凝血指标与肺癌患者预后的关系  

Relationship of coagulation indices with prognosis of lung cancer patients

作　　者：张月莉[1] 梁红[1] 沈维敏[1] 朱砚萍[1] 李向阳[1] 朱惠莉[1] 瞿介明[1] 

机构地区：[1]复旦大学附属华东医院呼吸科,上海200040

出　　处：《上海医学》2013年第12期1031-1037,共7页Shanghai Medical Journal

摘　　要：目的观察凝血指标在不同病理类型肺癌患者中的表达水平,及其与预后的关系。方法回顾性收集2007年12月-2012年4月复旦大学附属华东医院住院的肺癌患者(肺癌组)的临床资料,以同时期健康体格检查者为对照组,查阅病史,比较组间凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)水平、D-二聚体含量、血小板计数、血小板比容(PCT)、平均血小板体积(MPV)、血小板分布宽度(PDW)的差异。结果肺癌组141例,男100例,女41例,平均年龄为(71.5±11.8)岁。其中,非小细胞肺癌(NSCLC)131例(男92例,女39例),包括腺癌81例(男52例,女29例),鳞癌50例(男40例,女10例);小细胞肺癌(SCLC)10例(男8例,女2例)。对照组49名,男45名,女4名,平均年龄为(68.8±10.3)岁。腺癌ⅡA至ⅢA期患者的APTT显著长于腺癌ⅢB至Ⅳ期患者(P<0.05);SCLC局限期患者的FIB水平显著高于SCLC广泛期患者(P<0.05),生存期显著长于SCLC广泛期患者(P<0.05)。根据FIB水平正常(2～4g/L)与否将患者分为高FIB(>4g/L)和非高FIB(≤4g/L),两组患者间的一般资料、生存期和不同临床分期患者比例的差异均无统计学意义(P值均>0.05)。肺癌组中,高FIB患者的PT显著短于同组中非高FIB患者(P<0.01),FIB水平显著高于同组中非高FIB患者(P<0.01),D-二聚体含量显著少于同组中非高FIB患者(P<0.05)。对照组中,高FIB患者的FIB、血小板计数和PCT均显著高于非高FIB患者(P值分别<0.01、0.05)。肺癌组的PT、APTT、FIB水平、D-二聚体含量、血小板计数均显著高于对照组(P值均<0.05),而MPV显著小于对照组(P<0.05)。肺癌组中高FIB患者的APTT、FIB水平均显著高于对照组中高FIB患者(P值分别<0.01、0.05),MPV显著低于对照组中高FIB患者(P<0.05)。肺癌组中非高FIB患者的PT、APTT、D-二聚体、PDW均显著高于对照组中非高FIB患者(P值分别<0.01、0.05),PCT显著低于对照组中非高FIB患者(P<0.05)。腺癌高FIB患者�Objective To investigate the expression of coagulation markers and the relationship with prognosis of lung cancer patients of different pathological types. Methods Clinical data of 141 lung cancer patients admitted to our hospital from December 2007 to April 2012 were collected and reviewed. The control group contained 49 healthy individuals examined physically from December 2007 to April 2012 in our hospital. The coagulation markers and fibrinolysis parameters, such as prothrombin time （PT）, activated partial thromboplastin time （APTT）, fibrinogen （FIB） level, D-dimer （DD） level, platelet count （PLT）, platelet hematocrit （PCT）, mean platelet volume （MPV） and platelet distribution width （PDW） were compared between two groups. Results In the lung cancer group, there were 100 males and 41 females with an average age of （71.5± 11.8） years; ofthem, there were 131 patients （92 males and 39 females） with nonsmall-cell lung cancer （NSCLC）, including 81 cases of adenocarcinoma （52 males and 29 females） and 50 cases of squamous carcinoma （40 males and 10 females）, and 10 patients （8 males and 2 females） with small cell lung cancer （SOLO）. In the control group, there were 45 males and 4 females with an average age of （68.8 ± 10.3） years. APTT from adenocarcinoma patients on ]] A- ]~ A level was significantly longer than that from adenocarcinoma patients on Ⅲ B- IV level （ P〈 0.05）. The patients in SOLO limited stages had much higher FIB level and longer survival than patients in SOLO extensive stages （P〈0.05）. There were no significant differences in general information, survival or numbers in different clinical stages between the patients with high coagulation （FIB〉4.0 g/L） and the patients with normal coagulation （FIB^4.0 g/L, P〈0.05）. In the lung cancer group, PT and DD in the patients of FIB〉4. 0 g/L were significantly less than those in the patients of FIB≤4.0 g/L （P〈0.01 or 0.05）, while FIB level in the patients of

关 键 词：肺癌 高凝状态 生存期 

分 类 号：R734.2[医药卫生—肿瘤]