妇科恶性肿瘤患者凝血功能及D-二聚体水平变化及意义

Changes of blood coagulation function and D-dimer in patients with malignant gynecologic tumor and its significance

目的探讨妇科恶性肿瘤患者的凝血功能及D-二聚体水平变化及临床意义。方法妇科恶性肿瘤患者228例为恶性肿瘤组,其中子宫内膜癌51例,宫颈癌93例,卵巢癌84例;TNM分期Ⅰ～Ⅱ期148例,Ⅲ～Ⅳ期80例;同期体检健康女性200例为对照组。检测并比较2组凝血酶原时间（prothrombin time,PT）、凝血活酶时间（activated partial thromboplasin time,APTT）、纤维蛋白原（fibrinogen,Fib）、凝血酶时间（thrombin time,TT）、血小板计数（blood platelet,PLT）及D-二聚体水平;观察不同临床分期和不同类型肿瘤患者凝血功能及D-二聚体水平差异。结果恶性肿瘤组PLT[（240.71±104.92）×10^9/L]、Fib[（2.91±0.96）g/L]、D-二聚体[（2.06±1.45）mg/L]水平高于对照组[（192.35±59.96）×10^9/L、（2.69±0.54）g/L、（0.59±0.32）mg/L],APTT[（30.49±5.44）s]长于对照组[（30.07±4.33）s]（P〈0.05）,2组PT、TT比较差异无统计学意义（P〉0.05）;Ⅲ～Ⅳ期恶性肿瘤患者PLT[（285.88±127.77）×10^9/L]、D-二聚体[（2.68±2.33）mg/L]高于Ⅰ～Ⅱ期患者[（216.30±80.72）×10^9/L、（1.67±0.15）mg/L]（P〈0.05）;卵巢癌患者D-二聚体水平[（3.26±2.63）mg/L]高于子宫内膜癌患者[（0.55±0.23）mg/L]和宫颈癌患者[（0.51±0.16）mg/L]（P〈0.05）。结论部分凝血指标及D-二聚体水平对妇科恶性肿瘤的诊断、分期及预后评估有一定价值。

Objective To explore the changes of blood coagulation function and D-dimer in patients with malignant gynecologic tumors and its clinical significance.Methods Totally 228 patients with malignant gynecologic tumors（cancer group）included 51 patients with endometrial carcinoma,93 patients with cervical carcinoma and 84 patients with ovarian carcinoma,in which 148 patients were in stageⅠtoⅡand 80 patients in stageⅢtoⅣ.Another 200 healthy volunteers were as controls（control group）.The levels of prothrombin time（PT）,activated partial thromboplasin time（APTT）,fibrinogen（Fib）,thrombin time（TT）,blood platelet（PLT）and D-dimer were detected and compared between two groups to observe the differences of blood coagulation function and D-dimer in different stages and tumors types.Results The levels of PLT（（240.71±104.92）×10^9/L）,Fib（（2.91±0.96）g/L）and D-dimer（（2.06±1.45）mg/L）were significantly higher and APTT（（30.49±5.44）s）was significantly longer in cancer group than those in control group（（192.35±59.96）×10^9/L,（2.69±0.54）g/L,（0.59±0.32）mg/L,（30.07±4.33）s）（P〈0.05）,and there were no significant differences in the levels of PT and TT between two groups（P〈0.05）.The levels of PLT（（285.88±127.77）×10^9/L）and D-dimer（（2.68±2.33）mg/L）in stageⅢtoⅣ were significantly higher than those in stageⅠtoⅡ（（216.3±80.72）×109/L,（1.67±0.15）mg/L）（P〈0.05）.The level of D-dimer in patients with ovarian cancer（（3.26±2.63）mg/L）was significantly higher than that in patients with endometrial carcinoma（（0.55±0.23）mg/L）and in patients with cervical carcinoma（（0.51±0.16）mg/L）（P〈0.05）.Conclusion Some blood coagulation indexes and D-dimer have certain values to the diagnosis,staging and prognosis of malignant gynecologic tumors.