血小板计数与纤维蛋白原水平及其与临床病理特征的相关性研究

Study on the relationship between platelet counts and fibrinogen level and its clinicopathological characteristics

目的探讨接受根治性切除的直肠癌患者术前血浆中血小板(PLT)计数及纤维蛋白原(FIB)水平与其临床病理特征关系。方法选择2011年1月至2014年2月在该院接受根治性手术具备完整临床病历资料的直肠癌患者302例,检测PLT计数及FIB水平并进行比较。结果 (1)直肠癌患者中术前PLT计数与肿瘤组织学类型、大体类型、分化程度、浸润深度、分期、淋巴结转移相关(P<0.01),与性别、年龄、民族、肿瘤部位、肿瘤直径均无密切关系(P>0.05);(2)术前FIB水平与肿瘤分期、淋巴结转移相关(P<0.01),而与性别、年龄、民族、肿瘤部位、肿瘤直径、组织类型、大体类型、分化程度、浸润深度均无密切关系(P>0.05);(3)多因素Logistic回归分析显示,民族、分化程度、大体类型、PLT计数及FIB水平均为肿瘤转移的独立危险因素(P<0.01);(4)直肠癌转移组中PLT计数及FIB水平具有相关性(r=0.348),差异有统计学意义(P<0.01)。结论直肠癌患者PLT计数及FIB水平均与肿瘤转移相关,两指标联合检测对直肠癌转移的早期诊断具有重要意义。

Objective To explore the associations of preoperative plasma levels of platelet and fibrinogen with clinicopatho-logic parameters in rectal cancer patients after curative resection .Methods From January 2011 to February 2014 ,a total of 302 rec-tal cancer patients underwent curative resection .And their relevant clinical data were reviewed .The preoperative plasma levels of platelet and fibrinogen were examined ,the correlation of clinicopathologic findings .The logistic regression analysis was used for for multivariate analysis .Results （1）Elevated plasma levels of platelet were associated with histologic grade ,gross type ,degree of dif-ferentiation ,invasion depth ,tumor stage and lymph node involvement（P〈0 .01） .（2）Elevated plasma levels of fibrinogen were asso-ciated with tumor stage and lymph node involvement（P〈0 .01） ,but not with histologic grade ,gross type ,degree of differentiation , invasion depth（P〈0 .05） .（3）Multivariate analysis showed that the platelet count ,fibrinogen ,ethnic ,degree of differentiation ,gross type were independent risk factors to rectal cancer（P〈0 .01） .（3）PLT and FIB were correlated in tumor metastases（r=0 .348 ,P〈0 .01） ,and the combined detection of them could increase the sensitivity and accuracy on prediction of tumor metastases .Conclusion Elevated plasma levels of platelet and fibrinogen are both associated with metastases in rectal cancer ,and the combined detection of them are important for the early diagnosis of rectal cancer metastases .