• BinBin Zhang, GongBao Liu, XiangQi Liu, Shan Zheng, Kuiran Dong, and Rui Dong.
• Children's Hospital of Fudan University Department of Pediatric Hepatobiliary Surgery, Children's Hospital of Fudan University Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai, China.
• Medicine (Baltimore). 2017 Nov 1; 96 (47): e8798.

ObjectivesHepatoblastoma (HB) is the most common pediatric liver malignancy, typically affecting children within the first 4 years of life. However, only a few validated blood biomarkers are used in clinical evaluation. The current study explored the clinical application and significance of D-dimer levels in patients with HB.MethodForty-four patients with HB were included in this retrospective study. D-dimer and plasma fibrinogen levels were examined, and their correlation with other clinical features was analyzed. D-dimer and plasma fibrinogen levels were examined between HB and other benign hepatic tumors.ResultsD-dimer levels were significantly associated with high-risk HB features, such as advanced stage and high α-fetoprotein (AFP) levels. Higher D-dimer levels were observed in stage 4 patients compared with stage 1/2/3 patients (P = .028). Higher D-dimer levels were also observed in patients with higher AFP levels before chemotherapy compared with patients with lower AFP levels after chemotherapy (P< 0.001). In addition, higher D-dimer levels were observed in HB compared with other benign hepatic tumors such as hepatic hemangioma and hepatocellular adenoma (P = .012). No significant difference in D-dimer levels was found between sex (P = .503) and age (≥12 vs <12 months, P = .424). There was no significant difference in plasma fibrinogen levels between sex or age and high-risk HB features, such as advanced stage and high AFP levels.ConclusionsElevated D-dimer levels could be a useful determinant biomarker for high-risk features in patients with HB. This finding also supports the clinical application of D-dimer in HB.Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

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