凝血指标检测对胃癌患者的意义

Significance of detecting blood coagulation indicators in patients with gastric cancer

目的研究凝血相关指标对胃癌患者临床病理特征的评估意义。方法采用系统抽样方法随机在江苏大学附属医院胃肠外科(2016年1月至2019年12月)抽取胃癌手术患者244例,其中男177例,女67例,年龄范围35~84岁。检测244例胃癌手术患者的凝血指标,分析凝血指标在不同病理分期(pTNM)、组织分化程度和淋巴结转移患者中的差异。结果pTNMⅠ期胃癌患者外周血凝血酶原时间(prothrombin time,PT)为(11.03±0.72)s、D-二聚体(D-dimer,D-D)水平为0.21(0.10,0.41)mg/L、血小板计数(platelets,PLTs)为(183.21±46.96)×10^(9)/L,Ⅱ期分别为(11.07±0.79)s、0.34(0.17,0.66)mg/L、(205.18±84.81)×10^(9)/L,Ⅲ期分别为(11.27±0.64)s、0.39(0.18,0.70)mg/L、(212.60±69.53)×10^(9)/L,Ⅳ期分别为(11.44±0.72)s、0.91(0.30,2.09)mg/L、(215.50±50.23)×10^(9)/L;胃癌患者pTNM分期越高,外周血PT、D-D水平和PLTs越高(均P<0.05)。组织分化程度不同的胃癌患者各项凝血指标差异均无统计学意义(均P<0.05);有淋巴结转移患者D-D水平[0.39(0.19,0.84)mg/L]和PLTs[(210.64±70.09)×10^(9)/L]高于无淋巴结转移的患者[分别为0.25(0.12,0.50)mg/L、(191.17±59.93)×10^(9)/L](均P<0.05)。结论胃癌患者检测PT、D-D和PLTs水平不仅可以了解患者的凝血功能,还有助于了解胃癌患者的临床病理特征,对指导临床治疗和评估预后有重要意义。

Objective To study the significance of coagulation indicators on different clinicopathologic features in patients with gastric cancer.Methods Two hundred and forty-four 35-84 years old patients with gastric cancer,including 177 males and 67 females,were randomly selected from our hospital between January,2016 and December,2019 by systematic sampling.Coagulation indicators in the patients were measured;and the differences in coagulation indicators between the patients with pathological stages(pTNM stages),histological differentiations,and lymph node metastasis were analyzed.Results The prothrombin time(PT),D-dimer(D-D)level,and platelets(PLTs)count were(11.03±0.72)s,0.21(0.10,0.41)mg/L,and(183.21±46.96)×10^(9)/L in the pTNM Ⅱ patients,were(11.07±0.79)s,0.34(0.17,0.66)mg/L,and(205.18±84.81)×10^(9)/L in the pTNM Ⅲ patients,were(11.27±0.64)s,0.39(0.18,0.70)mg/L,and(212.60±69.53)×10^(9)/L in the pTNM Ⅳ patients,and were(11.44±0.72)s,0.91(0.30,2.09)mg/L,and(215.50±50.23)×10^(9)/L in the pTNM patients.The PT,D-D level,and PLTs count increased with the pTNM stages of gastric cancer(all P<0.05).There were no statistical differences in coagulation indicators of gastric cancer between the patients with different degrees of tissue differentiation(all P>0.05).The D-D level and PLTs count were higher in the patients with lymph node metastasis than in those without[0.25(0.12,0.50)mg/L vs.0.39(0.19,0.84)mg/L and(210.64±70.09)×10^(9)/L vs.(191.17±59.93)×10^(9)/L;both P<0.05].Conclusion The detection of PT,D-D,and PLTs in patients with gastric cancer is helpful to acquire their coagulation function and study the clinicopathologic features of gastric cancer,which is of great benefit to guide clinical treatment and evaluate their prognosis.