恶性肿瘤患者凝血功能相关指标与其临床特征关系的研究

The relationship between coagulation function indicators of cancer patients and their clinical features

目的探讨不同类型的恶性肿瘤患者凝血功能与其肿瘤分期、淋巴结转移的关系。方法选取2010年1月至2014年12月于该院住院的恶性肿瘤患者135例,选取同期于本院体检且合格的健康者57例纳入对照组。检测恶性肿瘤患者及对照组人群凝血酶原时间（PT）、凝血酶凝固时间（TT）、活化部分凝血活酶时间（APTT）、D-二聚体、纤维蛋白原（FIB）水平,并对不同肿瘤分期、不同淋巴结转移情况的同类型恶性肿瘤患者的凝血功能相关指标进行比较和分析。结果与对照组比较,恶性肿瘤患者PT、APTT缩短,D-二聚体及FIB水平升高（P〈0.05）。食管癌、乳腺癌、胃癌患者PT、TT、APTT较肺癌组延长,D-二聚体及FIB水平较肺癌组降低（P〈0.05）。恶性肿瘤（肺癌、食管癌、乳腺癌、胃癌）患者Ⅲ～Ⅳ期PT、TT、APTT缩短,而D-二聚体、FIB水平升高（P〈0.05）。有淋巴结转移的恶性肿瘤患者较无淋巴结转移者PT、TT、APTT缩短,FIB水平增高（P〈0.05）。结论恶性肿瘤患者血液存在高凝状态。不同临床分期、淋巴结转移情况不同的恶性肿瘤患者凝血功能也有差异,凝血功能的异常有可能参与了肿瘤的进展和转移。

Objective To investigate the relationship between the clinical features of patients with different cancer and their clin‐icalstage,lymphnodemetastasissituation.Methods 135cancerpatientsdiagnosedandtreatedinthehospitalfromJanuary2010to December 2014 were enrolled in the study ,in addition to that ,57 people who underwent healthy examination in the hospital and proved to be healthy were also recruited as control group .Prothrombin time（PT） ,thrombin clotting time（TT） ,activated partial thromboplastin time（APTT） ,D‐dimer ,fibrinogen（FIB） were tested for the people mentioned above .Results The level of routine coagulation indicators were statistically significant different between people with different types of cancers and control group（P〈0 .05） .Compared with the control group ,PT ,APTT of the cancer patients significantly shortened ,FIB ,D‐dimer levels were signifi‐cantly increased（P〈0 .05） .PT ,APTT was prolonged in lung cancer ,esophageal cancer ,breast cancer ,stomach cancer compared with lung cancer ,FIB ,D‐dimer decreased compared with other malignancies（P〈0 .05） .PT ,APTT was decreased and D‐dimer ,FIB was significantly increased in cancer（lung ,esophagus ,breast ,stomach） with Ⅲ‐Ⅳ stage or lymph node metastasis than Ⅰ‐Ⅱstage or non‐lymph node metastasis ,the difference was statistically significant（P〈0 .05） .Conclusion The malignant tumors were with hypercoagulable state ,there are differences in coagulation in different clinical stages ,lymph node metastasis .