The value of serum D-dimer and tumor markers in predicting venous thromboembolism in elderly patients with stage III-IV lung adenocarcinoma

Abstract

AbstractObjective To investigate the predictive value of serum D-dimer levels combined with tumor markers for venous thromboembolism (VTE) in elderly patients with stage III-IV lung adenocarcinomas. Methods A retrospective analysis was conducted involving elderly patients with inoperable stage III-IV lung adenocarcinoma admitted to the Department of Geriatrics and Department of Respiratory and Critical Care Medicine at Henan Provincial People's Hospital between January 2019 and January 2021. Patients were divided into VTE (n = 129) and non-VTE groups (n = 192). Serum D-dimer, carcinoembryonic antigen (CEA), lung cancer antigen (CYFRA21-1), carbohydrate antigen 125 (CA-125), carbohydrate antigen 199 (CA19-9), and neuron-specific enolase (NSE) levels were compared between the two groups. The risk factors for serum D-dimer and tumor markers in elderly patients with stage III-IV lung adenocarcinoma complicated by VTE were analyzed using binary logistic regression. The ROC curve was used to evaluate the predictive value of serum D-dimer and tumor markers in elderly patients with stage III-IV lung adenocarcinoma complicated by VTE. Results Compared to the non-VTE group, the serum D-dimer, CEA, CYFRA21-1, CA-125, and CA19-9 levels in elderly patients with stage III-IV lung adenocarcinoma and VTE were significantly different (P < 0.05). Further logistic regression analysis showed that D-dimer, CEA, and CYFRA21-1 levels were risk factors for VTE in elderly patients with stage III-IV lung adenocarcinoma. The area under the curve (AUC) of D-dimer, CEA, and CYFRA21-1 levels for the prediction of stage III-IV lung adenocarcinoma combined with VTE in the elderly were 0.839, 0.720, and 0.676, respectively (P < 0.05).The predicted AUC of D-dimer combined with CEA for stage III-IV lung adenocarcinoma complicated with VTE in elderly patients was 0.861, sensitivity was 0.868, specificity was 0.671, and cut-off value was 0.771. Conclusion: Serum D-dimer levels combined with the tumor marker CEA can improve the clinical diagnosis of VTE in elderly patients with stage III-IV lung adenocarcinoma.