化疗对浸润性乳腺癌凝血功能的影响及其与分子特性的关系  

Effects of Chemotherapy on Coagulation in Invasive Breast Cancer and Its Relationship with Molecular Properties

作　　者：万玉秋[1] 兰晶[1] 周晔辉[1] 王璋瑜[1] 江志鸿 李雪娇 谢芳[2] WAN Yu-qiu;LAN Jing;ZHOU Ye-hui;WANG Zhang-yu;JIANG Zhi-hong;LIXue-jiao;XIE Fang(Department of General Surgery,the First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China;Department of Pathology,Medical College of Soochow University,Suzhou,Jiangsu,215123,China)

机构地区：[1]苏州大学附属第一医院普外科,江苏苏州215006 [2]苏州大学病理系,江苏苏州215123

出　　处：《中国血液流变学杂志》2019年第1期71-74,83,共5页Chinese Journal of Hemorheology

摘　　要：目的 探讨浸润性乳腺癌患者术前及化疗前后机体的凝血功能的改变,与肿瘤分期、分子分型的相关性.方法 回顾性研究分析40 例乳腺纤维瘤,101 例浸润性乳腺癌患者手术、化疗对凝血功能指标变化的影响.结果 (1)浸润性乳腺癌患者APTT与TT较纤维瘤缩短,差异具有统计学意义(P<0.05).(2)浸润性乳腺癌手术后PT、APTT、AT-Ⅲ、INR、FiB均较手术前延长,差异具有统计学意义(P<0.05).(3)浸润性乳腺癌化疗后AT-Ⅲ、TT较化疗前缩短,差异具有统计学意义(P<0.05).(4)不同分子分型的浸润性乳腺癌的凝血功能对化疗反应不一.(5)浸润性乳腺癌Ⅰ期、Ⅱ期及Ⅲ期的AT-Ⅲ和TT均在化疗后缩短,而Ⅰ期患者APTT在化疗后较化疗前延长,差异具有统计学意义(P<0.05).(6)Ki-67高表达组AT-Ⅲ和TT在化疗后比化疗前缩短,APTT在化疗后比化疗前延长(P<0.05);中表达组AT-Ⅲ和TT化疗后比化疗前缩短,差异具有统计学意义(P<0.05);低表达组INR化疗后比化疗前缩短,差异具有统计学意义(P<0.05).结论 乳腺癌患者易出现血凝异常,肿瘤负荷消除后,凝血功能可得到改善,化疗能促进机体高凝状态,特别是具有高复发转移风险的患者.Objective To investigate the changes of coagulation function in breast cancer patients before surgery, before chemotherapy and after chemotherapy, and the correlation with tumor stage and molecular typing. Methods 40 cases of breast fibroma and 101 cases of invasive breast cancer were selected to monitor the effects of surgery and chemotherapy on the changes of coagulation function. Results (1)The APTT and TT of invasive breast cancer were shorter than those of breast fibroma (P<0.05). (2)After surgical treatment, the PT, APTT, AT-Ⅲ, INR and FiB were extended than before surgery (P<0.05). (3)Chemotherapy improved blood coagulation function, and the AT-Ⅲand TT were shortened after chemotherapy (P<0.05). (4)Different molecular classification of breast cancer had different response of chemotherapy to coagulation function. (5)AT-Ⅲ and TT of stageⅠ, stage Ⅱ and stage Ⅲ were shortened, and the APTT of stageⅠwas extended after chemotherapy (P<0.05). (6) After chemotherapy, the AT-Ⅲ and TT were shortened, APTT was extended in Ki-67 high expression group (P<0.05), AT-Ⅲ and TT were shortened in moderate expression group (P<0.05), while INR was shortened in low expression group (P<0.05). Conclusion Breast cancer patients are prone to abnormal blood coagulation, and the coagulation function can be improved after the elimination of tumor burden. Chemotherapy can promote the hypercoagulation state of the body, especially in patients with high risk of recurrence and metastasis.

关 键 词：浸润性乳腺癌 化疗 凝血功能 KI-67 

分 类 号：R737.9[医药卫生—肿瘤] R730.5[医药卫生—临床医学]