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.
引文
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