Background The coagulation function in carcinoma patients is abnormal, but in renal cell carcinoma the extent and relationships of coagulation function remain unclear. This study retrospectively investigated the relat...Background The coagulation function in carcinoma patients is abnormal, but in renal cell carcinoma the extent and relationships of coagulation function remain unclear. This study retrospectively investigated the relationships between coagulation function, clinical stage and metastasis in patients with renal cell carcinoma.Methods A total of 350 consecutive patients admitted to our Urology Department from 2004 to 2010 were diagnosed with renal cell carcinoma by histolopathologic examination and were included in this study. A total of 231 cases of renal benign tumors were considered as the control group. Fibrinogen, prothrombin time, activated partial thromboplastin time and international normalized ratio were evaluated in all subjects. Tumor size, clinical stage, lymph node metastasis, and distant metastasis were evaluated using radiologic imaging, intraoperative findings, and histological studies.Results The preoperative plasma fibrinogen levels of patients with renal cell carcinoma （（383.9±146.7） mg/dl） were significantly higher than those of the control group （（316.7±62.0） mg/dl） （P ＜0.01）. We divided the renal cell carcinoma group into stages la, lb, Ⅱ, Ⅲ, and Ⅳ. The fibrinogen values were （315.6±64.6） mg/dl, （358.3±91.1） mg/dl, （465.6±164.7）mg/dl, （500.0±202.1） mg/dl, and （585.8±179.7） mg/dl, respectively. There were no significant differences in fibrinogen values between stage la and control groups. However, results of other stages showed significant differences when compared to control group values （P ＜0.01）. Using the cutoff value of 440 mg/dl, which defines hyperfibrinogenemia,plasma fibrinogen levels had a positive predictive value of 39.8% and a negative predictive value of 93.3% for predicting distant metastasis, with a sensitivity of 64.7% and specificity of 83.3%.Concluslons Preoperative plasma fibrinogen levels are elevated in patients with renal cell carcinoma with distant metastasis or lymph node metastasis. Potential metastasis is more likely if the tumor size larger than 4 cm. Increased preoperative plasma fibrinogen levels, especially hyperfibrinogenemia, may be an indicator of metastasis.展开更多
文摘目的探究接受静脉溶栓的急性缺血性脑卒中(AIS)患者中高纤维蛋白原血症与预后的相关性研究。方法回顾性收集浙江省人民医院2018年8月-2021年12月神经内科收治的发病4.5 h内接受重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓的急性缺血性脑卒中患者327例,根据溶栓前纤维蛋白原(FIB)水平判断高纤维蛋白原血症。根据出院后90 d改良Rankin量表(mRS)评分判断患者的预后。采用多因素Logistic回归分析确定AIS患者接受rt-PA静脉溶栓治疗预后的独立影响因素。结果327例患者中高纤维蛋白原血症组52例(15.90%),非高纤维蛋白血原血症组275例(84.10%);出院90 d预后不良63例(19.27%),预后良好264例(80.73%)。与非高纤维蛋白原血症组比较,高纤维蛋白原血症组的患者基线FIB水平、饮酒史及预后不良占比均较高,差异有统计学意义(P<0.05)。与预后良好组相比,预后不良组年龄较大,就诊至接受溶栓治疗时间(DNT)较长,FIB较高,小动脉闭塞型及早期神经功能改善比例较低,抗凝药物使用、大动脉粥样硬化型、心源性栓塞型、脑实质出血(PH)转化、症状性颅内出血及重度脑水肿比例均较高,差异均有统计学意义(P<0.05)。多因素Logistic回归,结果显示:基线FIB(OR=0.566,95%CI 0.368~0.872,P<0.05)、7 d NIHSS评分(OR=0.638,95%CI 0.490~0.831,P<0.05)是静脉溶栓患者预后不良的独立影响因素。结论高纤维蛋白原血症与AIS患者静脉溶栓不良预后相关,基线高水平FIB与7 d NIHSS评分较高的AIS患者静脉溶栓治疗后易预后不良。
文摘Background The coagulation function in carcinoma patients is abnormal, but in renal cell carcinoma the extent and relationships of coagulation function remain unclear. This study retrospectively investigated the relationships between coagulation function, clinical stage and metastasis in patients with renal cell carcinoma.Methods A total of 350 consecutive patients admitted to our Urology Department from 2004 to 2010 were diagnosed with renal cell carcinoma by histolopathologic examination and were included in this study. A total of 231 cases of renal benign tumors were considered as the control group. Fibrinogen, prothrombin time, activated partial thromboplastin time and international normalized ratio were evaluated in all subjects. Tumor size, clinical stage, lymph node metastasis, and distant metastasis were evaluated using radiologic imaging, intraoperative findings, and histological studies.Results The preoperative plasma fibrinogen levels of patients with renal cell carcinoma （（383.9±146.7） mg/dl） were significantly higher than those of the control group （（316.7±62.0） mg/dl） （P ＜0.01）. We divided the renal cell carcinoma group into stages la, lb, Ⅱ, Ⅲ, and Ⅳ. The fibrinogen values were （315.6±64.6） mg/dl, （358.3±91.1） mg/dl, （465.6±164.7）mg/dl, （500.0±202.1） mg/dl, and （585.8±179.7） mg/dl, respectively. There were no significant differences in fibrinogen values between stage la and control groups. However, results of other stages showed significant differences when compared to control group values （P ＜0.01）. Using the cutoff value of 440 mg/dl, which defines hyperfibrinogenemia,plasma fibrinogen levels had a positive predictive value of 39.8% and a negative predictive value of 93.3% for predicting distant metastasis, with a sensitivity of 64.7% and specificity of 83.3%.Concluslons Preoperative plasma fibrinogen levels are elevated in patients with renal cell carcinoma with distant metastasis or lymph node metastasis. Potential metastasis is more likely if the tumor size larger than 4 cm. Increased preoperative plasma fibrinogen levels, especially hyperfibrinogenemia, may be an indicator of metastasis.
