宫颈癌患者凝血功能的测定及其临床意义
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摘要
目的：通过了解宫颈癌患者的凝血机能,以探讨其临床应用价值。
方法：以吉林市中心医院2004年1月至2009年9月收治的127例宫颈癌患者为病例组,以68例子宫肌瘤患者为对照组,采用class方法测定纤维蛋白原(FIB)含量,用散射比浊法测定凝血酶原时间(PT)、凝血酶原活动度(PTA)、国际标准化比值(INR)和活化部分凝血活酶时间(APTT),采用日本SF-3000机计数血小板(PLT),综合反应研究对象的凝血机能。
结果：宫颈癌患者FIB含量及PTA明显高于子宫肌瘤患者,差异有统计学意义,而PT、INRv APTT、PLT两组患者差异无统计学意义；FIB含量与宫颈癌病理分期呈正相关；不同病理组织学分化程度的宫颈癌患者凝血机能差异无统计学意义；宫颈癌患者血小板计数无明显改变。
结论：宫颈癌患者凝血功能有所改变；在宫颈癌抗凝治疗时应考虑应用抗FIB含量和PTA增加药物；随着宫颈癌病理期别的增加,应加强预防血栓等并发症发生药物的应用。
Ojective:To evaluate the coagulation function condition of cervical cancer patients by coagulation function tests, and to discover its clinical value.
Methods:We collect cases from Central Hospital of Jilin City, including 127 cervical cancer patients as case group, and 68 uterine fibroids patients as control group, to test their coagulation function. Using class method to test FIB content; using nephelometry to test PT, PTA, INR and APTT; using SF-3000 to test PLT.
Results:FIB and PTA content are higher than uterine fibroids patients, and the difference has statistical significant, while PT, INR, APTT, PLT are similar between two groups. FIB content is positive correlative with pathological stage. The coagulation function of different differentiation level patients has no significancant difference. The PLT of cervical cancer patients has little change.
Conclusions:The coagulation function of cervical cancer patients has altered. Anti-FIB and anti-PTA drugs should be considered to be increased when anticoagulation of cervical cancer. As pathological stage advances, more drugs should be administrated to prevent thrombus.
方法：以吉林市中心医院2004年1月至2009年9月收治的127例宫颈癌患者为病例组,以68例子宫肌瘤患者为对照组,采用class方法测定纤维蛋白原(FIB)含量,用散射比浊法测定凝血酶原时间(PT)、凝血酶原活动度(PTA)、国际标准化比值(INR)和活化部分凝血活酶时间(APTT),采用日本SF-3000机计数血小板(PLT),综合反应研究对象的凝血机能。
结果：宫颈癌患者FIB含量及PTA明显高于子宫肌瘤患者,差异有统计学意义,而PT、INRv APTT、PLT两组患者差异无统计学意义；FIB含量与宫颈癌病理分期呈正相关；不同病理组织学分化程度的宫颈癌患者凝血机能差异无统计学意义；宫颈癌患者血小板计数无明显改变。
结论：宫颈癌患者凝血功能有所改变；在宫颈癌抗凝治疗时应考虑应用抗FIB含量和PTA增加药物；随着宫颈癌病理期别的增加,应加强预防血栓等并发症发生药物的应用。
Ojective:To evaluate the coagulation function condition of cervical cancer patients by coagulation function tests, and to discover its clinical value.
Methods:We collect cases from Central Hospital of Jilin City, including 127 cervical cancer patients as case group, and 68 uterine fibroids patients as control group, to test their coagulation function. Using class method to test FIB content; using nephelometry to test PT, PTA, INR and APTT; using SF-3000 to test PLT.
Results:FIB and PTA content are higher than uterine fibroids patients, and the difference has statistical significant, while PT, INR, APTT, PLT are similar between two groups. FIB content is positive correlative with pathological stage. The coagulation function of different differentiation level patients has no significancant difference. The PLT of cervical cancer patients has little change.
Conclusions:The coagulation function of cervical cancer patients has altered. Anti-FIB and anti-PTA drugs should be considered to be increased when anticoagulation of cervical cancer. As pathological stage advances, more drugs should be administrated to prevent thrombus.
引文
[1]AL-MondhiryHV, et al. Tumor mteraction with Bascular endothe lium Heamostasis,1987,17:245-53
[2]Glassma AB, etal, Thromboss is and coagulation abmomalit-Ies sociatde with cancer Annclinlabsci.1994, Jan-Feb24(1):1-5
[3]黄平平,李尚珠.自体外周血于细胞移植治疗下肢动脉硬化性闭塞症[J].中华血液学杂志,2003,6：308-311.
[4]AL-. Mondihiry HV. Tumor interaction with vascular endothe lium[J]. Hramostasis,1987,17:245
[5]金力,沈铿,朗景和,等.妇科肿瘤术后并发深静脉血栓的诊治与预防[J].中华妇科杂志,1999,34(8)：488-490.
[6]王建中,姜晓峰等.实验诊断学[M].北京：北京大学医学出版社,2004：112-124.
[7]刘廉.血小板与肿瘤.国外医学输血与血液学分册,1991,14(1)：234.
[8]农辉图,黄光武,小杉忠诚等.喉癌患者的血小板聚集功能检测.中华耳鼻喉科杂志,1993,28(6)：364
[9]农辉图,黄光武,吉晓宾等.头颈恶性肿瘤病人血小板聚集功能的研究.中华肿瘤杂志,1993,15(6)：454.
[10]高进主编.癌的侵袭与转移—基础研究与临床1北京：北京医科大学中国协和医科大学联合出版社,1996：195.
[11]齐元富.恶性肿瘤与血栓前状态研究.中西医结合杂志,1994,7：647
[12]张璐芳,赵军.妇科肿瘤合并急性下肢深静脉血栓形成14例临床分析[J].实用妇产科杂志,2005。21(3)：162.165.
[13]SHTHERLAND D E, WEITZ 1 C, LIEBMAN H A. Thromboembolic complications of cancer:epidemiology, Pathogenesis, diagnosis, and treantment [J]. Am J Hematol,2003,72(1):43-52.
[14]LUXEMBOURG B, BAUERSACHS R. malignancy and thrombosis:a double-sided clinical relationship[J]. Vaza,2005,34(4):225·234.
[15]BARON J A, GRIDLEY G, WEIDERPASS E, et al. Venous throm boembolism and cancer [J]. Lancet,1998,351(9109):1007-1080.
[16]Chew HK, Wun T, Harvey D, et al. Incidence of venous thromboembolism and its effect on survival among patients with common cancers. Arch Intem Med,2006,166(4):458-464.
[17]Deitcher SR. Cancer and thrombosis:mechanisms and treatment. J Thromb Thrombolysis,2003,16(1-2):21-31.
[18]ViMe PH. Abnormal clotting in cancer:an overview of pathophysiology and etiology. Semin Oncol Nurs,2005,21(4 suppl 1):12-20.
[19]Deitcher SR. Cancer and thrombosis:mechanisms and treatment. J Thromb Thrombolysis,2003,16(1-2):21-31.
[20]BRECHOT J M. Thrombosis and lung cancer [J]. Bey Mal Respir,2005.22(6 Pt 2):8S33. a8$37.
[21]AVRIJSCHER EB.CANTOR SB. SHIHYC, etal. Cost. aminmization analysis of Low amoleenlar. aweight heparinoom pard to unfraetionated hepar for Inpatient treatment of Cance patients with deep venous thrombsis[J] Support Care.2004,12(7):531-536.
[22]Deitcher S R. Cancer-related deep venous thrombosis:clinical importance, treatment challenges, and management strategies [J]. Semin Thromb Hemost,2003,29(3):247-258.
[23]Buller H R, Agnelli G, Hull R, et al. Antithrombotic therapy forvenous thromboembolic disease:the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy [J]. Chest,2004,126(3 Suppl):401-428.
[24]MOUSA S A. low-amolecular-aweight heparin in thrombosis and canoer[J]. Semin Thromb Hcmost,2004,30(Suppl 1):25-30.
[25]Tagalakis V, Blostein M, Robinson-Cohen C, et al. The effect of anticoagulants on cancer risk and survival:systematic review. Caneer Treat Rev,2007,33(4):358-368.
[26]王红英,李东峰,李玉珍,等.妇科肿瘤术后井发下肢深静脉血栓24例分析[J].中国实用妇科与产科杂志。2003。19(2)：108-109
[27]Clarke-Pearson DL, Dodge RK, Synanl, et al. Venous throm boembolism prophylaxis:patients at high risk to fail intemaittent pneumatic compression[J]. Obstet Gynecol,2003,101:157-163
[28]sallall S, WanJY, Nguyen NP. Venous thrombosis in patients witIl solid tumors:determination of frequency and characteristics[J]. Thrombosis & Haemostasis,2002,87(4):575.
[29]Bick RL. Cancer-associated thrombosis[J]. New England Journal of Medicine,2003,349(2):109.
[30]CzaykowskipM, Moorem, TannockI. Hish risk of vascljlar events in patients with urothelial transitional cell carcinoma treated with cisplatin based chemotherapy [J]. Journ a of urology,1998,160(6-1):202 1
[31]Tham J, Albertsson M. Upper extremity deep venous thrombosis in patients wit11 5-fluorouracil-containing adjuvant chemotherapy:three case reports and a review[J]. Acta Oncologica,2004,43(1):108.
[1]赵文华.恶性肿瘤流行趋势.分析及预防的研究[J].天津科技,2006,3：38-39.
[2]AL-Mondhiry HV, et al. Tumor mteraction with Bascular endothe lium. Heamostasis,1987,17:245-53.
[3]Minna JD, et al. Editors cancer ptinciples and practice of oncology Bided philaephia. JB hppincott,1989:1920-1940
[4]Glassman AB, et al, Thrombossis and coagulation abmomalities as sociatde with cancer Annclinlabsci.1994, Jan-Feb24(1):1-5.
[5]Warren B, Vales 0. The adhesion of thromboplastic turmor emboh to vessel wall in witro. Br J Exp pathol.1972,53:301-13.
[6]Heffner RR. Myopathy of embolic origin in patients with Carcino ma-Neurology.1971,21:840-843.
[7]Moake JL. Hyperooagulable states Adv Intern Med,1990,35:235-248.
[8]Marstern J,etal. Thrombosis and neoplasia Thromb Heamost,1995,73: 129.
[9]林梅英,黄妍,秦冰.血小板参数对化疗患者骨髓功能状态评估价值的初步研究[J].广西医学,2008,30(9)：1338-1339.
[10]Federick R, Riic K, Richard L. Activation of blood coagu-lation in cancer:Troussean's syndrome revisited [J]. Blood,1983,62 (1):14-31.
[11]齐元富.恶性肿瘤与血栓前状态研究.中西医结合杂志,1994,7：647
[12]刘秀巧,王淑娟,吴振茹,等.恶性肿瘤与高纤维蛋白原血症[J].中华肿瘤杂志,2002,24(1)：52.
[13]张培彤,裴迎霞,朴柄奎,等.肿瘤患者与正常人血小板表面黏附蛋白表达异同的临床观察及意义[J].中华肿瘤杂志,1998,20(3)：207-209.
[14]Cordon SG, Cross BA. A factor x-actisating cysteme protease from malignant tissue. J clin Innest.1981,67:1665-1671.
[15]Edwad RL-Abnomalities of blood coagulation in patients with
cancer mononuclear cell tissue factor generation. J lab clin Med, 1981,98:917-928.
[16]Tickles FR, Edwards TL-Activation of blood coagulation in Cancer. Thousseaus sysdrone revisited. Blood.1983,62:14-31.
[17]Donati MB, et al. Cancer and thrombosis:from phlegriasial bedolens to transgenic mice Thromb-Haemost,1995, Jul:74:278-281.
[18]Piccioli A, et al. Cancer and Venous theomboemolism. Am Heart J, 1996, Oct.132:850-855.
[19]Gabazza MD. et al. Coagulation Fibrinolysis systerm and Markers of collegem Metabolism in long cancer. Cancer December 1992, 70:2631
[20]Collen D. On the regulation and control of fibrinolysis [J]. Thromb Hemost,1980,43 (2):77-89
[21]Bell WR. The fibrinolytic system in neopllasia semin Thromb Haemost, 1996,22:456-473.
[22]Collins RF. et al. Neurology manifestations of intravascular coagu lation in Cancer-Neurology.1975,25:795-806.
[23]LEVI M, Systemic microangiopathies in the cancer patients[M] Lugassy G, Fanlanga A, Kskksr A, etal Thrombosis and cancer. London:Taylor & Francis,2004:117-127.
[24]CORDON L I. KWAAN H C. Thrombotic microangiopathy manifesting as thrombocytopenic purpura/hemolytic uremic syndrome in the cander [J]. Semin Thromb Hemost,1999,25(2):217-221.
[25]李家增.止血异常与恶性肿瘤[J].血栓与止血学,2006,12(2)：88-89.
[26]SHEN V S, POLLOCK E W. Fatal Pulmonary embolism in cancer patients:is heparin prophylaxis jnstifide [J]. South med J, 1980,73(7)841-843.
[27]魏文宁,郭涛,祝建芳,等.恶性肿瘤血栓前体蛋白水平改变的临床意义[J].中华内科杂志,2006,12(45)：1026.1027
[28]Dziarski R, et al. Enbancement of mixed leukocyte reaction and cytotixac antirumor responses by heparin. J urmunol,1989, Jull.143:365.
[29]Wssik M, et al, Heparm enhances generation of naturalkiller ac urity in vitro, Arch urmunol Ther Exp Warsz,1994,42:73-76.
[30]Antachopoulos CT, et al. In vitro effects of heparin on SW480 turnor cell-matrx. Antrancer Res,1995 Jul-Aug:15:1411-1416.
[31]Glantz [M].et al.Treatment of radiation induced nervous system miury with heparin and warfan. Neurology,1994,44:2002.
[32]BRECHOT J M. Thrombosis and lung cancer [J]. Rev Mal Respir,2005, 22(6 Pt 2):8S33-a8S37.
[33]AVRITSCHER EB, CANTOR SB, SHIH YC, et al, Cost-aminimization analysis of low-amolecnlar-aweight heparin (dalteparin) compared to unfractionated heparin for inpatient treatment of cancer patients with deep venous thrombosis [J]. Support care cancer,2004, 12(7):531-536.
[34]MOUSA S A. low-amolecular-aweight heparin in thrombosis and cancer [J]. Semin Thromb Hemost,2004,30(Suppl 1):25-30.
[2]Glassma AB, etal, Thromboss is and coagulation abmomalit-Ies sociatde with cancer Annclinlabsci.1994, Jan-Feb24(1):1-5
[3]黄平平,李尚珠.自体外周血于细胞移植治疗下肢动脉硬化性闭塞症[J].中华血液学杂志,2003,6：308-311.
[4]AL-. Mondihiry HV. Tumor interaction with vascular endothe lium[J]. Hramostasis,1987,17:245
[5]金力,沈铿,朗景和,等.妇科肿瘤术后并发深静脉血栓的诊治与预防[J].中华妇科杂志,1999,34(8)：488-490.
[6]王建中,姜晓峰等.实验诊断学[M].北京：北京大学医学出版社,2004：112-124.
[7]刘廉.血小板与肿瘤.国外医学输血与血液学分册,1991,14(1)：234.
[8]农辉图,黄光武,小杉忠诚等.喉癌患者的血小板聚集功能检测.中华耳鼻喉科杂志,1993,28(6)：364
[9]农辉图,黄光武,吉晓宾等.头颈恶性肿瘤病人血小板聚集功能的研究.中华肿瘤杂志,1993,15(6)：454.
[10]高进主编.癌的侵袭与转移—基础研究与临床1北京：北京医科大学中国协和医科大学联合出版社,1996：195.
[11]齐元富.恶性肿瘤与血栓前状态研究.中西医结合杂志,1994,7：647
[12]张璐芳,赵军.妇科肿瘤合并急性下肢深静脉血栓形成14例临床分析[J].实用妇产科杂志,2005。21(3)：162.165.
[13]SHTHERLAND D E, WEITZ 1 C, LIEBMAN H A. Thromboembolic complications of cancer:epidemiology, Pathogenesis, diagnosis, and treantment [J]. Am J Hematol,2003,72(1):43-52.
[14]LUXEMBOURG B, BAUERSACHS R. malignancy and thrombosis:a double-sided clinical relationship[J]. Vaza,2005,34(4):225·234.
[15]BARON J A, GRIDLEY G, WEIDERPASS E, et al. Venous throm boembolism and cancer [J]. Lancet,1998,351(9109):1007-1080.
[16]Chew HK, Wun T, Harvey D, et al. Incidence of venous thromboembolism and its effect on survival among patients with common cancers. Arch Intem Med,2006,166(4):458-464.
[17]Deitcher SR. Cancer and thrombosis:mechanisms and treatment. J Thromb Thrombolysis,2003,16(1-2):21-31.
[18]ViMe PH. Abnormal clotting in cancer:an overview of pathophysiology and etiology. Semin Oncol Nurs,2005,21(4 suppl 1):12-20.
[19]Deitcher SR. Cancer and thrombosis:mechanisms and treatment. J Thromb Thrombolysis,2003,16(1-2):21-31.
[20]BRECHOT J M. Thrombosis and lung cancer [J]. Bey Mal Respir,2005.22(6 Pt 2):8S33. a8$37.
[21]AVRIJSCHER EB.CANTOR SB. SHIHYC, etal. Cost. aminmization analysis of Low amoleenlar. aweight heparinoom pard to unfraetionated hepar for Inpatient treatment of Cance patients with deep venous thrombsis[J] Support Care.2004,12(7):531-536.
[22]Deitcher S R. Cancer-related deep venous thrombosis:clinical importance, treatment challenges, and management strategies [J]. Semin Thromb Hemost,2003,29(3):247-258.
[23]Buller H R, Agnelli G, Hull R, et al. Antithrombotic therapy forvenous thromboembolic disease:the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy [J]. Chest,2004,126(3 Suppl):401-428.
[24]MOUSA S A. low-amolecular-aweight heparin in thrombosis and canoer[J]. Semin Thromb Hcmost,2004,30(Suppl 1):25-30.
[25]Tagalakis V, Blostein M, Robinson-Cohen C, et al. The effect of anticoagulants on cancer risk and survival:systematic review. Caneer Treat Rev,2007,33(4):358-368.
[26]王红英,李东峰,李玉珍,等.妇科肿瘤术后井发下肢深静脉血栓24例分析[J].中国实用妇科与产科杂志。2003。19(2)：108-109
[27]Clarke-Pearson DL, Dodge RK, Synanl, et al. Venous throm boembolism prophylaxis:patients at high risk to fail intemaittent pneumatic compression[J]. Obstet Gynecol,2003,101:157-163
[28]sallall S, WanJY, Nguyen NP. Venous thrombosis in patients witIl solid tumors:determination of frequency and characteristics[J]. Thrombosis & Haemostasis,2002,87(4):575.
[29]Bick RL. Cancer-associated thrombosis[J]. New England Journal of Medicine,2003,349(2):109.
[30]CzaykowskipM, Moorem, TannockI. Hish risk of vascljlar events in patients with urothelial transitional cell carcinoma treated with cisplatin based chemotherapy [J]. Journ a of urology,1998,160(6-1):202 1
[31]Tham J, Albertsson M. Upper extremity deep venous thrombosis in patients wit11 5-fluorouracil-containing adjuvant chemotherapy:three case reports and a review[J]. Acta Oncologica,2004,43(1):108.
[1]赵文华.恶性肿瘤流行趋势.分析及预防的研究[J].天津科技,2006,3：38-39.
[2]AL-Mondhiry HV, et al. Tumor mteraction with Bascular endothe lium. Heamostasis,1987,17:245-53.
[3]Minna JD, et al. Editors cancer ptinciples and practice of oncology Bided philaephia. JB hppincott,1989:1920-1940
[4]Glassman AB, et al, Thrombossis and coagulation abmomalities as sociatde with cancer Annclinlabsci.1994, Jan-Feb24(1):1-5.
[5]Warren B, Vales 0. The adhesion of thromboplastic turmor emboh to vessel wall in witro. Br J Exp pathol.1972,53:301-13.
[6]Heffner RR. Myopathy of embolic origin in patients with Carcino ma-Neurology.1971,21:840-843.
[7]Moake JL. Hyperooagulable states Adv Intern Med,1990,35:235-248.
[8]Marstern J,etal. Thrombosis and neoplasia Thromb Heamost,1995,73: 129.
[9]林梅英,黄妍,秦冰.血小板参数对化疗患者骨髓功能状态评估价值的初步研究[J].广西医学,2008,30(9)：1338-1339.
[10]Federick R, Riic K, Richard L. Activation of blood coagu-lation in cancer:Troussean's syndrome revisited [J]. Blood,1983,62 (1):14-31.
[11]齐元富.恶性肿瘤与血栓前状态研究.中西医结合杂志,1994,7：647
[12]刘秀巧,王淑娟,吴振茹,等.恶性肿瘤与高纤维蛋白原血症[J].中华肿瘤杂志,2002,24(1)：52.
[13]张培彤,裴迎霞,朴柄奎,等.肿瘤患者与正常人血小板表面黏附蛋白表达异同的临床观察及意义[J].中华肿瘤杂志,1998,20(3)：207-209.
[14]Cordon SG, Cross BA. A factor x-actisating cysteme protease from malignant tissue. J clin Innest.1981,67:1665-1671.
[15]Edwad RL-Abnomalities of blood coagulation in patients with
cancer mononuclear cell tissue factor generation. J lab clin Med, 1981,98:917-928.
[16]Tickles FR, Edwards TL-Activation of blood coagulation in Cancer. Thousseaus sysdrone revisited. Blood.1983,62:14-31.
[17]Donati MB, et al. Cancer and thrombosis:from phlegriasial bedolens to transgenic mice Thromb-Haemost,1995, Jul:74:278-281.
[18]Piccioli A, et al. Cancer and Venous theomboemolism. Am Heart J, 1996, Oct.132:850-855.
[19]Gabazza MD. et al. Coagulation Fibrinolysis systerm and Markers of collegem Metabolism in long cancer. Cancer December 1992, 70:2631
[20]Collen D. On the regulation and control of fibrinolysis [J]. Thromb Hemost,1980,43 (2):77-89
[21]Bell WR. The fibrinolytic system in neopllasia semin Thromb Haemost, 1996,22:456-473.
[22]Collins RF. et al. Neurology manifestations of intravascular coagu lation in Cancer-Neurology.1975,25:795-806.
[23]LEVI M, Systemic microangiopathies in the cancer patients[M] Lugassy G, Fanlanga A, Kskksr A, etal Thrombosis and cancer. London:Taylor & Francis,2004:117-127.
[24]CORDON L I. KWAAN H C. Thrombotic microangiopathy manifesting as thrombocytopenic purpura/hemolytic uremic syndrome in the cander [J]. Semin Thromb Hemost,1999,25(2):217-221.
[25]李家增.止血异常与恶性肿瘤[J].血栓与止血学,2006,12(2)：88-89.
[26]SHEN V S, POLLOCK E W. Fatal Pulmonary embolism in cancer patients:is heparin prophylaxis jnstifide [J]. South med J, 1980,73(7)841-843.
[27]魏文宁,郭涛,祝建芳,等.恶性肿瘤血栓前体蛋白水平改变的临床意义[J].中华内科杂志,2006,12(45)：1026.1027
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