中晚期肿瘤患者围术期血浆TF和TFPI水平变化及意义

Variation and meaning of the plasma tissue factor and tissue factor pathway inhibitor in middle-later period tumor patients in peri-operation

目的 观察中、晚期肿瘤患者围术期血浆组织因子 (TF) ,组织途径抑制物 (TFPI)水平的变化 ,旨在了解患者在围术期机体的凝血活性状态 .方法 采集 58例恶性肿瘤患者作为观察组I,1 6例良性肿瘤患者作为观察组II及 2 0例非肿瘤手术患者作为正常对照组 ,运用ELISA法检测血浆TF和TFPI的水平。结果 恶性肿瘤患者血浆TF水平较正常对照组术前明显升高 (P <0 .0 5) ,术中继续有轻微升高 (P <0 .0 1 )的现象 ,肺癌患者术中升高较明显 (自身术前 ,术后比较P <0 .0 5〉。术后除肺癌患者仍高于对照组外 ,其他基本恢复正常 .良性肿瘤患者在整个围术期无明显变化。而血浆TFPI水平术中有轻微升高 ,术前、术后及良性肿瘤患者与正常对照组比较没有明显的差异。结论 恶性肿瘤患者术前血浆具有较高表达的TF水平较对照组 ,术中继续有轻微升高 ,肺癌患者升高更明显 ,且术后仍处于较高的水平。TFPI术中有轻微的升高。这也许能解释为什么肺癌等恶性肿瘤患者围术期尤其术后易发生深部静脉血栓栓塞及肿瘤转移和复发。

Objective To investigate the plasma tissue factor (TF) and tissue factor pathway inhibitor (TFPI) levels of middle-later period tumor patients in peri-operation for understanding their coagulational activities.Methods Fifty-eight patients with malignant tumors,16 cases benign tumors and 20 normal persons were divided into group 1,group 2 and control group respectively,whose plasma TF,TFPI were measured by ELISA.Results The levels of plasma TF in group 1 was significantly higher than that of control group in per-operation (P<0.05),continued to increase lightly during operation (P<0.01),especially showed in patients with lung carcinoma whose TF level in pre-operation were higher than that in post-operation (P<0.05),Except for patients with lung carcinoma,the TF level of other ones in group 1 restored to be normal basically.The level of TF didn't change group 2 during peri-operation.With a little increasing during operation, the levles of TFPI were not significantly different between pre-operation and post-operation among group 1,group 2 and control group.Conclusions The experiment may explain why lung cancer etc. often occer deep vein thrombus embolism,malignant tumors metastasis and recurrence.