乳腺癌患者凝血功能与临床病理特征的关系

Correlation analysis of coagulation function and clinicopathological characteristics in breast cancer patients

目的检测乳腺癌患者血栓弹力图（TEG）各参数,分析其与临床病理特征的关系。方法选取2014年1月—2015年12月在本院接受治疗的360例女性乳腺癌患者作为观察组,乳腺良性疾病患者240例作为对照组,2组均进行TEG与常规凝血试验,通过对比分析其不同临床病理因素下凝血功能的变化情况。结果与乳腺良性疾病患者相比,乳腺癌患者PT（10. 67±1. 00）、APTT（30. 45±4. 59）、TT（16. 74±1. 67）明显缩短,FIB（2. 79±0. 56）及Plt（2. 79±0. 56）明显升高,差异具有统计学意义（P〈0. 05）;乳腺癌组TEG参数R（3. 63±0. 85）、K值显著减小（1. 43±0. 41）,Angle（69. 93±4. 88）、MA（64. 20±4. 22）、CI（2. 46±1. 19）值则显著增大,差异具有统计学意义（P〈0. 05）。对乳腺癌患者的临床病理因素分组分析发现：Ⅳ期乳腺癌患者Angle（74. 78±2. 50）、MA（68. 68±3. 30）、CI（3. 78±0. 50）值明显较Ⅰ期、Ⅱ期、Ⅲ期乳腺癌患者高,K值（1. 00±0. 22）明显较Ⅰ、Ⅱ、Ⅲ期缩短,差异有统计学意义（P〈0. 05）;Ⅲ期乳腺癌患者Angle（71. 23±4. 17）、MA（65. 43±4. 37）、CI值（2. 81±1. 09）明显较Ⅰ期、Ⅱ期乳腺癌患者高,K值（1. 33±0. 35）明显较Ⅰ、Ⅱ期缩短,差异有统计学意义（P〈0. 05）;Ⅱ期乳腺癌患者R值（3. 61±0. 81）明显较Ⅰ期乳腺癌患者低（P〈0. 05）。T_（3-4）组分别与T_1组、T_2组比较,Angle（72. 05±3. 82）、MA（65. 25±4. 36）、CI（3. 06±1. 11）值明显增高,K值（1. 28±0. 35）明显较T_1、T_2组降低,差异有统计学意义（P〈0. 05）。T_2组与T_1组比较,Angle（70. 12±4. 50）明显增高,R值（3. 58±0. 80）明显降低,差异有统计学意义（P〈0. 05）。N_2、N_3组乳腺癌患者与N_0组乳腺癌患者比较,Angle增高（71. 27±3. 77和70. 03±4. 69）,CI值增高（2. 83±1. 08和2. 81±1. 13）,差异有统计学意义（P〈0. 05）。结论乳腺癌患者容易出现血液高凝状态,凝血相关指标或可在临床上作为预测乳腺癌临床分期的参考指标。

Objective To investigate the relationship between TEG and conventional coagulation of patients with breast cancer, and evaluate the similarities and differences of these two Methods.Methods TEG were performed in 360 breast cancer patients and 230 cases of patients with benign breast disease. Results Compared with patients with benign breast disease,the FIB and Ph of breast cancer patients had increased, but the PT,APTF and TT had decreased （P〈0. 05）.The Angle,MA and CI of breast cancer patients with stage IV were higher than the patients with stage I , Ⅱ and Ⅲ（P〈O. 05） ,theAngle and CI of breast cancer patients with stage Ⅱ were higher than the patients with stage I （P〈O. 05）. Higher Angle, MA ,CI levels and lower K levels were found in patients with T3- 4tumor compared to T1/T2 tumor patients （ P〈0. 05） .Higher Angle,CI levels and lower R level were found in patients with T2 tumor compared to T1 tumor ones （ P〈0. 05） .Higher MA,CI levels were found in patients with N2/N3 tumor compared to TO tumor ones（ P〈0. 05）.The testing results of TEG have no connection with breast cancer patients, immunohistochemical features. Conclusion Breast cancer patients are prone to be in hypercoagulable state. Coagulation parameters might be used as predictors of clinical characteristics of breast cancer.