胃癌患者凝血指标变化的临床意义
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摘要
目的分析胃癌患者血浆凝血酶原时间(PT)、纤维蛋白原(Fib)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、以及D-二聚体(DD)等凝血指标变化情况和胃癌临床分期、淋巴结转移以及肿瘤侵犯深度之间的相关性。方法 2015年5月至2018年9月,北京市朝阳区桓兴肿瘤医院收治的胃癌患者50例为观察组,50名健康体检者为对照组,用凝固法检测PT、Fib、TT和APTT,用免疫比浊法测定DD,分析凝血各项指标和胃癌临床分期、淋巴结转移以及肿瘤侵袭深度之间的相关性。结果观察组Fib和DD水平高于对照组(P<0.05),Ⅱ、Ⅲ和Ⅳ期胃癌组患者Fib、DD水平均高于Ⅰ期组(P<0.05);与对照组对比,N_0组胃癌患者Fib、DD水平更高(P<0.05);与N_0组相比,N_(1-3)组胃癌患者Fib、DD水平更高(P<0.05);与对照组对比,T_1期患者Fib水平更高(P<0.05);与T_1期患者相比,T_2-T_4期患者Fib、DD水平更高(P<0.05)。结论胃癌患者凝血功能差,并且和胃癌临床分期、淋巴结转移以及肿瘤侵袭深度有关。
Objective To analyze the correlation between the change of the blood coagulation indexes and the clinical stages of the stomach cancer, the lymph node metastasis, the depth of tumor invasion through the data of the gastric cancer patients' PT(plasma prothrombin time), Fib(fibrinogen), TT(thrombin time) and APTT(activated clotting time live enzymes) and DD(D-dimer). Methods The group of 50 patients with gastric cancer who were admitted from May 2015 to September 2018 were included into test group, 50 healthy individuals from physical examination were used as control. The solidification methods were used to detect PT, Fib, TT and APTT. DD is measured by immune turbidimetry to analyze the correlation between the change of the blood coagulation indexes and the clinical stages of the stomach cancer, the lymph node metastasis, the depth of tumor invasion. Results The observation group's Fib and DD level was higher than the control group's(P<0.05). The Ⅱ, Ⅲ and Ⅳ period Fib, DD level in patients with gastric cancer group was higher than Ⅰ period group(P<0.05). Compared with the control group, N_0 group had higher Fib and DD levels in gastric cancer patients(P<0.05). Compared with the N_0 group, the Fib andDD level of patients with gastric cancer in the N_(1-3) group was higher(P<0.05). Compared with the control group, the level of Fib in T_1 patients was higher(P<0.05). Compared with T_1-stage patients, T_2-T_4 patients had a significant higher level of Fib and DD(P<0.05).Conclusions The coagulation function is poor in patients with gastric cancer, and it is related to the clinical stage, lymph node metastasis and the depth of tumor invasion.
Objective To analyze the correlation between the change of the blood coagulation indexes and the clinical stages of the stomach cancer, the lymph node metastasis, the depth of tumor invasion through the data of the gastric cancer patients' PT(plasma prothrombin time), Fib(fibrinogen), TT(thrombin time) and APTT(activated clotting time live enzymes) and DD(D-dimer). Methods The group of 50 patients with gastric cancer who were admitted from May 2015 to September 2018 were included into test group, 50 healthy individuals from physical examination were used as control. The solidification methods were used to detect PT, Fib, TT and APTT. DD is measured by immune turbidimetry to analyze the correlation between the change of the blood coagulation indexes and the clinical stages of the stomach cancer, the lymph node metastasis, the depth of tumor invasion. Results The observation group's Fib and DD level was higher than the control group's(P<0.05). The Ⅱ, Ⅲ and Ⅳ period Fib, DD level in patients with gastric cancer group was higher than Ⅰ period group(P<0.05). Compared with the control group, N_0 group had higher Fib and DD levels in gastric cancer patients(P<0.05). Compared with the N_0 group, the Fib andDD level of patients with gastric cancer in the N_(1-3) group was higher(P<0.05). Compared with the control group, the level of Fib in T_1 patients was higher(P<0.05). Compared with T_1-stage patients, T_2-T_4 patients had a significant higher level of Fib and DD(P<0.05).Conclusions The coagulation function is poor in patients with gastric cancer, and it is related to the clinical stage, lymph node metastasis and the depth of tumor invasion.
引文
[1] 杨之敏,邱堃,王静.胃癌患者凝血功能与病理特征的关系探讨[J].中国实验诊断学,2016,20:1480-1482.
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[4] Kinoshita K,Beppu T,Miyata T,et al.A case of 15-Year recurrence-free survival after microwave coagulation therapy for liver metastasis from gastric cancer[J].Anticancer Res,2018,38:1595-1598.
[5] 刘根斌,陈端英,何孙本.评价温度和时间对血凝四项PT、FIB、APTT和TT结果的影响研究[J].现代预防医学,2016,43:887-890.
[6] Park S,Ha S,Kwon HW,et al.Prospective evaluation of changes in tumor size and tumor metabolism in advanced gastric cancer undergoing chemotherapy:association and clinical implication[J].J Nuclear Med,2017,58:899-904.
[7] 胡阳,刘博,欧阳文,等.S100A4蛋白及ZEB1蛋白表达水平与胃癌侵袭转移及预后的关系[J].海南医学,2017,28:3832-3835.
[8] Dore MP,Cipolli A,Ruggiu MW,et al.Helicobacter pylorieradication may influence timing of endoscopic surveillance for gastric cancer in patients with gastric precancerous lesions:a retrospective study[J].Medicine,2018,97:e9734.doi:10.1097/MD.0000000000009734.
[9] Floury J,Bianchi T,Thévenot J,et al.Exploring the breakdown of dairy protein gels during in vitro gastric digestion using time-lapse synchrotron deep-UV fluorescence microscopy[J].Food Chemistry,2018,239:898-910.
[2] 郝宝岚,郝新建,叶昱坪,等.血栓弹力图对胃癌患者凝血功能的检测及意义[J].实用医学杂志,2017,33:1688-1690.
[3] Kanda M,Tanaka C,Kobayashi D,et al.Proposal of the coagulation score as a predictor for short-term and long-term outcomes of patients with resectable gastric cancer[J].Annals Surgical Oncol,2017,24:502-509.
[4] Kinoshita K,Beppu T,Miyata T,et al.A case of 15-Year recurrence-free survival after microwave coagulation therapy for liver metastasis from gastric cancer[J].Anticancer Res,2018,38:1595-1598.
[5] 刘根斌,陈端英,何孙本.评价温度和时间对血凝四项PT、FIB、APTT和TT结果的影响研究[J].现代预防医学,2016,43:887-890.
[6] Park S,Ha S,Kwon HW,et al.Prospective evaluation of changes in tumor size and tumor metabolism in advanced gastric cancer undergoing chemotherapy:association and clinical implication[J].J Nuclear Med,2017,58:899-904.
[7] 胡阳,刘博,欧阳文,等.S100A4蛋白及ZEB1蛋白表达水平与胃癌侵袭转移及预后的关系[J].海南医学,2017,28:3832-3835.
[8] Dore MP,Cipolli A,Ruggiu MW,et al.Helicobacter pylorieradication may influence timing of endoscopic surveillance for gastric cancer in patients with gastric precancerous lesions:a retrospective study[J].Medicine,2018,97:e9734.doi:10.1097/MD.0000000000009734.
[9] Floury J,Bianchi T,Thévenot J,et al.Exploring the breakdown of dairy protein gels during in vitro gastric digestion using time-lapse synchrotron deep-UV fluorescence microscopy[J].Food Chemistry,2018,239:898-910.