血浆D-二聚体及纤维蛋白原水平与肺癌临床病理类型及预后的相关性

The relativity of blood D-dimer and fibrinogen to clinical pathological typies and patients prognosis in patients with lung cancer

目的研究血浆D-二聚体及纤维蛋白原(FIB)对肺癌临床治疗的指导意义。方法收集2014年10月—2017年12月笔者所在医院首次确诊的106例肺癌患者的一般临床资料,采用德国罗氏公司提供的试剂盒对患者外周血中D-二聚体进行分析,采用全自动血凝分析仪对FIB进行测定。并对其与肿瘤病理类型及肿瘤分期的相关性进行对比分析。结果D-二聚体水平在肺癌不同病理类型间存在显著性差异(P<0.05),FIB含量在不同病理类型间有差异,表现为小细胞肺癌>腺癌>鳞癌,但三组间FIB均值无统计学差异。D-二聚体在不同肿瘤分期间表现为Ⅳ期>Ⅲ期>Ⅰ~Ⅱ期,Ⅲ期与Ⅳ期FIB明显高于Ⅰ~Ⅱ期,差异有显著性(P<0.05)。结论肺癌患者血浆D-二聚体、FIB可作为判断肺癌预后的重要参数,特别对不同病理类型有一定的参考,分期较晚的肺癌患者D-二聚体、FIB明显高于早期患者。

Objective To study the clinical significance of blood plasm D-dimer and fibrinogen in the treatment of lung cancer.Methods The general clinical data of 106 confirmed lung cancer patients in author's hospital from October 2014 to December 2017 were collected,and the blood plasma D-dimer was analyzed by the Kits of Roche Company in Germany,and the fibrinogen was determined by automatic hem agglutination analyzer.The results were compared and analyzed in the pathological type and the tumor stage.Results There were significant differences in D-dimers between small-medium cell lung cancer with different pathological types(P<0.05).The mean values of fibrinogen in different pathological types was compared as the orders:small cell lung cancer>glandular cancer>squamous-cell carcinoma,but there was no statistical difference between three groups(P>0.05).The D-dimer was compared in stages as the orders:Ⅳ>Ⅲ>stageⅠtoⅡ,and the fibrinogen in stageⅢandⅣwas all significantly higher than that in stageⅠtoⅡ(P<0.05).Conclusion The plasma D-dimer and fibrinogen in lung cancer patients can be used as important parameters in judging lung cancer,especially for ones of different pathological types.The level of D-dimer and fibrinogen in late stage lung cancer patients are significantly higher than those of early stage patients,thus D-dimer may be more distant than fibrous egg white in the diagnosis of distant metastasis.