The Value Of Preoperative Detection Of Fibrinogen And D-dimer In The Diagnosis And Treatment Of Colorectal Cancer

Objective:With the development of our country’s economy,the social environment and dietary structure are changing constantly,the incidence of colorectal cancer(CRC)is in a step-rising tendency.There is an important correlation between malignant tumor and abnormal coagulation function changes.In this study,we analyzed the relationship between preoperative fibrinogen(FIB)and D-dimer(DD)levels and multiple clinicopathological features of colorectal cancer,to investigate the application value of preoperative detection of fibrinogen and D-dimer in the diagnosis and treatment of colorectal cancer.Methods:A total of 310 patients with colorectal cancer who were pathologically confirmed before surgery and underwent radical surgery were collected from Gastrointestinal Surgery Department from January 2019 to December 2022.The data collected in this research mainly include: 1.Basic information of patients: age,gender,etc.2.Laboratory test indicators: FIB,DD,tumor markers such as carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),etc.3.Tumor pathological features:specific tumor site,tumor size,differentiation degree,number of lymph nodes examined,number of lymph node metastases,vascular tumor thrombus and peripheral nerve invasion.3.Data were analyzed by SPSS26.0 software,to investigate the value of preoperative detection of fibrinogen and D-dimer in the diagnosis and treatment of colorectal cancer.Since the collected preoperative fibrinogen and D-dimer data did not follow normal distribution,spearman correlation analysis was used to analyze the association between them.Chi-square test was used to compare the positive rate of common tumor markers.Nonparametric rank sum test was used to test the association between them and various clinicopathological features and stages of CRC.The test level was set at 0.05,and P<0.05 indicated that the difference was statistically significant.The area under the curve(AUC)of ROC was compared between the combined detection of FIB and DD and the single detection of each marker.Results:A total of 310 patients with colorectal cancer were included in this study,whose FIB and DD levels were 3.81(3.66,4.13)g/L and 0.52(0.44,0.81)mg/LFEU.Spearman correlation analysis showed that there was a positive correlation between DD and FIB,and the difference was statistically significant,the rank correlation coefficient was 0.335(p <0.05).Chi-square test was used to analyze the difference between the positive rates of FIB and DD and common tumor markers.It was found that the positive rates of FIB and DD were higher than those of AFP,CEA,CA199 and CA125 in CRC(p <0.05).FIB was significantly correlated with age,tumor differentiation,tumor thrombus formation and nerve invasion(p = 0.020,0.027,0.000,0.011),but not with sex,tumor location and tumor size(p = 0.224,0.308,0.105).DD was related to the degree of tumor differentiation,the formation of tumor thrombus and the invasion of peripheral nerve(all p <0.05),but not related to age,sex,tumor location and tumor size(all p>0.05).Preoperative FIB levels were correlated with T(depth of invasion),N(lymph node metastasis),and TNM stage(p = 0.007,0.000,0.000,respectively),but not with M stage(p=0.433>0.05).The higher the preoperative FIB level was,the higher the stage was.The FIB level of stage Ⅲ+Ⅳwas 4.03(3.86,4.20)g/L higher than that of stage Ⅰ+Ⅱ was 3.71(3.59,3.89)g/L.The higher the preoperative DD value,the deeper the invasion of intestinal wall,the more the number of lymph node metastasis,the more likely to occur distant metastasis and the later the pathological stage.The area under the curve of combined detection of FIB,DD,AFP,CEA,CA125,CA199 and individual detection of each index were0.953,0.684,0.939,0.602,0.608,0.669,0.563 respectively,indicating that combined detection had better diagnostic efficacy.Conclusion:1.The changes of plasma FIB and DD levels in serum before surgery are more obvious than those of traditional tumor markers,which is a better detection index of sensitivity.2.The preoperative FIB and DD levels are closely related to the general pathological characteristics and TNM staging of colorectal cancer,which have important reference value for the preoperative diagnosis and comprehensive evaluation of patients with colorectal cancer.3.The combined detection of FIB,DD and traditional markers had higher diagnostic power in differentiating colorectal cancer stages,and can be used as an effective supplementary means to provide new assistance for the clinical diagnosis and treatment of CRC.