不同分期恶性肿瘤患者外周血凝血功能指标、NLR检测及其临床意义

Peripheral blood coagulation function indicators and NLR detection in patients with different stages of malignant tumors and their clinical significance

目的 探讨不同分期恶性肿瘤患者外周血凝血功能指标、中性粒细胞/淋巴细胞比值(NLR)检测及其临床意义。方法 选择2021年1月至2023年1月通用环球西安西航医院收治的85例恶性肿瘤(宫颈癌26例,结直肠癌24例,肺癌19例,卵巢癌16例)患者作为肿瘤组,根据TNM分期分为早期组44例(TNM分期为Ⅰ、Ⅱ期)和晚期组41例(TNM分期为Ⅲ、Ⅳ期),同时选取45例健康体检者作为对照组。比较各组受检者的血小板(PLT)、纤维蛋白原(FIB)、凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-Dimer)和NLR水平。结果 早期组、晚期组患者的FIB、PT、TT、D-Dimer水平分别为(3.04±0.41) g/L、(11.21±0.62) s、(17.23±2.95) s、(221.47±102.86)μg/L和(3.42±0.77) g/L、(14.32±1.78) s、(15.84±1.91) s、(545.76±320.15)μg/L,均高于对照组的(2.38±0.24) g/L、(10.83±0.39) s、(14.27±1.33) s、(119.13±45.22)μg/L,且晚期组患者的FIB、PT、D-Dimer水平明显高于早期组,TT水平明显低于早期组,差异均有统计学意义(P<0.05);早期组、晚期组患者的APTT水平分别为(31.33±2.22) s、(29.54±2.18) s,均低于对照组的(27.56±1.57) s,且晚期组明显低于早期组,差异均有统计学意义(P<0.05);早期组、晚期组患者的PLT、NLR水平分别为(270.93±69.45)×10^(9)/L、2.54±1.31和(320.41±88.67)×10^(9)/L、3.26±1.46,均高于对照组的(243.14±44.32)×10^(9)/L、1.85±0.65,且晚期组明显高于早期组,差异均有统计学意义(P<0.05)。结论 恶性肿瘤患者存在凝血、抗凝、纤溶系统异常,是发生血栓事件的高危人群。不同分期恶性肿瘤患者外周血凝血功能指标和NLR存在差异,有助于了解患者的凝血功能状态,可为临床治疗提供病情和预后判断的指导意义。

Objective To explore the peripheral blood coagulation function indicators,neutrophil/lymphocyte ratio(NLR) detection,and their clinical significance in patients with different stages of malignant tumors.Methods Eighty-five patients with malignant tumors(26 cases of cervical cancer,24 cases of colorectal cancer,19 cases of lung cancer,and16 cases of ovarian cancer) admitted to Genertec Universal Xi'an Aero-Engine Hospital from January 2021 to January2023 were selected as the tumor group.According to TNM staging,they were divided into an early group of 44 cases(TNM staging Ⅰ and Ⅱ) and an advanced group of 41 cases(TNM staging Ⅲ and Ⅳ).Forty-five healthy individuals were selected as the control group.The levels of platelets(PLT),fibrinogen(FIB),prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),D-dimer(D-Dimer),and NLR in different groups of subjects were compared.Results The levels of FIB,PT,TT,and D-Dimer in the early and late stage groups were(3.04±0.41) g/L,(11.21±0.62) s,(17.23±2.95) s,(221.47±102.86) μg/L and(3.42±0.77) g/L,(14.32±1.78) s,(15.84±1.91) s,(545.76±320.15) μg/L,which were significantly higher than(2.38±0.24) g/L,(10.83±0.39) s,(14.27±1.33) s,(119.13±45.22) μg/L in the control group;the levels of FIB,PT,and D-Dimer in the late stage group were significantly higher than those in the early stage group,while the level of TT was significantly lower than that in the early stage group;the differences were statistically significant(P<0.05).The APTT levels in the early group and late group were(31.33±2.22) s and(29.54±2.18) s,which were significantly lower than(27.56±1.57) s in the control group;and the level in the late group was significantly lower than that in the early group;the differences were statistically significant(P<0.05).The levels of PLT and NLR in the early group and late group were(270.93±69.45)×10^(9)/L,2.54±1.31 and(320.41±88.67)×10^(9)/L,3.26±1.46,which were significantly higher than(243.14±44.32)×10^(9)/L,1.85±0.65 in the control group;the levels in the late group were significantly higher than those in the early group;the differences were statistically significant(P<0.05).Conclusion Malignant tumor patients have abnormalities in coagulation,anticoagulation,and fibrinolysis systems,making them a high-risk group for thrombotic events.There are differences in peripheral blood coagulation function indicators and NLR among patients with different stages of malignant tumors,which helps to understand the coagulation function status of patients and provides guidance for clinical treatment in determining the condition and prognosis.