血浆组织因子在非小细胞肺癌患者中的表达及意义  

Level and clinical significance of plasma tissue factor in patient with non-small cell lung cancer

作　　者：黄琬玲[1] 周燕斌[1] 黎银焕[1] 黄丽霞[1] 蔡兴东[1] 曾庆理[1] 李少丽[1] 

机构地区：[1]中山大学附属第一医院呼吸内科,广州510080

出　　处：《中国综合临床》2013年第3期246-249,共4页Clinical Medicine of China

基　　金：国家自然科学基金资助项目（81071931）;教育部留学回国人员科研启动基金（教外司留2010-609）;广东省自然科学基金（$2011010004703）

摘　　要：目的检测组织因子在非小细胞肺癌（NSCLC）患者血浆中的表达，探讨其与NSCLC患者高凝状态、血栓栓塞性疾病及预后的关系。方法应用酶联免疫吸附法检测61例NSCLC患者、13例肺部良性疾病患者及14名健康对照者血浆组织因子浓度，分析比较各组临床资料，并进行随访。结果组织因子浓度NSCLC组、良性肺病组均显著高于健康对照组[（550．88±201．58）、（510．77±201．20）、（178．34±66．73）ng／L，P均〈0．05]。按组织因子水平分为低组织因子组（103．73—476．22ng／L）和高组织因子组（476．22～1003．00ng／L）后进行分析发现，NSCLC患者血浆组织因子水平随着肿瘤分期的升高而升高（P=0．026），且与肿瘤的远处转移明显相关（P=0．020）。Kaplan—Meier生存分析（X2=0．145，P=0．704）、多因素Cox比例风险回归模型显示，组织因子表达水平与NSCLC预后无显著相关关系（RR=1．001，95％C10．998～1．004，P=0．452）。结论NSCLC患者组织因子水平与TNM分期有密切联系，与m栓栓塞性疾病的发生及生存率无明显相关，对NSCLC病情和预后的判断有局限性。Objective To detect the plasma level of tissue factor （TF） in non-small cell lung cancer （NSCLC） patients, and to discuss its association with hypercoagulation, venous thromboembolism and prognosis of lung cancer. Methods Sixty-one impatients in our hospital with confirmed lung cancer were enrolled as the study group. Thirteen patients with benign pulmonary diseases and 14 healthy volunteers were selected as the control groups. Bseline and follow-up clinical data were collected from participants. Enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of TF in plasma of all subjects. Results The levels of TF in plasma from NSCLC patients and participants with benign pulmonary diseases was significantly higher than that in healthy controls（ （550. 88 ± 201.58） ng/L vs （510. 77 ± 201.20） ng/L vs （ 178.34 ± 66. 73） ng/L,P 〈 0. 05 ）. According to the plasma levels of TF, which have been detected in all subjects, the patients were divided into two groups ： low level group （ range from 103.73 ng/L to 476. 22 ng/L） and high level group （range from 476. 221 ng/L to 1003.00 ng/L）. Statistical analysis showed that there was a positive correlation between plasma TF levels and TNM stages in NSCLC patients （ P = 0. 026）. Patient with metastasis had a higher plasma TF level than other patients （ P = O. 020 ）. The log-rank test revealed that there was no significant difference in survival between the high level group and low level group （ X2 = 0. 145, P = 0. 704 ）. Multivariate Cox proportional hazards regression analysis indicated that plasma TF levels did not predicted for death（RR = 1. 001,95% CI O. 998 - 1. 004 ,P =0. 452）. Conclusion The plasma TF level in NSCLC patients was correlated with TNM stages;it had no significant relationship with hypercoagnlation state and survival rate in NSCLC patients. Limitations should be aware of while evaluating the clinical course and prediction of prognosis of NSCLC patients using plasma TF levels.

关 键 词：非小细胞肺癌 组织因子 高凝状态 

分 类 号：R734.2[医药卫生—肿瘤]