血浆D-二聚体和纤维蛋白原检测在小细胞肺癌中的应用

Application of plasma D-dimer and fibrinogen detection in small cell lung cancer

目的探讨血浆D-二聚体和纤维蛋白原(FIB)检测在小细胞肺癌(SCLC)中的应用价值。方法采用免疫比浊法检测74例SCLC患者(SCLC组),70例肺良性疾病患者(肺良性疾病组),60例健康人群(健康对照组)血浆D-二聚体和FIB水平;分析D-二聚体及FIB与SCLC患者临床特征的关系;比较SCLC患者放疗和化疗前后血浆D-二聚体和FIB水平的变化情况。结果SCLC组患者血浆D-二聚体和FIB水平均明显高于健康对照组和肺良性疾病组,差异均有统计学意义(P<0.05);广泛性SCLC(ED-SCLC)患者血浆D-二聚体水平明显高于局限性SCLC(LD-SCLC)患者,差异有统计学意义(P<0.05)。D-二聚体水平与SCLC患者吸烟、肿瘤累及部位、最大肿块直径、远处转移有关(P<0.05);FIB水平与SCLC患者肿块数目、病理分型、远处转移有关(P<0.05)。SCLC治疗有效组患者放疗和化疗后血浆D-二聚体和FIB水平较放疗和化疗前均明显下降,差异均有统计学意义(P<0.05);但病情稳定组患者放疗和化疗前后D-二聚体和FIB水平差异均无统计学意义(P>0.05);治疗无效组患者放疗和化疗后血浆D-二聚体水平明显升高,与放疗和化疗前比较差异有统计学意义(P<0.05)。结论血浆D-二聚体和FIB可作为SCLC辅助诊断、病情监测、放疗和化疗疗效和预后判断的观察指标。

Objective To explore the application value of plasma D-dimer and fibrinogen (FIB) in small cell lung cancer (SCLC). Methods Plasma D-dimer and FIB levels were measured by immunoturbidimetric assay in 74 SCLC patients (SCLC group),70 benign lung disease patients (benign lung disease group),and 60 healthy people (healthy control group).The relationship between the D-dimer and FIB levels and clinical features of SCLC patients was analyzed.The plasma of D-dimer and FIB levels before and after radiotherapy and chemotherapy in SCLC patients were compared. Results Plasma D-dimer,FIB levels in the SCLC group were significantly higher than those in the healthy control group and benign lung disease group,and the differences were statistically significant ( P <0.05).The level of plasma D-dimer in extensive SCLC (ED-SCLC) patients was significantly higher than that in limited SCLC (LD-SCLC) patients,and the differences were statistically significant ( P <0.05).In SCLC patients,the D-dimer level was associated with smoking,tumor involvement site,maximum mass diameter,and distant metastasis ( P <0.05).FIB level was correlated with the number of tumors,pathological type and distant metastasis ( P <0.05).After radiotherapy and chemotherapy,the levels of D-dimer and FIB were significantly lower than those before treatment in the treatment effective group ( P <0.05),but there was no statistically significant difference in the stable group ( P >0.05).The level of D-dimer was significantly increased in the treatment ineffective group after radiotherapy and chemotherapy,and the difference was statistically significant ( P <0.05). Conclusion Plasma D-dimer and FIB can be used as observational indexes for SCLC-assisted diagnosis,disease monitoring,radiotherapy and chemotherapy efficacy and prognosis.