enhanced computed tomography and liver function was classified using the Child-Pugh system. Receiver operating curve analysis was performed.
  
  
  RESULTS
  D-dimer increased, and protein S decreased, with decreasing liver function in the total study population (n = 188). D-dimer concentrations were significantly higher and protein S concentrations were significantly lower in patients with (n = 51) than those without PVT (n = 137). D-dimer had high specificity and negative predictive value (NPV) in Child-Pugh class A or B patients (cut-off values>0.56 mg/l and >1.18 mg/l, respectively). In class C patients>0.77 mg/l D-dimer had high sensitivity and NPV. Protein S had high sensitivity but low specificity in class A or B patients (cut-off values < 17.4 mg/l and <19.2 mg/l, respectively).
  
  
  CONCLUSIONS
  Plasma D-dimer and protein S are potential biomarkers for PVT diagnosis in patients with cirrhosis. PVT can be excluded when D-dimer is low and protein S is elevated.
authors: Department of Gastroenterology, Beijing Chao-yang Hospital Affiliate of Capital Medical University, Beijing, China.
authors: Dong-Lei
authors: DL
authors: Zhang
authors: Jian-Yu
authors: JY
authors: Hao
authors: Ning
authors: N
authors: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D008103:Liver Cirrhosis / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D017293:Protein S / Q000378:metabolism*; D011859:Radiography; D012720:Severity of Illness Index; D020246:Venous Thrombosis / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D017293:Protein S; C036309:fibrin fragment D
keywords: D-dimer; Portal vein thrombosis; diagnosis; liver cirrhosis; protein S