食管癌患者凝血功能的变化及其与肿瘤进展的相关性研究  

Changes of coagulation function in patients with esophageal cancer and its correlation with tumor progression

作　　者：李泽亚[1] 王佳林[1] 冯维忠[1] 

机构地区：[1]四川省阆中市人民医院胸外科,四川阆中637400

出　　处：《吉林医学》2017年第11期2047-2050,共4页Jilin Medical Journal

摘　　要：目的:分析食管癌患者凝血功能的变化特点,探讨凝血指标的变化与肿瘤进展的相关性,为食管癌患者预后的预测及个体化治疗提供参考依据。方法:选取128例食管癌患者为研究组,并选取100例健康体检者作为对照组,比较研究组与对照组各项凝血指标的差异,再分析食管癌患者各项凝血指标与食管癌病理分期的相关性。结果:与对照组比较,研究组的血小板数目增加,PT缩短,APTT延长,Fib和D-二聚体水平升高,两组间的TT值差异无统计学意义,Fib水平与食管癌T分期呈正相关,D-二聚体水平与食管癌T分期呈正相关,Fib值与食管癌TNM分期呈正相关,D-二聚体值与食管癌TNM分期呈正相关,N1-N3期患者较N0期患者的D-二聚体水平升高,M1期患者较M0期患者的Fib和D-二聚体水平升高。结论:食管癌患者凝血功能存在异常,表现为凝血-抗凝-纤溶系统的紊乱,存在高凝状态和出血倾向。食管癌患者的血浆Fib和D-二聚体含量与食管癌的组织浸润、淋巴结转移及远处转移密切相关。Fib和D-二聚体有望成为预测患者预后的重要指标。因此,有必要密切监测食管癌患者的凝血指标,这对食管癌患者的预后评估、血栓相关疾病的防治及个体化治疗具有十分重要的意义。Objective To analyze the changes of coagulation function in patients with esophageal cancer,and to explore the correlation between the changes of coagulation parameters and the progression of esophageal cancer,so as to provide a reference for prognosis prediction and individual treatment of esophageal cancer patients. Method 128 patients with esophageal cancer treated were selected as the study group and 100 healthy subjects were selected as the control group to compare the difference of coagulation indexes between the study group and the control group,And to analyze the correlation between coagulation index and pathologic staging of esophageal carcinoma. Results Compared with the control group,the number of platelets in study group increased,PT was shortened,APTT was prolonged,Fib and D-dimer levels were increased,while TT between the two groups were not significantly different. Fib level and D-dimer level were positively related to T staging as well as TNM staging of esophageal cancer. N1-N3 patients had higher D-dimer levels compared to N0 patients. And M1 patients had higher levels of Fib and D-dimer compared to M0 patients. Conclusion Coagulation abnormalities are detected in patients with esophageal cancer,manifested as disorders of the coagulation-anticoagulation-fibrinolysis system with a hypercoagulable state and bleeding tendency. The levels of Fib and D-dimer in esophageal carcinoma are closely related to the infiltration of tumor,lymph node metastases and distant metastases. Fib and D-dimer may be important prognostic indicators for esophageal carcinoma patients. Therefore,it is necessary to closely monitor the coagulation functions of patients with esophageal cancer.

关 键 词：食管癌 凝血功能 肿瘤进展 D-二聚体 纤维蛋白原 

分 类 号：R735.1[医药卫生—肿瘤]