可手术乳腺癌患者外周血循环肿瘤细胞阳性对围手术期凝血功能的影响  

Influence of tumor cell positive in peripheral blood circulation on perioperative coagulation function in operable breast cancer patients

作　　者：张成雷[1] ZHANG Chenglei(Five Departments of General Surgery,Thyroid and Breast Surgery Departments of Zhanjiang Central People's Hospital,Guangdong Zhanjiang 524000,China)

机构地区：[1]湛江中心人民医院普外五科甲状腺乳腺外科,广东湛江524000

出　　处：《临床普外科电子杂志》2023年第2期2-6,共5页Journal of General Surgery for Clinicians(Electronic Version)

基　　金：广东省医学科学技术研究基金项目(B2019116)。

摘　　要：目的分析可手术乳腺癌患者外周血循环肿瘤细胞(circulating tumor cell,CTC)阳性对围手术期凝血功能的影响。方法选择2019年7月至2020年3月湛江中心人民医院行手术治疗的80例乳腺癌患者,根据其外周血循环肿瘤细胞水平分为阳性组(术前CTC阳性)和阴性组(术前CTC阴性),分别在术前、术后第1天、术后第3天、术后第7天、术后第14天进行常规凝血功能指标和血栓弹力图检测,比较两组凝血功能、血栓弹力图检测结果。结果80例患者中CTC阳性12例,阳性检出率15.00%。阳性组与阴性组术前、术后不同时间纤维蛋白原、D-二聚体水平无显著差异(P>0.05)。阳性组患者凝血酶原时间、活化部分凝血酶时间、血栓弹力图反应时间及凝血时间显著短于阴性组,且血小板计数、血栓弹力图最大振幅、Angle角明显高于阴性组,差异均有显著性(P<0.05)。结论术前CTC阳性可手术乳腺癌患者围手术期存有凝血功能异常,有潜在深静脉血栓栓塞症发生风险。Objective To analyze the influence of positive circulating tumor cell(CTC)in peripheral blood of operable breast cancer patients on coagulation function in perioperative period.Method 80 cases of breast cancer patients who underwent surgical treatment in Zhanjiang Central People's Hospital from July 2019 to March 2020 were selected for the study.According to the level of tumor cells in their peripheral blood circulation,they were divided into positive group(preoperative CTC positive)and negative group(preoperative CTC negative).Before operation,on the 1st,3rd,7th and 14th day after operation,the patients were tested by routine coagulation function indexes and thromboelastogram.The results of coagulation function and thrombelastography were compared between the two groups.Result Among the 80 patients,12 were positive for CTC,with a positive detection rate of 15.00%.There were no significant difference in FIB and DD levels between positive group and negative group at different time before and after operation(P>0.05).The prothrombin time,activated partial thrombin time,thromboelastogram reaction time,and coagulation time in the positive group were significantly lower than those in the negative group,and the platelet count,thromboelastogram maximum amplitude,and Angle angle were significantly higher than those in the negative group,with significant differences(P<0.05).Conclusion Patients with operable breast cancer who have positive circulating tumor cells before operation have abnormal coagulation function during the perioperative period and have potential risk of deep vein thromboembolism.

关 键 词：乳腺癌手术 循环肿瘤细胞 凝血功能 相关性 

分 类 号：R73[医药卫生—肿瘤]