宫颈癌患者血栓相关的预后因素分析

Prognostic factors of thrombosis in patients with cervical cancer

目的探讨以凝血功能为主的危险因素对宫颈癌预后的影响,并进行分析。方法回顾性分析2014年6月至2016年6月在郑州大学附属肿瘤医院妇瘤科住院治疗的宫颈癌患者的一般临床资料,采用SPSS 22.0统计软件进行分析,Kaplan-Meier法计算生存率,Log-rank法检验比较各组生存差异,Cox模型行多因素预后分析。结果共纳入分析412例患者,其中血栓组患者47例,非血栓组患者365例,非血栓组患者生存率明显优于血栓组(P=0.002)。单因素分析显示,肿瘤分期(P<0.001)、Khorana评分(P=0.010)、D-二聚体(P<0.001)及APTT(P<0.001)与宫颈癌患者预后有关。多因素分析显示,肿瘤分期、Khorana评分、D-二聚体和APTT为影响患者生存的独立预后因素。死亡组患者D-二聚体(P<0.001)、APTT(P<0.001)和SCC(P=0.032)水平明显高于生存组。结论宫颈癌患者伴深静脉血栓形成预后不佳,可能与高水平D-二聚体、高水平APTT、高Khorana评分相关。

Objective To investigate the influence of coagulation-based risk factors on the prognosis of cervical cancer and to analyze the prognostic factors.Methods The clinical data of cervical cancer patients from June of 2014 to June of 2016 were analyzed by SPSS 22.0 statistical software.Kaplan-Meier method was used to calculate the survival rate of patients with cervical cancer.The survival difference of each group was compared by the Log-rank method, and the multivariate prognostic analysis was performed in the Cox model.Results A total of 412 patients were enrolled in this study, including 47 patients with thrombosis and 365 non-thrombotic patients.The mortality rate of non-thrombotic patients was higher than thrombotic patients （P=0.002〈0.001）.Univariate analysis showed that tumor stage（P〈0.001）, Khorana score （P=0.010）, D-dimer （P〈0.001） and APTT （P〈0.001） were related to the prognosis of cervical cancer patients.Multivariate regression analysis showed that tumor stage, Khorana score, D-dimer and APTT were independent prognostic factors.D-dimer（P〈0.001）, APTT （P〈0.001）, and SCC （P=0.032） in the death group were significantly higher than the survival group.Conclusion The prognosis of cervical cancer patients accompanied by deep vein thrombosis is poor, which may be related to high level of D-dimer, high level of APTT and high Khorana score.