肿瘤患者凝血及纤溶分子标志物的变化

Variation of coagulation and fibrinolytic molecular markers in tumor patients

目的：探讨肿瘤患者凝血及纤溶分子标志物的变化情况。方法：正常对照组35例，子宫肌瘤组18例，恶性肿瘤组86例，其中肺癌19例，食管癌19例，胃癌22例，结直肠癌26例。采用双抗体夹心酶免疫法（ELISA）检测患者凝血及纤溶分子的血浆含量，并进行比较。结果：与正常对照组比较，各种恶性肿瘤术前组织因子（TF）、凝血酶-抗凝血酶复合物（TAT）、尿激酶型纤溶酶原激活物（u-PA）、尿激酶型纤溶酶原激活物受体（u-PAR）和纤溶酶-抗纤溶酶复合物（PAP）的血浆含量显著升高，差异均有统计学意义（P〈0．05～0．01），组织因子途径抑制物（TFPI）水平与正常对照组比较差异无统计学意义；术后恶性肿瘤组TF、TAT、u-PAR及PAP水平有所下降，但仍高于正常对照组；子宫肌瘤组术前各指标与正常对照组比较，差异无统计学意义。结论：恶性肿瘤存在明显的凝血、纤溶激活状态。TF、TAT、u-PA、u-PAR及PAP可以作为良、恶性肿瘤鉴别的辅助指标，u-PA、u-PAR可以作为判断预后的指标。

Objective： To investigate the variation of coagulation and fibrinolytic molecular markers in tumor patients. Methods： The plasma levels of tissue factor （TF） and its inhibitor （TFPI）, thrombin-antithrombin complex （TAT）, urokinase-type plasminogen activator （u-PA） and its receptor （u-PAR）, as well as plasmin-antiplasmin complex （PAP）, were measured using ELISA in 18 patients with hysteromyoma and 86 patients with malignant tumors including lung cancer 19, esophageal cancer 19, gastric cancer 22, and colorectal carcinoma 26. Results： Compared to normal controls, the level of TF, TAT, u-PA, u-PAR, and PAP in group of malignant tumor were significantly higher （P 〈0.05）. The level of TFPI has no difference between them. However, all these parameters did not vary in patients with uterus myoma. Conclusion： Activation of coagulation and fibrinolysis existed in patients with malignant tumor. TF, TAT, u- PA and u-PAR might also be clinical useful markers for tumor determination and u-PA and u-PAR for tumor prognosis.