新辅助化疗前后乳腺癌患者凝血相关指标变化与化疗疗效的关系研究  

Study on the relationship between the changes of blood coagulation index before and after neoadjuvant chemotherapy and the chemotherapeutic efficacy in patients with breast cancer

作　　者：陈锋[1] 

机构地区：[1]南方医科大学附属南方医院放疗科,广州510515

出　　处：《中国医师进修杂志》2014年第15期43-46,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 探讨新辅助化疗前后乳腺癌患者凝血相关指标变化与化疗疗效的关系.方法 选取90例乳腺癌患者,分别于新辅助化疗（TAC方案）前后检测凝血相关指标的变化,并分析其与化疗疗效的关系.结果 化疗后纤维蛋白原（Fib）、血小板计数（PLT）较化疗前显著升高[（3.42±0.50） g/L比（2.44±0.46） g/L、（267.83±61.34）×109/L比（174.18±48.65）×109/L],D-二聚体（D-D）较化疗前显著降低[（176.32±101.41） mg/L比（214.55±106.34） mg/L],差异均有统计学意义（P＜0.01）.其余指标化疗前后比较差异无统计学意义（P＞0.05）.化疗后D-D降低68例,其中化疗有效53例（77.9％,53/68）,无效15例（22.1％,15/68）;升高22例,其中化疗有效9例（40.9％,9/22）,无效13例（59.1％,13/22）,比较差异有统计学意义（P=0.000）.化疗后PLT降低10例,其中化疗有效3例（3/10）,无效7例（7/10）;升高80例,其中化疗有效59例（73.8％,59/80）,无效21例（26.3％,21/80）,比较差异有统计学意义（P=0.044）.结论 乳腺癌患者容易出现凝血相关指标的异常,化疗后可能导致Fib、PLT升高,D-D降低,因此化疗期间有必要监测Fib、PLT、D-D水平.D-D和PLT水平是乳腺癌患者新辅助化疗疗效评价的有效指标.Objective To investigate the relationship between the changes of blood coagulation index before and after neoadjuvant chemotherapy and the chemotherapeutic efficacy in patients with breast cancer.Methods Ninety patients with breast cancer were selected,and detected the changes of blood coagulation index before and after neoadjuvant chemotherapy （TAC regimen）,and the relationship between blood coagulation index and the chemotherapeutic efficacy were analyzed.Results The levels of fibrinogen （Fib）,platelet count （PLT） after chemotherapy were significantly higher than those before chemotherapy [（3.42 ±0.50） g/L vs.（2.44 ±0.46） g/L,（267.83 ±61.34） × 109/L vs.（174.18 ±48.65） × 109/L] （P 〈 0.01）,D-dimer （D-D） was significantly lower than that before chemotherapy [（176.32 ± 101.41） mg/L vs.（214.55 ± 106.34） mg/L] （P 〈 0.01）.The remaining indicators before and after chemotherapy had no significant differences （P 〉 0.05）.The level of D-D in 68 cases was reduced after chemotherapy,the effective chemotherapy in 53 cases （77.9%,53/68）,ineffective in 15 cases （22.1%,15/68）;the level of D-D in 22 cases was increased after chemotherapy,the effective chemotherapy in 9 cases （40.9%,9/22）,ineffective in 13 cases （59.1%,13/22）,the difference was statistically significant （P=0.000）.The level of PLT in 10 cases was reduced after chemotherapy,the effective chemotherapy in 3 cases（3/10）,ineffective in 7 cases （7/10）;the level of PLT in 80 cases was increased after chemotherapy,the effective chemotherapy in 59 cases （73.8%,59/80）,ineffective in 21 cases （26.3%,21/80）,the difference was statistically significant （P=0.044）.Conclusions The Fib and PLT increase while the D-D decreases after chemotherapy,so it is necessary to monitor Fib,PLT,D-D level during chemotherapy.The D-D and PLT are effective indexes in evaluating curative effect of neoadjuvant chemotherapy in patients with breast cancer.

关 键 词：乳腺肿瘤 新辅助化疗 凝血相关指标 

分 类 号：R737.9[医药卫生—肿瘤]