胃癌细胞侵犯骨髓患者临床实验室检查特点分析

Analysis of clinical laboratory characteristics of patients with gastric cancer with bone marrow invasion

目的:分析胃癌骨髓侵犯患者临床实验室检测结果的特点,筛选对胃癌细胞骨髓侵犯具有提示意义的实验室指标。方法:回顾性分析2013年1月至2021年3月河北医科大学第四医院收治的30例胃癌发生骨髓侵犯患者,收集血常规、凝血功能、免疫、生化及骨髓等临床指标检测结果资料。分析上述患者与未发生骨髓侵犯的Ⅳ期胃癌患者临床实验室检测结果的差异,并制作受试者工作特征(receiver operating characteristic,ROC)曲线评价各指标在提示胃癌细胞骨髓侵犯中的意义。结果:与未发生骨髓侵犯的Ⅳ期胃癌患者相比较,发生骨髓侵犯的患者血小板(Plt)计数、凝血酶原时间(PT)、凝血酶时间(TT)、乳酸脱氢酶(LDH)、D二聚体(D-DIMER)、纤维蛋白原降解产物(FDP)、CEA及CA72-4等指标的检测结果差异均具有统计学意义(均P<0.05)。其中FDP的ROC曲线下面积最大(AUC=0.988),且阳性似然比最高。同时,两组患者外周血幼红、幼粒细胞检出率差异具有统计学意义(P<0.01)。结论:胃癌骨髓侵犯患者的部分临床实验室检测指标较未发生骨髓侵犯患者异常检出率更高且变化更为明显,上述指标对骨髓侵犯具有提示意义。

Objective:To analyze clinical laboratory characteristics of patients with gastric cancer with bone marrow invasion and screen laboratory indexes with clinical significance.Methods:Clinical data of blood routine tests,coagulation function,immunity,biochemistry,and bone marrow detection of 30 patients with gastric adenocarcinoma with bone marrow invasion in The Fourth Hospital of Hebei Medical University from January 2013 to March 2021 were collected.Differences in clinical laboratory test results of patients with gastric cancer with bone marrow invasion and those with stage IV gastric cancer without bone marrow invasion were analyzed.Furthermore,receiver operating characteristic(ROC)curves were developed to evaluate the significance of each indicator in predicting gastric cancer with bone marrow invasion.Results:The values of Plt,PT,TT,LDH,D-DMER,FDP,CEA and CA72-4 in patients with bone marrow invasion were significantly different from those in patients with stage IV gastric cancer without bone marrow invasion(P<0.05).The area under the ROC curve of FDP was the largest(AUC=0.988),and the positive likelihood ratio was the highest.Moreover,there was significant difference between the two patient groups with respect to the detection rate of nucleated red cells and immature granular cells in peripheral blood(P<0.01).Conclusions:Several clinical laboratory parameters of patients with gastric cancer with bone marrow invasion have higher abnormal detection rates and more obvious changes than those of patients with gastric cancer without bone marrow invasion.These indicators have certain suggestive significance for gastric cancer invading the bone marrow.