肺癌伴血小板增多患者的临床病理特征及与预后的关系  

Relationship between the clinical pathological features and prognosis of lung cancer with increased platelet count

作　　者：周文杰[1] 朱丽娜[1] 鲁露[1] 吴骏[1] 

机构地区：[1]江苏省常州市第一人民医院,江苏常州213003

出　　处：《现代中西医结合杂志》2015年第36期4017-4019,4035,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的分析肺癌伴血小板增多患者的临床病理特征及与预后的关系,为判断肺癌患者预后提供参考依据。方法以92例伴血小板增多肺癌患者为观察组,以105例血小板正常肺癌患者为对照组,分析2组临床病理特征及预后情况。结果 2组TNM分期、淋巴结转移、远处转移、吸烟史比较差异均有统计学意义(P均<0.05),而病理分型、分化程度、肿瘤标记物阳性率、饮酒史比较差异均无统计学意义(P均>0.05)。观察组血小板压积、D-二聚体及纤维蛋白原升高率明显高于对照组(P均<0.05),血小板平均体积、血小板分布宽度均明显低于对照组(P均<0.05)。2组凝血酶原时间、活化部分凝血酶原时间降低率比较差异均无统计学意义(P均>0.05)。观察组病死率明显高于对照组(P<0.05),最短总生存期、最长总生存期、中位生存时间均明显短于对照组(P均<0.05)。Cox回归模型分析结果示,存在淋巴结转移、存在远处转移、血小板计数≥400×109L-1均为影响患者生存时间的危险因素(P均<0.05),血小板计数≥400×109L-1的肺癌患者死亡风险是血小板计数正常患者的1.009倍。结论肺癌患者血小板增多与肿瘤的发生发展及转移有密切关系,是预后不良的重要参考指标。Objective It is to observe the relationship between the pathological features and prognosis of lung cancer with thrombocytosis,and provide a reference for the prognosis judgment of the patients with lung cancer. Methods 92 patients with lung cancer and thrombocytosis were included in the observe group,while 105 cases patients with lung cancer were included in the control group,the difference of the pathological characteristics and prognosis influence of the both groups were analyzed.Results There were significant difference in TNM stage,lymph node metastasis,distant metastasis and smoking history between the two groups（ all P 〈 0. 05）,but was not significant difference in the pathological type,differentiation,tumor markers,alcohol history（ all P 〉 0. 05）. There were significant difference in platelet hematocrit,mean platelet volume,platelet distribution width,D- dimer,fibrinogen between the two groups（ all P 〈 0. 05）,but was no significant difference in prothrombin time and activated partial prothrombin time（ all P 〉 0. 05）. The Mortality of the observed group was markedly higher than that of the control group（ P 〈 0. 05）,the shortest overall survival,the longest overall survival and the median survival time of the study group were markedly shorter than those of the control group（ all P 〈 0. 05）. The results of Cox regression model analysis showed,lymph node metastasis,distant metastasis,Plt ≥ 400 × 109L- 1were the risk factors for the survival time of patients（ all P 〈 0. 05）,the risk of death of the lung cancer patients with Plt ≥ 400 × 109L- 1was 1. 009 times to other patients with lung cancer. Conclusion The thrombocytosis of lung cancer patients had a closely relationship with the increasing of tumor staging,tumor progression and metastasis ability,it’s the important reference index for poor prognosis.

关 键 词：肺癌 血小板增多 病理特征 预后 

分 类 号：R734.2[医药卫生—肿瘤]