肺癌术后血液高凝状态与外周血循环肿瘤细胞的关系  

Relationship between hypercoagulable state and peripheral blood circulating tumor cell after lung cancer surgery

作　　者：何小平[1] 李书平[1] 马瑞东[1] 王洪 陆宇海 HE Xiao-ping;LI Shu-ping;MA Rui-dong;WANG Hong;LU Yu-hai(Department of Cardiothoracic Surgery,the First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]成都医学院第一附属医院胸心外科

出　　处：《中国医学前沿杂志（电子版）》2019年第11期115-119,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨肺癌患者术后血液高凝状态与外周血循环肿瘤细胞(circulating tumor cell,CTC)的关系。方法回顾性分析本院胸心外科2013年1月至2015年1月收治的150例原发性肺癌且行手术治疗患者的临床资料,依据CTC检测结果是否为阳性,将患者分为CTC阳性组和CTC阴性组,比较两组患者临床资料和D-二聚体(D-dimer,D-D)、纤维蛋白原(fibrinogen,FIB)、血小板(platelet,PLT)等凝血指标;以患者死亡或随访截止日期为终点,依据患者是否死亡将其分为死亡组和存活组,分析影响肺癌术后患者预后的危险因素。结果CTC阳性组患者术后远处转移、术后淋巴结转移、TMN分期为Ⅲ期患者占比和D-D、FIB、PLT水平均显著高于CTC阴性组(均P<0.05);多因素Logistic回归分析结果显示,TMN分期为Ⅲ期、小细胞肺癌、CTC阳性均为影响肺癌术后患者预后的危险因素(均P<0.05)。结论血液高凝状态可促进肺癌术后患者远处转移,CTC是预测肿瘤远处转移的重要指标,影响患者预后。Objective To explore the relationship between postoperative hypercoagulable state and peripheral blood circulating tumor cell(CTC)in patients with lung cancer.Method The clinical data of 150 patients with primary lung cancer who underwent surgery from January 2013 to January 2015 in cardiothoracic surgery of our hospital were retrospectively analyzed.According to whether the CTC test results were positive or not,all patients were divided into CTC positive group and CTC negative group,and the clinical data and coagulation parameters of D-dimer(D-D),fibrinogen(FIB)and platelet(PLT)were compared between the two groups.Taken death or expiration date as the follow-up end point,the patients were divided into death group and survival group according to whether the patient died or not.The risk factors affecting prognosis in patients with lung cancer after surgery were analyzed.Result The proportions of patients with postoperative distant metastasis,postoperative lymph node metastasis and stage Ⅲ of TMN staging and levels of D-D,FIB and PLT in CTC positive group were higher than those in CTC negative group(all P<0.05).Multivariate Logistic regression analysis showed that stage Ⅲ of TMN staging,small cell lung cancer and CTC positive were risk factors influencing the prognosis of patients with lung cancer after surgery.Conclusion Hypercoagulable state can promote distant metastasis of patients with lung cancer after surgery.CTC is an important indicator for predicting tumor distant metastasis,and it affects the prognosis of patients.

关 键 词：肺癌 高凝状态 循环肿瘤细胞 

分 类 号：R73[医药卫生—肿瘤]