消化道恶性肿瘤患者血栓前状态标志物的检测及临床意义

Clinical Significance of Prethrombotic State in Patients with Malignant Tumors of Digestive Tract

目的:通过检测消化道恶性肿瘤患者血小板参数及血管性血友病因子(vWF)、纤维蛋白原(Fb)、血栓前体蛋白(TpP)、D-二聚体(D-D)的水平,探讨其临床意义。方法:选取100例消化道恶性肿瘤患者、50例良性消化道疾病患者(对照组),测定其血小板参数、vWF、Fb、TpP、D-D的水平,并对结果进行分析和比较。结果:胃癌、食管癌、肝癌、肠癌患者血液血小板参数、vWF、Fb、TpP、D-D水平显著高于对照组(P<0.05);消化道恶性肿瘤患者各组之间比较,上述指标无明显差异(P>0.05);淋巴结转移者血小板参数、vWF、Fb、TpP、D-D水平显著高于未淋巴结转移者(P<0.05)。结论:消化道恶性肿瘤患者存在明显的血栓前状态,表现为继发性纤溶亢进,血小板活性增加及血管内皮细胞损伤,可能影响着消化道恶性肿瘤的转移和预后。

Objective To explore the change of Platelet parameters, von-Willebrand factor（vWF）, Fibrinogen （Fb）, thrombus precursor protein（TpP ）and D-dimer（ D-D ） in patients with malignant tumors of digestive trace and its clinical relevances. Methods To detect the platelet parameters, vWF, Fb, TpP and D-D levels in 100 cases of digestive tract tumor patients, 50 cases of patients with benign diseases of the digestive tract（control group） and the results were compared. Results The levels of platelet parameters, vWF, Fb, TpP and D-D in patients with gastric cancer, esophageal cancer, liver cancer and colorectal cancer were significantly higher than those of control group （P 〈 0.05）. In those indicators, there is no substantiae difference between those groups of patients with gas- trointestinal cancer （P 〉 0.05 ）. The levels of platelet parameters, vWF, Fb, TpP and D-D in lymph node metastasis group were obvi- ously higher than those without lymph node metastasis （P 〈 0.05）. Conclusion PTS exist in patients with tumors of digestive tract, manifested as secondary fibrinolysis, provide a boost to platelet activity and vascular endothelial cell injury. It might be affect the metastases and prognosis with digestive tract tumors.