非小细胞肺癌患者术前血浆纤维蛋白原降解产物水平与临床病理特征的相关性

Correlation between preoperative plasma fibrin degradation products level and clinicopathological features in patients with non-small cell lung cancer

目的探讨接受完全切除的非小细胞肺癌(NSCLC)患者术前血浆纤维蛋白原降解产物(FDP)水平与临床病理特征的关系。方法回顾性病例系列研究。回顾性分析2016年1月至2017年12月首都医科大学附属北京友谊医院确诊的521例NSCLC患者资料,其中406例经术后病理证实无淋巴结及远处转移(无转移组),115例有淋巴结或远处转移(转移组)。比较两组患者术前血浆FDP水平、临床病理特征及不同FDP水平患者的临床病理特征;采用Spearman相关分析比较术前FDP水平与TNM分期的相关性。结果521例NSCLC患者中,女性266例,男性255例;年龄[M(Q_(1),Q_(3))]59岁(54岁,65岁);腺癌441例,鳞状细胞癌70例。无转移组和转移组NSCLC患者术前FDP水平分别为2.78 mg/L(2.35 mg/L,3.13 mg/L)和2.99 mg/L(2.56 mg/L,4.16 mg/L),差异有统计学意义(Z=6.13,P<0.001)。早期(Ⅰ~Ⅱ期)患者术前FDP水平为2.56 mg/L(2.35 mg/L,3.20 mg/L),晚期(Ⅲ~Ⅳ期)患者术前FDP水平为2.99 mg/L(2.56 mg/L,3.20 mg/L),差异具有统计学意义(Z=8.42,P<0.001)。Spearman相关性分析结果显示,术前FDP水平与肿瘤长径呈正相关(r=0.287,P<0.001)。115例患者有淋巴结转移,术前FDP水平与淋巴结转移数呈正相关(r=0.679,P<0.001)。根据术前中位FDP水平(2.78 mg/L),将患者分为FDP≤2.78 mg/L组和FDP>2.78 mg/L组,两组NSCLC患者年龄、转移情况、肿瘤分期、肿瘤长径、淋巴结转移数和组织学类型比较,差异均有统计学意义(均P<0.05)。结论NSCLC患者术前血浆FDP水平升高可能与肿瘤的转移情况和肿瘤临床分期有关。

Objective To investigate the relationship between preoperative plasma fibrin degradation products(FDP)level and clinicopathological features of patients with completely resected non-small cell lung cancer(NSCLC).Methods A retrospective case series study was performed.The clinical data of 521 patients who were pathologically diagnosed with NSCLC in Beijing Friendship Hospital Affiliated to Capital Medical University from January 2016 to December 2017 were retrospectively analyzed.Among 521 cases,406 cases were postoperatively pathologically confirmed as non-lymph node and non-distant metastasis(non-metastasis group)and 115 cases were postoperatively pathologically confirmed as lymph node or distant metastasis(metastasis group).The preoperative FDP level and clinicopathological characteristics as well as the clinicopathological characteristics of NSCLC patients with different FDP levels were compared between the two groups.The correlation between preoperative FDP level and TNM staging was analyzed by using Spearman correlation analysis.Results Among 521 NSCLC patients,266 cases were female,255 cases were male;the age[M(Q_(1),Q_(3))]was 59 years(54 years,65 years);441 cases were adenocarcinoma and 70 cases were squamous cell carcinoma.The preoperative median FDP level was 2.78 mg/L(2.35 mg/L,3.13 mg/L)and 2.99 mg/L(2.56 mg/L,4.16 mg/L),respectively of NSCLC patients in non-metastasis group and metastasis group,and the difference was statistically significant(Z=6.13,P<0.001).The preoperative FDP level was 2.56 mg/L(2.35 mg/L,3.20 mg/L)and 2.99 mg/L(2.56 mg/L,3.20 mg/L),respectively in the early-stage NSCLC(stageⅠ-Ⅱ)and advanced NSCLC(stageⅢ-Ⅳ)patients,and the difference was statistically significant(Z=8.42,P<0.001).Spearman correlation analysis showed that preoperative FDP level was positively correlated with tumor diameter(r=0.287,P<0.001).There was a positive correlation between preoperative FDP level and the number of metastatic lymph nodes in 115 patients with lymph node metastasis(r=0.679,P<0.001).According to the preoperative median FDP(2.78 mg/L),all patients were divided into FDP≤2.78 mg/L group and FDP>2.78 mg/L,and there were statistically significant differences in age,metastasis,tumor staging,tumor diameter,the metastatic number of lymph node and histological types of NSCLC patients in both groups(all P<0.05).Conclusions The increase of preoperative plasma FDP level may be related to the tumor metastasis and clinical stage of NSCLC patients.