凝血指标及中性粒细胞与淋巴细胞比值在卵巢癌患者凝血状态评估中的应用价值  

Application value of coagulation indices and neutrophil-to-lymphocyte ratio for assessing coagulation status of ovarian cancer patients

作　　者：张瑞 白鑫 李霞[2] 贺鹭 王静芳 Zhang Rui;Bai Xin;Li Xia;He Lu;Wang Jingfang(Department of Social Medicine Teaching and Research,School of Public Health,Shanxi Medical University,Taiyuan 030001,China;Department of Obstetrics and Gynecology,the Second Hospital of Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学公共卫生学院社会医学教研室,太原030001 [2]山西医科大学第二医院妇产科,太原030001

出　　处：《肿瘤研究与临床》2023年第11期840-844,共5页Cancer Research and Clinic

基　　金：山西省自然科学基金(201901D111364);山西省科技合作交流专项(202104041101006)。

摘　　要：目的探讨一般凝血指标、中性粒细胞与淋巴细胞比值(NLR)在卵巢癌患者凝血状态评估中的临床应用价值。方法回顾性分析2019年10月至2022年9月山西医科大学第二医院收治的190例卵巢癌患者资料,按照国际妇产科联盟(FIGO)分期分为早期(Ⅰ~Ⅱ期)卵巢癌组(70例)和晚期(Ⅲ~Ⅳ期)卵巢癌组(120例);选取同期在山西医科大学第二医院治疗的44例良性卵巢肿瘤者。检测血浆D-二聚体(D-D)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(FIB)、凝血酶时间(TT),同时采用血细胞分析仪测定血小板计数(Plt)、中性粒细胞计数和淋巴细胞计数,并计算NLR。采用受试者工作特征(ROC)曲线分析凝血指标及NLR对卵巢癌患者出现静脉血栓栓塞(VTE)的评估价值。结果与良性卵巢肿瘤组比较,早期和晚期卵巢癌组患者的PT均缩短(均P<0.05),D-D、Plt均增高(均P<0.05)。与良性卵巢肿瘤组比较,晚期卵巢癌组患者TT缩短(P<0.05),FIB、NLR增高(均P<0.05)。与早期卵巢癌组比较,晚期卵巢癌组PT和TT缩短(均P<0.05),FIB、D-D、NLR和Plt均增高(均P<0.05)。卵巢癌组出现VTE的Ⅰ~Ⅱ期、Ⅲ~Ⅳ期患者的FIB、D-D和NLR最佳临界值分别为3.165、333.500、2.455,曲线下面积(AUC)分别为0.731、0.837、0.759。结论卵巢癌患者在治疗期间凝血指标存在异常,提示可能产生活动性血栓,晚期患者症状更为严重。Objective To explore the clinical application value of general coagulation indices and neutrophil-to-lymphocyte ratio(NLR)for assessing coagulation status of patients with ovarian cancer.Methods The data of 190 patients with ovarian cancer who were admitted to the Second Hospital of Shanxi Medical University from October 2019 to September 2022 were retrospectively analyzed.According to the International Federation of Gynecology and Obstetrics(FIGO)staging,the patients were divided into early(stageⅠ-Ⅱ)ovarian cancer group(70 cases)and advanced(stageⅢ-Ⅳ)ovarian cancer group(120 cases).Forty-four patients with benign ovarian tumors who were treated in the Second Hospital of Shanxi Medical University during the same period were selected.Plasma D-dimer(D-D),activated partial thromboplastin time(APTT),prothrombin time(PT),fibrinogen(FIB)and thrombin time(TT)were tested.Platelet count(Plt),neutrophil count and lymphocyte count were measured by blood cell analyzer,and NLR was calculated.The receiver operating characteristic(ROC)curve was used to analyze the value of coagulation indices and NLR in the assessment of venous thromboembolism(VTE)in patients with ovarian cancer.Results Compared with the benign ovarian tumor group,PT of patients in the early and advanced ovarian cancer groups was shorter(both P<0.05),and D-D and Plt increased(both P<0.05).Compared with the benign ovarian tumors group,TT of patients in the advanced ovarian cancer group decreased(P<0.05),and FIB and NLR increased(both P<0.05).Compared with the early ovarian cancer group,PT and TT in the advanced ovarian cancer group were shorter(both P<0.05),and FIB,D-D,NLR and Plt increased(all P<0.05).The optimal cut-off values of FIB,D-D and NLR in stageⅠ-Ⅱand stageⅢ-Ⅳpatients with VTE in ovarian cancer group were 3.165,333.500 and 2.455,and the area under the curve(AUC)was 0.731,0.837 and 0.759.Conclusions The coagulation indices of patients with ovarian cancer are abnormal during treatment,suggesting that patients may produce active thrombosi

关 键 词：卵巢肿瘤 凝血酶原时间 部分促凝血酶原时间 中性粒细胞与淋巴细胞比值 

分 类 号：R737.31[医药卫生—肿瘤]