胃腺癌患者凝血指标与临床病理特征相关性分析

The related analysis between coagulation index in peripheral blood and clinicopathological characteristics in pre-operative patients with gastric adenocarcinoma

目的探讨胃腺癌患者术前四项凝血功能指标检测值与临床病理学方面的相关性。方法回顾性分析84例胃腺癌患者术前凝血酶原时间(PT)、部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)值。结果 APTT在不同年龄组间有统计学差异,低年龄段胃腺癌APTT较高年龄者延长,而TT较后者缩短(P<0.05)。TT在III期胃腺癌较I^II期缩短(P<0.05)。FIB在高年龄组、高分期、肿瘤范围≥5cm、淋巴结转移数>2枚者要高于低年龄组、低分期、肿瘤范围<5cm、淋巴结转移数0~2枚者(P<0.05)。其余凝血指标在年龄、性别、组织学分级、肿瘤大小、淋巴结阴阳性方面差异无统计学意义(P>0.05)。结论不同年龄组胃癌患者APTT、TT、FIB不同,提示在研究胃癌凝血功能时要对不同年龄组进行分析。胃癌患者凝血功能紊乱,特别是恶性程度高的胃腺癌患者FIB升高,提示FIB可作为监测胃癌恶性程度的指标。

Objective To explore the relationship among the four coagulation indexes and clinicopathological characteristics in pre-operative patients with gastric adenocarcinoma. Methods Prothrombin time（PT）, activated partial thromboplastin time （APTF）, fibrinogen （FIB） and thrombin time （TT） in 84 cases of patients with gastric adenocarcinoma were retrospectively statisted. Results APTT in different age groups was statistically different（ P 〈 0. 05 ）. APTT of low age group is lengthened than that of higher age group, while TT shortened than the latter one. TT in stage Ⅲ is shortened than that in stage Ⅰ-Ⅱ （P 〈 0. 05 ）. There were significant differences in the expression of FIB in age , tumor stage, tumor size and lymph node metastasis. The levels of FIB in high age, high stage, the invasive length≥5cm group, cases with more than 2 lymph node metastasis are higher than that of low age, low stage, the invasive length 〈 5cm group, cases with 0-2 positive lymph nodes （P 〈 0. 05 ）. There is no statistical difference in the rest coagulation indexes in age, gender, histological grade, tumor size, positive and negative lymph node metastasis （P 〉 0.05）. Conclusions Patients with gastric cancer in different age have different level of APTT, tit and FIB. In view of this, it is neccessary to divide the patients into two groups in other research , and study the differences respectively. Patients with gastric cancer have coagulation disorders, especially the adenocarcinoma with high malignant degree, which suggests that FIB can be used as an index monitoring gastric malignant degree.