血浆D-二聚体和纤维蛋白原检测在小细胞肺癌中的应用
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摘要
目的探讨血浆D-二聚体和纤维蛋白原(FIB)检测在小细胞肺癌(SCLC)中的应用价值。方法采用免疫比浊法检测74例SCLC患者(SCLC组),70例肺良性疾病患者(肺良性疾病组),60例健康人群(健康对照组)血浆D-二聚体和FIB水平;分析D-二聚体及FIB与SCLC患者临床特征的关系;比较SCLC患者放疗和化疗前后血浆D-二聚体和FIB水平的变化情况。结果 SCLC组患者血浆D-二聚体和FIB水平均明显高于健康对照组和肺良性疾病组,差异均有统计学意义(P<0.05);广泛性SCLC(ED-SCLC)患者血浆D-二聚体水平明显高于局限性SCLC(LD-SCLC)患者,差异有统计学意义(P<0.05)。D-二聚体水平与SCLC患者吸烟、肿瘤累及部位、最大肿块直径、远处转移有关(P<0.05);FIB水平与SCLC患者肿块数目、病理分型、远处转移有关(P<0.05)。SCLC治疗有效组患者放疗和化疗后血浆D-二聚体和FIB水平较放疗和化疗前均明显下降,差异均有统计学意义(P<0.05);但病情稳定组患者放疗和化疗前后D-二聚体和FIB水平差异均无统计学意义(P>0.05);治疗无效组患者放疗和化疗后血浆D-二聚体水平明显升高,与放疗和化疗前比较差异有统计学意义(P<0.05)。结论血浆D-二聚体和FIB可作为SCLC辅助诊断、病情监测、放疗和化疗疗效和预后判断的观察指标。
Objective To explore the application value of plasma D-dimer and fibrinogen(FIB)in small cell lung cancer(SCLC).Methods Plasma D-dimer and FIB levels were measured by immunoturbidimetric assay in 74 SCLC patients(SCLC group),70 benign lung disease patients(benign lung disease group),and 60 healthy people(healthy control group).The relationship between the D-dimer and FIB levels and clinical features of SCLC patients was analyzed.The plasma of D-dimer and FIB levels before and after radiotherapy and chemotherapy in SCLC patients were compared.Results Plasma D-dimer,FIB levels in the SCLC group were significantly higher than those in the healthy control group and benign lung disease group,and the differences were statistically significant(P<0.05).The level of plasma D-dimer in extensive SCLC(ED-SCLC)patients was significantly higher than that in limited SCLC(LD-SCLC)patients,and the differences were statistically significant(P<0.05).In SCLC patients,the D-dimer level was associated with smoking,tumor involvement site,maximum mass diameter,and distant metastasis(P<0.05).FIB level was correlated with the number of tumors,pathological type and distant metastasis(P<0.05).After radiotherapy and chemotherapy,the levels of D-dimer and FIB were significantly lower than those before treatment in the treatment effective group(P<0.05),but there was no statistically significant difference in the stable group(P>0.05).The level of D-dimer was significantly increased in the treatment ineffective group after radiotherapy and chemotherapy,and the difference was statistically significant(P<0.05).Conclusion Plasma D-dimer and FIB can be used as observational indexes for SCLC-assisted diagnosis,disease monitoring,radiotherapy and chemotherapy efficacy and prognosis.
Objective To explore the application value of plasma D-dimer and fibrinogen(FIB)in small cell lung cancer(SCLC).Methods Plasma D-dimer and FIB levels were measured by immunoturbidimetric assay in 74 SCLC patients(SCLC group),70 benign lung disease patients(benign lung disease group),and 60 healthy people(healthy control group).The relationship between the D-dimer and FIB levels and clinical features of SCLC patients was analyzed.The plasma of D-dimer and FIB levels before and after radiotherapy and chemotherapy in SCLC patients were compared.Results Plasma D-dimer,FIB levels in the SCLC group were significantly higher than those in the healthy control group and benign lung disease group,and the differences were statistically significant(P<0.05).The level of plasma D-dimer in extensive SCLC(ED-SCLC)patients was significantly higher than that in limited SCLC(LD-SCLC)patients,and the differences were statistically significant(P<0.05).In SCLC patients,the D-dimer level was associated with smoking,tumor involvement site,maximum mass diameter,and distant metastasis(P<0.05).FIB level was correlated with the number of tumors,pathological type and distant metastasis(P<0.05).After radiotherapy and chemotherapy,the levels of D-dimer and FIB were significantly lower than those before treatment in the treatment effective group(P<0.05),but there was no statistically significant difference in the stable group(P>0.05).The level of D-dimer was significantly increased in the treatment ineffective group after radiotherapy and chemotherapy,and the difference was statistically significant(P<0.05).Conclusion Plasma D-dimer and FIB can be used as observational indexes for SCLC-assisted diagnosis,disease monitoring,radiotherapy and chemotherapy efficacy and prognosis.
引文
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[9]胡泓,王帏,潘虹,等.纤维蛋白原和D-二聚体与老年晚期非小细胞肺癌化疗疗效和无进展生存期的相关性[J].中国老年学杂志,2018,38(3):589-591.
[10]曲洪澜.晚期非小细胞肺癌患者血浆纤维蛋白原、D-二聚体水平与预后的相关性分析[J].重庆医学,2015,44(19):2665-2667.
[11]刘春花,巩平,杨杰.肺癌患者外周血中循环肿瘤细胞与D-二聚体纤维蛋白原及血小板的关系[J].中华肿瘤杂志,2016,38(5):368-371.
[12]GE L P,LI J,BAO Q L,et a1.Prognostic and predictive value of plasma D-dimer in advanced non-small cell lung cancer patients undergoing first-line chemotherapy[J].Chin Transl Oncol,2015,17(1):57-64.
[13]单霞,朱颖,杨健,等.血浆D-二聚体水平对晚期非小细胞肺癌患者化疗效果的预测价值[J].江苏医药,2018,44(9):1050-1053.
[14]邓淑萍,勒建军,田蕊,等.肺癌患者血浆D-二聚体、纤维蛋白原水平分析[J].国际呼吸杂志,2014,36(12):922-925.
[2] GO S I,LEE M J,LEE W S,et al.D-Dimer can serve as a prognostic and predictive biomarker for metastatic gastric cancer treated by chemotherapy[J].Medicine,2015,94(30):951-954.
[3]张金虹,孙延庆,周春红,等.D-二聚体及纤维蛋白原对老年髋部骨折患者围术期深静脉血栓形成的诊断价值[J].山东医药,2012,52(18):44-45.
[4]申旺,王希平,叶丽燕,等.胃泌素释放肽前体和神经元特异性烯醇化酶在小细胞肺癌诊疗中的应用[J].热带医学杂志,2015,15(9):1232-1235.
[5] HAN C,ZHAO Y,CHENG W,et al.The performance of age-adjusted D-dimer cut-off in Chinese outpatients with suspected venous thromboembolism[J].Thromb Res,2015,136(4):739-743.
[6] SAKURAI M,SATOH T,MATSUMOTO K,et al.High pretreatment plasma D-dimer levels are associated with poor prognosis in patients with ovarian cancer independently of venous thromboembolism and tumor extension[J].Int J Gynecol Cancer,2015,25(4):593-598.
[7] MEGO M,KARABA M,MINARIK G,et al.Relationship between circulating tumor cells,blood coagulation and urokinase-plasminogen-activator system in early breast cancer patients[J].Breast J,2015,21(2):155-160.
[8] NEKI K,KAWAHARA H,WATANABE K,et a1.Uesfulness of circulating tumor cells after preliminary chemotherapy for prediction of response to further anticancer therapy in patients with initially unresectable metastatic colorectal cancer[J].Anticancer Res,2013,33(4):1769-1772.
[9]胡泓,王帏,潘虹,等.纤维蛋白原和D-二聚体与老年晚期非小细胞肺癌化疗疗效和无进展生存期的相关性[J].中国老年学杂志,2018,38(3):589-591.
[10]曲洪澜.晚期非小细胞肺癌患者血浆纤维蛋白原、D-二聚体水平与预后的相关性分析[J].重庆医学,2015,44(19):2665-2667.
[11]刘春花,巩平,杨杰.肺癌患者外周血中循环肿瘤细胞与D-二聚体纤维蛋白原及血小板的关系[J].中华肿瘤杂志,2016,38(5):368-371.
[12]GE L P,LI J,BAO Q L,et a1.Prognostic and predictive value of plasma D-dimer in advanced non-small cell lung cancer patients undergoing first-line chemotherapy[J].Chin Transl Oncol,2015,17(1):57-64.
[13]单霞,朱颖,杨健,等.血浆D-二聚体水平对晚期非小细胞肺癌患者化疗效果的预测价值[J].江苏医药,2018,44(9):1050-1053.
[14]邓淑萍,勒建军,田蕊,等.肺癌患者血浆D-二聚体、纤维蛋白原水平分析[J].国际呼吸杂志,2014,36(12):922-925.
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