凝血功能与胃癌侵犯深度?分期及转移的关系
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Correlation of coagulation function to tumor infiltration,tumor stage and metastasis status in patients with gastric cancer
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    目的:探讨胃癌患者凝血指标-血小板计数的变化与肿瘤侵犯深度-分期及淋巴结-血行转移的关系-方法:根据TNM分期将229例胃癌患者分为Ⅰ期53例,Ⅱ期45例,Ⅲ期116例,Ⅳ期15例,其中无淋巴结及远处转移者(T1~4N0M0)73例,有转移者(N1~3和/或M1)156例,按肿瘤侵犯深度分为早期胃癌组(癌组织浸润仅限于黏膜层及黏膜下层)36例-进展期胃癌组(癌组织进入肌层及以下)193例,同期50例健康体检者为对照组-术前检测血浆凝血酶原时间(prothrombin time,PT)-活化部分凝血活酶时间(activated partial thromboplastin time,APTT)-凝血酶时间(thrombin time,TT)-纤维蛋白原(fibrinogen,FIB)-抗凝血酶(antithrombin,AT)-Ⅲ和血小板(platelet,PLT)计数-结果:胃癌患者与对照组比较,FIB升高,AT-Ⅲ增多,PLT增多(P < 0.05 或P < 0.01)-胃癌分期越晚-侵犯深度越深,FIB水平越高,PLT计数越多(P < 0.01)-胃癌无转移组PT缩短,与对照组比较,差异有统计学意义(P < 0.05)-胃癌转移组FIB明显升高,PLT增多,与对照组及无转移组相比,差异均有统计学意义(P < 0.01)-结论:胃癌患者普遍存在凝血功能异常,与肿瘤分期-侵犯深度-淋巴结或血行转移有关,术前常规凝血指标检测有助于预测胃癌的进展和转移情况-

    Abstract:

    Objective:To investigate the relationship between coagulation function,platelet(PLT)counting and tumor infiltration,the clinical stage and metastasis status in gastric cancer patients. Methods:A total of 229 patients with gastric cancer were included in the study,with 53 cases in stageⅠof TNM classification,45 cases in stage Ⅱ,116 cases in stage Ⅲ,15 cases in stage Ⅳ. According the depth of tumor infiltration,there were 36 cases of early gastric cancer and 193 cases of advanced gastric cancer .There were 73 cases without metastasis and 156 cases with metastasis. Fifty heathy volunteers were set as the control group. The prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),antithrombase(AT)-Ⅲ and PLT were detected. Results:FIB,AT-Ⅲ and PLT were significantly higher in the group with gastric cancer than in the control group(P < 0.05 or P < 0.01). Along with the progression of tumor infiltration,the Levels of FIB and PLT became gradually higher. PT were obviously shorten in gastric cancer patients without metastasis than in control group(P < 0.05). FIB and PLT were significantly higher in group with metastasis than in group without metastasis and the normal group(P < 0.01). Conclusion:The patients with gastric cancer are usually accompanied with disorder of coagulation and fibrinolytic systems. FIB and PLT significantly increasing associated with tumor infiltration,lymphatic and distal metastasis of cancer cells. Therefore,monitoring the coagulation indexes could be a useful way to diagnose and predict clinical stage of gastric cancer.

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王润洁,刘超英,李 江.凝血功能与胃癌侵犯深度?分期及转移的关系[J].南京医科大学学报(自然科学版),2012,(11):1545-1549

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  • 收稿日期:2012-05-30
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