D-dimer is an essential accompaniment of circulating tumor cells in gastric cancer. Issue 1 (December 2017)

• Record Type: Journal Article
• Authors: Diao, Dongmei; Cheng, Yao; Song, Yongchun; Zhang, Hao; Zhou, Zhangjian; Dang, Chengxue
• Is Part Of: BMC cancer. Volume 17:Issue 1(2017)
• Page Start: 1
• Page End: 9
• Publication Date: 2017-12
• Subjects: D-dimer -- Gastric cancer (GC) -- Metastasis -- Circulating tumor cells (CTCs) -- Outcome; Cancer -- Periodicals; 616.994005
• DOI: 10.1186/s12885-016-3043-1
• Languages: English
• ISSNs: 1471-2407

Abstract

Abstract Background Fibrinogen (FIB) is an important source of fibrin, which plays a crucial role in circulating tumor cells (CTCs) extravasation and distant metastasis development. We hypothesize it's stable final product, plasma D-dimer, may be associated with CTCs appearance and can reflect the metastatic phenotype in cancer patients. Methods We first verified our hypothesis in different murine gastric cancer metastasis models in vivo, plasma D-dimer and fibrinogen as well as its degradation products were directly examined in three metastasis immune-deficient mouse models and in controls. Next, we gathered and analyzed the result of plasma D-dimer levels and CTCs numbers in 41 advanced primary gastric cancer (GC) patients. A follow-up study was conducted in these patients. Results In three in vivo murine metastasis models, plasma D-dimer levels were extremely elevated in a hematogenous and intraperitoneal murine model of metastasis compared with a subcutaneous tumor model and the control group, supporting our previous hypothesis. While in 41 GC patients, the result displayed that plasma D-dimer levels were remarkably increased in patients with distant metastases, especially in visceral metastases patients. Additionally, linear association was shown between D-dimer level and CTCs numbers (R 2 = 0.688, p < 0.001), additionally, plasma D-dimer represent a better survival predictor than CTCs. Conclusions Plasma D-dimer is an essential accompaniment of CTCs in GC that is easy to measure and lower in cost, and can be used in the detection of hematogenous metastasis.