肺癌根治术患者手术前后血小板数量、比积和分布宽度的变化及临床意义

Changes and clinical significance of platelet count,platelet specific volume and platelet distribution width in patients with lung cancer before and after radical operation

目的探讨肺癌根治术前、后病患血小板数量(PLT)、血小板比积(PCT)以及血小板分布宽度(PDW)水平变化,并分析其临床意义。方法选择接受肺癌根治术患者73例,根据肺癌TMN分为ⅠA患者为IA组(n=41),ⅠB患者设为IB组(n=32);另选取同期进行健康体检的志愿者设为对照组(n=50)。术后7 d后,研究者测定受试者外周血中的血小板相关指标:包括血小板数量(PLT)、血小板比积(PCT)以及血小板分布宽度(PDW)。随访5年,频率为0.5年1次,统计患者的生存期限并测量其KPS评分,取其生存期限内的KPS评分的平均值。结果肺癌患者的PLT、PCT以及PDW水平高于对照组(P<0.05)。术后,ⅠA组和ⅠB组的PLT、PCT以及PDW水平均显著高于对照组(P<0.05)。小细胞癌患者的PLT、PCT水平相对较高,大细胞癌患者的PDW水平相对较高(P<0.05)。ⅠA组的手术时间及术后并发症例数少于ⅠB的患者,而手术中清除得到的淋巴结数目多于ⅠB病患,差异均有统计学意义(P<0.05)。结论采用常规根治术治疗肺癌能有效改变病患血小板指标,其中PLT、PCT以及PDW都有明显的降低。

Objective To observe the changes of platelet count （PLT）, platelet specific volume （PCT） and platelet distribution width （ PDW） in patients with lung cancer before and after radical operation , and to explore its clinical significance.Methods Seventy-three patients with lung cancer who received radical operation were divided into IA group （n =41） and IB group （n =32） according to TMN,moreover, 50 healthy subjects were served as control group .On 7 days after surgery,the platelet related parameters in peripheral blood were detected ,including PLT,PCT and PDW.All the subjects were followed up for 5 years,with the frequency being once in 6 months.The survival duration and KPS scores of patients were statistically analyzed.Results The levels of PLT,PCT and PDW in patients with lung cancer were higher than those in control group.After operation,the levels of PCT,PLT and PDW in IA group and IB group were significantly higher than those in control group （ P 〈0.05）.The levels of PLT and PCT in patients with small cell carcinoma were relatively higher ,however, the levels of PDW in patients with large cell carcinoma were relatively higher （ P 〈0.05）.The operation duration and the cases with postoperative complications in IA group were fewer than those in IB group ,however, the lymph nodes removed during operation in IA group were more than those in IB group （ P 〈0.05）.Conclusion The conventional radical operation in treatment of lung cancer can effectively change platelet indexes ,in which PLT,PCT and PDW are obviously decreased.