Predictive value of indicator of CA125 combined with D-dimer (ICD) for
lymph node metastasis in patients with ovarian cancer: A multicenter
retrospective study
Abstract
Objective: To explore a new index that predict lymph node
metastasis(LNM) of ovarian cancer(OC). Design: A cross-sectional study
of two medical centers. Setting: Two medical centers from Nantong,
China. Sample: There were 447 patients included as the training set
meanwhile 284 patients were included in the validation set. Methods: A
total of 447 patients diagnosed with OC from January 2008 to June 2019
were included in this retrospective study as the training set. A total
of 284 patients were included in the validation set. The optimal cut-off
critical value of indicator CA125 combined with D-dimer(ICD) was
evaluated by the receiver operating characteristic curves(ROC), and the
maximum Youden index (sensitivity + specificity-1). Univariate and
multivariate analysis were used to evaluate ICD as a predictor of LNM in
OC. Main outcome measures: LNM burden. Results: According to ROC curve,
area under curve(AUC) of ICD (AUC=0.706, p<0.001) was
significantly larger than that of CA125 (AUC=0.671, p<0.001)
and D-dimer (AUC=0.562, p=0.022) alone. Multivariate analysis showed
that ICD (HR 2.651, 95% CI 1.273–5.520, p=0.009) was an independent
predictor of LNM rather than overall survival(OS) in OC. It has also
been verified in another medical center. Conclusions: ICD can be used to
screen and predict the development process of OC. ICD is an independent
predictor of LNM in ovarian cancers, which is helpful for clinicians to
draw up individual treatment plans. Funding Scientific Research Project
of “333 Project” in Jiangsu Province (BRA2019030). Nantong Science and
Technology Foundation grant (MS22019008). Keywords: OC, CA125, D-dimer,
ICD, NLM