同型半胱氨酸凝血功能指标与结直肠癌发病风险相关性的病例对照研究

Correlation between homocysteine,coagulation function indicators and the risk of colorectal cancer incidence:a case-control study

目的:探讨同型半胱氨酸、凝血功能指标与结直肠癌发病风险及临床病理特征的相关性。方法:收集2021年1月至2021年12月天津医科大学肿瘤医院收治的结肠癌患者481例,选取同期结直肠良性病变患者126例为对照组,采用t检验、χ^(2)检验、Logistic回归分析等统计学方法对两组之间的临床病理特征与同型半胱氨酸、凝血功能指标进行差异分析。结果:结直肠癌患者同型半胱氨酸(HCY)、部分活化凝血酶时间(APTT)、纤维蛋白原(Fbg)、凝血因子Ⅷ(F-Ⅷ)、纤维蛋白原降解产物(FDP)、D-二聚体(D-D)、血小板(PLT)水平均高于对照组(P<0.05),凝血酶时间测定(TT)、蛋白C(PC)水平低于对照组(P<0.05);HCY、PT、ATPP、Fbg、TT、PC、F-Ⅷ、FDP、D-D、PLT为结直肠癌的发病风险因素(P<0.05);F-Ⅷ、FDP、D-D、PLT水平在右半结肠癌高于左半结肠癌和直肠癌(P<0.05);PT(SEC)、PT(INR)、APTT、Fbg、F-Ⅷ、D-D、PLT水平与肿物最大径显著相关(P<0.01);PT(SEC)、PT(INR)、Fbg、F-Ⅷ、D-D、PLT水平在低分化患者中高于中、高分化患者(P<0.05);HCY、PT(INR)、PLT水平在Ⅲ期+Ⅳ期患者中高于Ⅰ期+Ⅱ期患者(P<0.05)。结论:同型半胱氨酸、凝血功能指标异常与结直肠癌发病风险呈正相关,并与结直肠癌患者临床病理特征、TNM分期、临床分期密切相关,在一定程度上能够提示发病风险及监测预后。

Objective:To explore the correlation between homocysteine(HCY),coagulation function,incidence risk,and clinicopathologic features of colorectal cancer.Method:A total of 481 patients with colon cancer admitted to Tianjin Medical University Cancer Institute&Hospital from January 2021 to December 2021 were selected as the case group,and 126 patients with colorectal benign lesions were selected as the control group.T test,Chi-square test,Logistic regression analysis and other statistical methods were used to analyze the clinicopathological features,HCY and coagulation function between the two groups.Results:The levels of HCY,activated partial thromboplastin time(APTT),fibrinogen(Fbg),factorⅧ(F-Ⅷ),fibrinogen degradation product(FDP),D-dimer(D-D),and platelets(PLT)in colorectal cancer patients were higher(P<0.05),whereas the levels of thrombin time(TT)and protein C(PC)were lower than those in control group(P<0.05).HCY,PT,APTT,Fbg,TT,PC,F-Ⅷ,FDP,D-D,and PLT were the risk factors of colorectal cancer(P<0.05).The levels of F-Ⅷ,FDP,D-D,and PLT in right colon cancer were higher than those in left colon cancer and rectal cancer(P<0.05).Additionally,the levels of PT(SEC),PT(INR),APTT,Fbg,F-Ⅷ,D-D and PLT were significantly correlated with the size of the tumor(P<0.01).The levels of PT(SEC),PT(INR),Fbg,F-Ⅷ,D-D,and PLT in poorly differentiated patients were higher than those in middle and highly differentiated patients(P<0.05).Moreover,the levels of HCY,PT(INR),and PLT in stagesⅢandⅣpatients were higher than those in stages I andⅡpatients.Conclusions:Abnormal HCY and coagulation function indexes were positively correlated with the risk of colorectal cancer and closely correlated with the clinicopathologic features,TNM stage,and clinical stage of patients with colorectal cancer.Therefore,these factors can indicate the risk of disease and monitor the prognosis to a certain extent.