卵巢癌患者凝血功能指标检测分析

Detection and Analysis of Coagulation function index in Patients with Ovar⁃ian Cancer

目的探究卵巢癌患者凝血功能凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)水平的检测分析。方法选取南京医科大学附属妇产医院2019年1月—2021年12月接收的42例卵巢癌患者(卵巢癌组)以及42例卵巢良性肿瘤患者(卵巢良性肿瘤组),两组研究对象均接受凝血功能检测,主要包括PT、APTT、TT、Fib 4项指标。比较良恶性肿瘤的凝血功能指标、卵巢癌不同病理分期的凝血功能指标、不同分化程度的凝血功能指标,通过受试者工作特征曲线(ROC曲线)判断各项指标单独检测以及联合检测在卵巢癌诊断中的敏感度及特异度。结果卵巢癌组患者的Fib水平(3.12±0.51)g/L高于卵巢良性肿瘤组(2.70±0.44)g/L,差异有统计学意义(t=4.041,P<0.05),两组PT、APTT、TT对比,差异无统计学意义(P>0.05)。将卵巢癌组患者进行病理分期,Ⅲ~Ⅳ期患者的Fib水平(4.26±0.85)g/L高于Ⅰ~Ⅱ期患者(3.64±0.98)g/L,TT(14.75±1.60)s短于Ⅰ~Ⅱ期患者(15.93±1.70)s,差异有统计学意义(t=2.165、2.299,P=0.036、0.027),PT、APTT对比,差异无统计学意义(P>0.05)。根据卵巢癌组患者分化程度,低分化患者的Fib水平(4.33±0.79)g/L高于中、高分化患者(3.60±0.83)g/L,TT(14.62±1.68)s短于中、高分化患者(15.76±1.54)s,差异有统计学意义(t=2.920、2.285,P=0.006、0.028),PT、APTT对比,差异无统计学意义(P>0.05)。PT、APTT、TT、Fib 4项指标对卵巢癌诊断的特异度偏高,TT、Fib的敏感度较高。4项指标联合检测的AUC值最高(0.954)、约登指数最高(0.88),敏感度、特异度分别为88.96%、96.23%,高于4项指标单一检测。结论PT、APTT、TT、Fib 4项凝血功能指标在卵巢癌疾病的诊断中具有一定价值,其中Fib在卵巢良恶性肿瘤中的差异明显,对卵巢癌的发生有一定预测价值,TT较短可考虑为卵巢癌中晚期以及低分化的指征,4项指标联合检测在该疾病的诊断中有一定参考价值。

Objective To investigate the detection and analysis of coagulation prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)and fibrinogen(Fib)levels in patients with ovarian cancer.Methods A total of 42 patients with ovarian cancer(ovarian cancer group)and 42 patients with ovarian benign tumors(ovarian benign tumor group)admitted to Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University from January 2019 to December 2021 were selected.All subjects in the two groups were tested for blood coagulation function,including PT,APTT,TT,and Fib.The coagulation function indexes of benign and malignant tumors,the coagulation function indexes of different pathological stages of ovarian cancer,and the coagulation function indexes of different degrees of differentiation were compared.Receiver operating characteristic curve(ROC curve)was used to judge the sensitivity and specificity of each index detection alone and combined detection in the diagnosis of ovarian cancer.Results The Fib level in the ovarian cancer group(3.12±0.51)g/L was higher than the ovarian benign tumor group(2.70±0.44)g/L,the difference was statistically significant(t=4.041,P<0.05).There was no statistically significant difference in PT,APTT and TT between the two groups(P>0.05).Pathological staging of ovarian cancer patients,the Fib level of patients with stage III-IV(4.26±0.85)g/L was higher than that of patients with stage I-II(3.64±0.98)g/L,and the TT(14.75±1.60)s was shorter than that of patients with stage I-II(15.93±1.70)s,the difference was statistically significant(t=2.165,2.299,P=0.036,0.027),and there was no statistically significant difference in PT and APTT(P>0.05).According to the degree of differentiation of ovarian cancer group,the Fib level of poorly differentiated patients(4.33±0.79)g/L was higher than the moderately and well differentiated patients(3.60±0.83)g/L,TT(14.62±1.68)s were shorter than the moderately and well differentiated patients(15.76±1.54)s,the difference was statistically significant(t=2.920,2.285,P=0.006,0.028).There was no statistically significant difference in PT and APTT(P>0.05).The specificity of PT,APTT,TT,and Fib for the diagnosis of ovarian cancer was high,and the sensitivity of TT and Fib was high.The combined detection of the four indicators has the highest AUC value(0.954)and the highest Youden index(0.88),the sensitivity and specificity were 88.96%and 96.23%respectively,which were higher than the single detection of 4 indicators.Conclusion PT,APTT,TT,Fib four coagulation function indexes have certain value in the diagnosis of ovarian cancer.Among them,Fib has obvious differences in ovarian benign and malignant tumors,and has certain predictive value for the occurrence of ovarian cancer.Shorter TT can be considered as an indication of advanced and poorly differentiated ovarian cancer,and the combined detection of the four indicators has a certain reference value in the diagnosis of this disease.