胃癌患者肿瘤恶性程度与凝血功能的相关性研究

摘要

目的:探讨胃癌患者凝血功能的改变及与肿瘤恶性程度的相关性.方法:选择172例胃癌患者,按照肿瘤侵犯深度,将其分为早期胃癌组(29例),进展期胃癌组(143例);又将172例患者根据是否有转移分为无转移组(52例),有转移组(120例);选择50名同期健康体检者为健康对照组.对所有入组人员的纤维蛋白原(FIB)、抗凝血酶Ⅲ(AT-Ⅲ)、血小板计数(PLT)等凝血功能进行检测并比较分析.结果:胃癌组与健康对照组相比,检测的FIB、AT-Ⅲ、PLT总体明显升高,差异有统计学意义(t=6.40,t=2.47,t=3.13;P<0.05);其中,进展期胃癌组患者与早期胃癌组比较,FIB、PLT明显升高,差异有统计学意义(t=4.14,t=-2.31;P<0.05);转移组患者与无转移组比较,FIB、PLT明显升高,差异均具有统计学意义(t=-4.24,t=-2.36;P<0.05).结论:对胃癌患者凝血功能的检测,有助于为血栓形成和消化道出血的诊断提供实验室依据,为是否需行抗凝或止血治疗提供参考,FIB、PLT的变化,对间接预测肿瘤的发生、浸润和转移有一定的临床意义.%Objective:To investigate the changes of coagulation function in patients with gastric carcinoma and the correlation between this changes and grade of malignancy.Methods:172 patients with gastric cancer were divided into early gastric carcinoma group (29cases) and advanced gastric carcinoma (143cases) as the different indicators of detection. At the same time, these patients also were divided into group without lymph node metastasis (52cases) and group with lymph node metastasis (120cases) according to the situation of lymph node metastasis. Besides, 50 health persons were selected as control group. A series of coagulation function indicators of them, including FIB, AT-Ⅲ and PLT, were detected and analyzed.Results: The levels of FIB, AT-Ⅲ and PLT of gastric carcinoma group were significantly higher than those of healthy group (t=6.40,t=2.47,t=3.13;P<0.05). Compared with the early gastric carcinoma group, the levels of FIB and PLT in the patients of advanced gastric carcinoma group were significantly higher (t=4.14,t=-2.31; P<0.05). The levels of FIB and PLT of the group with lymph node metastatic were significantly higher than that of the group without lymph nodes metastasis (t=-4.24,t=-2.36;P<0.05).Conclusion: The detection of coagulation function for patients with gastric carcinoma can contribute to provide laboratory reference for the diagnosis of thrombogenesis and alimentary tract hemorrhage, and can provide reference for whether the patients need anti-freezing or hemostasis. The changes of FIB and PLT might have some clinical value for the indirect prediction of the occurrence, invasion and metastasis of tumor.