中晚期食管癌患者血浆PAI-1水平及其临床意义

Level of plasma PAI-1 in patients with advanced esophageal carcinoma and its significance

目的探讨中晚期食管癌患者血浆纤溶酶原激活物抑制剂-1(PAI-1)的水平及其临床意义。方法收集2016年10月至2017年6月中晚期食管癌患者30例作为食管癌组,同时收集健康体检者20例作为对照组。检测两组血浆PAI-1水平,同时检测血小板(PLT)、纤维蛋白原(FIB)和D-二聚体(D-D)的水平,分析上述指标与食管癌临床病理特征的关系。结果食管癌组血浆PAI-1水平为(1.50±0.31)ng/ml,高于对照组的(0.87±0.22)ng/ml(P<0.05);血浆PLT水平为(285.13±62.50)×10~9/L,高于对照组的(190.60±36.61)×10~9/L(P<0.05);血浆FIB水平为(3.82±0.81)g/L,高于对照组的(2.91±0.48)g/L(P<0.05);血浆D-D水平为(1.70±0.39)μg/ml,高于对照组的(0.23±0.14)μg/ml(P<0.05)。PAI-1、PLT、FIB水平与血栓史、淋巴结转移和远处转移有关(P<0.05);D-D水平与血栓史有关(P<0.05)。食管癌患者血浆PAI-1水平与PLT、FIB和D-D水平均呈正相关(r值分别为0.683、0.499、0.417,P均<0.05),血浆PLT水平与FIB、D-D水平呈正相关(r值分别为0.644、0.472,P均<0.01),血浆FIB水平与D-D水平呈正相关(r=0.375,P<0.05)。结论中晚期食管癌患者存在高凝状态,有血栓史及转移的患者更易出现高凝状态。

Objective To investigate the level of plasma plasminogen activator inhibitor-1（ PAI-1） in patients with advanced esophageal carcinoma and its clinical significance. Methods Thirty patients with advanced esophageal carcinoma and 20 healthy control were enrolled in this study from October 2016 to June 2017. Plasma levels of PAI-1 and coagulation parameters including platelet（ PLT）,fibrinogen（ FIB） and D-dimer（ D-D） were compared between the two groups and the relationship between the above parameters and clinicopathological features of esophageal carcinoma was analyzed. Results The levels of plasma PAI-1,PLT,FIB and D-D were（ 1. 50±0. 31） ng/ml,（ 285. 13±62. 50） ×10~9/L,（ 3. 82±0. 81） g/L and（ 1. 70±0. 39） μg/ml in esophageal carcinoma group,higher than（ 0. 87±0. 22） ng/ml,（ 190. 60 ± 36. 61） × 10~9/L,（ 2. 91 ± 0. 48） g/L and（ 0. 23 ± 0. 14） μg/ml in control group（ P〈0. 05）. The level of plasma PAI-1,PLT,and FIB in patients with esophageal carcinoma were associated with history of thrombosis,lymph node metastasis and distant metastasis（ P〈0. 05）; the level of plasma D-D was associated with history of thrombosis（ P〈0. 05）.Plasma PAI-1 level was positively correlated with PLT,FIB,D-D levels in esophageal carcinoma（ r = 0. 683,0. 499,0. 417,P all0. 05）. Plasma PLT level was positively associated with FIB and D-D levels（ r = 0. 644,0. 472,P both0. 01）. Plasma FIB was positively correlated with D-D level（ r = 0. 375,P〈0. 05）. Conclusion There is hypercoagulable state in advanced esophageal carcinoma patients,and patients with thrombosis history and metastasis are more likely to develop hypercoagulable state.