凝血功能相关检测指标在非小细胞肺癌患者中的预后价值  

Value of coagulation function related indicators in the prognosis of non-small cell lung cancer

作　　者：马云飞[1] 于明薇[1] 李光达 高宇 杨国旺[1] 王笑民[1] Ma Yunfei;Yu Mingwei;Li Guangda;Gao Yu;Yang Guowang;Wang Xiaomin(Department of Oncology,Beijing Hospital of Traditional Chinese Medicine,Affiliated of Capital Medical University,Beijing 100010,China;Graduate School of Beijing University of Traditional Chinese Medicine,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京中医医院肿瘤科,北京100010 [2]北京中医药大学研究生院,北京100029

出　　处：《中华检验医学杂志》2021年第3期212-216,共5页Chinese Journal of Laboratory Medicine

基　　金：国家自然科学基金(81473643);北京市自然科学基金(7202065);国家“十三五”重大新药创制专项课题(2019ZX09734001);北京市医管局培育计划(PZ2018013)。

摘　　要：目的探讨凝血功能相关检测指标在非小细胞肺癌中预后的临床意义,为非小细胞肺癌患者的预后提供参考依据。方法回顾性分析首都医科大学附属北京中医医院肿瘤科2014年6月至2017年12月248例非小细胞肺癌患者的临床资料,采用受试者工作特征(ROC)曲线确定D-二聚体(D-D)、纤维蛋白原(FIB)、凝血酶原时间(PT)的阈值,Cox回归模型进行多因素分析,Kaplan-Meier方法进行生存分析。结果ROC曲线分析显示,D-D最佳临界值为0.18 mg/L,FIB最佳临界值为4.25 g/L,PT最佳临界值为12.0 s;Cox多因素回归分析发现,D-D(HR=1.197,95%CI 1.100~1.303)、PT(HR=1.111,95%CI 1.049~1.176)及FIB(HR=1.510,95%CI 1.276~1.788)的表达升高是影响非小细胞肺癌预后生存的危险因素(P均<0.001);Kaplan-Meier生存分析结果表明,D-D、FIB、PT高表达患者的生存期明显低于低表达患者(P均<0.001)。结论D-D、PT以及FIB对非小细胞肺癌预后有一定的临床意义,是其预后的独立影响因素。Objective To investigate the clinical significance of coagulation function related indicators in the prognosis of non-small cell lung cancer.Methods The clinical data of 248 patients with non-small cell lung cancer from June 2014 to December 2017 in the Department of Oncology,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,were retrospectively analyzed.The receiver operating characteristic(ROC)curve was used to determine the best cutoff values of prognostic indicators,the Cox regression model was used for multivariate analysis,and the Kaplan-Meier method was used for survival analysis.Results ROC curve analysis showed that the best cutoff values for D-dimer(D-D),fibrinogen(FIB)and prothrombin time(PT)were 0.18 mg/L,4.25 g/L and 12.0 s,respectively.Cox multivariate regression analysis showed that increased expression of D-D(HR=1.197,95%CI 1.100-1.303),PT(HR=1.111,95%CI 1.049-1.176)and FIB(HR=1.510,95%CI 1.276-1.788)were risk factors for the prognosis of non-small cell lung cancer(P<0.001).Kaplan-Meier survival analysis results showed that the overall survival in the high expression group of D-D,FIB and PT was shorter than in of the low expression group(P<0.001).Conclusion D-D,PT and FIB are independent factors affecting the prognosis of non-small cell lung cancer.

关 键 词：癌 非小细胞肺 凝血功能 D-二聚体 凝血酶原时间 纤维蛋白原 预后 

分 类 号：R734.2[医药卫生—肿瘤]