Combined use of D-dimer and P-selectin for the diagnosis of splenic or portal vein thrombosis following splenectomy

Wang, Li; Liu, Gui-Jie; Chen, Yan-Xin; Dong, Huai-Ping; Zhang, Yan-Qiang; Wang, Le-Xin

doi:10.1016/j.thromres.2009.12.012

« Previous Next »Thrombosis Research
Volume 125, Issue 5 , Pages e206-e209, May 2010

Combined use of D-dimer and P-selectin for the diagnosis of splenic or portal vein thrombosis following splenectomy

Li Wang
- Department of General Surgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng 252000, Shandong Province, China
Gui-Jie Liu
- Department of General Surgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng 252000, Shandong Province, China
- Corresponding authors. Wang is to be contacted at School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW 2678, Australia. Tel.: +61 2 69332905; fax: +61 2 69 332587.
Yan-Xin Chen
- Department of General Surgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng 252000, Shandong Province, China
Huai-Ping Dong
- Department of General Surgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng 252000, Shandong Province, China
Yan-Qiang Zhang
- Department of General Surgery, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng 252000, Shandong Province, China
Le-Xin Wang
- School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW 2650, Australia
- Corresponding authors. Wang is to be contacted at School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, NSW 2678, Australia. Tel.: +61 2 69332905; fax: +61 2 69 332587.

Received 21 October 2009; received in revised form 11 December 2009; accepted 26 December 2009. published online 22 February 2010.

Abstract

To investigate the predictive value of combined use of D-dimer and P-selectin for splenic or portal vein thrombosis (SPVT) after splenectomy. A prospective study was carried out in 82 patients who had undergone splenectomy for portal hypertension secondary to hepatic cirrhosis. Plasma levels D-dimer and P-selectin were measured before and after the surgery.27 (30.1%) patients developed SPVT following the portal hypertension surgery. The post-operative D-dimer and P-selectin levels in patients with SPVT were significantly higher than in those without PVT (n=55, P<0.01). The receiver-operated characteristics curves (ROC) of D-dimer and P-selectin showed a significant predictive value in SPVT (D-dimer, Az=0.880, P<0.01; P-slectin, Az=0.933, P<0.01). The sensitivity and specificity of D-dimer (>500µg/mL) in diagnosing SPVT were 88.9% and 78.2% respectively. P-selectin >90ng/mL had an 85.2% sensitivity and 85.5% specificity for SPVT. The combination of the D-dimer and P-selectin criteria yielded an 82.0% sensitivity and 97.6% specificity for SPVT. In Conclusion, there was a significant elevation in plasma D-dimer and P-selectin in patients with post-operative SPVT. A combination of plasma D-dimer and P-selectin may be used as biomarkers to screen or diagnose SPVT following splenectomy.