凝血因子Ⅲ在非小细胞肺癌高凝状态患者外周血中的表达及其临床意义

摘要

目的:研究凝血因子Ⅲ在非小细胞肺癌(non-small cell lung cancer,NSCLC)高凝状态患者外周血中的表达水平,并探讨其表达水平与临床病理特征和生存期的关系.方法:选取2013年1月至2014年10月云南省肿瘤医院病理和生化检测证实为NSCLC高凝状态患者74例,NSCLC无高凝状态患者42例作为研究对象,酶联免疫法检测血清凝血因子Ⅲ的表达水平,分析其与NSCLC临床病理特征和预后的关系.结果:化疗前NSCLC高凝状态患者血清凝血因子Ⅲ为(560.32~200.34)ng/L,显著高于无高凝状态患者(463.29~159.22)ng/L的表达水平(P=0.008),且显著高于化疗后凝血因子Ⅲ(471.39±160.31)ng/L的血清表达水平(P<0.001);凝血因子Ⅲ在NSCLC高凝状态患者血清中的表达水平与淋巴结转移(P=0.026)、远端转移(P=0.025)和TNM分期(P=0.007)有关,且与凝血酶原时间(PT)(r=-0.638,P=0.032)、活化部分凝血酶时间(APTT)(r=-0.702,P=0.028)呈负相关,与纤维蛋白原(FIB)(r=0.715,P=0.008)、血小板(PLT)(r=0.597,P=0.007)呈正相关;凝血因子Ⅲ高表达水平的NSCLC高凝状态患者1~3年总生存期显著低于低表达患者(P<0.05).结论:NSCLC高凝状态患者血清凝血因子Ⅲ表达水平与淋巴结转移和TNM分期有关,对患者生存期具有预测的指导意义.%Objective:To study the expression of coagulation factorⅢin patients with non-small cell lung cancer(NSCLC)with hyperco-agulability and its clinical significance,and to explore the relationship between its expression level and the clinicopathological features and the survival period.Methods:There were 74 patients with NSCLC with hypercoagulability and 42 without hypercoagulability,con-firmed using pathological and biochemical tests in Yunnan Cancer Hospital from January 2013 to October 2014.The enzyme-linked im-munosorbent assay(ELISA)was performed to detect the expression of serum coagulation factorⅢand its relationship with clinico-pathological features and prognosis was analyzed.Results:Serum coagulation factorⅢlevel in patients with hypercoagulable NSCLC before chemotherapy was 560.32-200.34 ng/L,which was significantly higher than that in patients without hypercoagulability(463.29-159.22 ng/L)(P=0.008),and significantly higher than that in patients after chemotherapy(471.39±160.31 ng/L)(P=0.000).Serum coag-ulation factorⅢlevel in patients with hypercoagulable state of NSCLC was related to lymph node metastasis(P=0.026),distant metas-tasis(P=0.025),and tumor-node-metastasis staging(P=0.007).They were negatively correlated with prothrombin time(r=?0.638,P=0.032)and activated partial thromboplastin time(r=?0.702,P=0.028),and positively correlated with fibrinogen(r=0.715,P=0.008)and platelets (r=0.597,P=0.007).The 1-to 3-year overall survival of patients with NSCLC with high coagulation factorⅢexpression was significantly lower than that of patients with low coagulation factorⅢexpression.Conclusions: The expression level of serum coagu-lation factorⅢin patients with high coagulation state of NSCLC is related to lymph node metastasis and TNM staging,which has cer-tain guiding significance for predicting the survival of patients.