吉林大学学报(医学版) ›› 2022, Vol. 48 ›› Issue (1): 203-210.doi: 10.13481/j.1671-587X.20220125

• 临床研究 • 上一篇    下一篇

外周血凝血指标、血小板计数和NLR检测对恶性肿瘤患者治疗前机体凝血状态的评估价值

汪敏,于鹏跃,王言,宋燕珂,李峣,孙莹,赵丽艳()   

  1. 吉林大学第二医院检验科,吉林 长春 130041
  • 收稿日期:2021-06-13 出版日期:2022-01-28 发布日期:2022-01-17
  • 通讯作者: 赵丽艳 E-mail:970201043@qq.com
  • 作者简介:汪 敏(1995-),女,四川省成都市人,在读硕士研究生,主要从事肿瘤和血栓形成机制方面的研究。
  • 基金资助:
    吉林省科技厅科技发展计划项目(20200801023GH)

Evaluation values of peripheral blood coagulation indexes, platelet count and NLR in coagulation state in patients with malignant tumors before treatment

Min WANG,Pengyue YU,Yan WANG,Yanke SONG,Yao LI,Ying SUN,Liyan ZHAO()   

  1. Department of Laboratory Medicine,Second Hospital,Jilin University,Changchun 130041,China
  • Received:2021-06-13 Online:2022-01-28 Published:2022-01-17
  • Contact: Liyan ZHAO E-mail:970201043@qq.com

摘要: 目的

检测恶性肿瘤患者临床治疗前外周血的凝血指标、血小板计数及中性粒细胞/淋巴细胞比值(NLR),探讨其对患者凝血状态的评估价值。

方法

选取354例恶性肿瘤(宫颈癌74例,肺癌65例,卵巢癌55例,结直肠癌50例,胃癌43例,食管癌35例和胰腺癌32例)患者作为肿瘤组,并按照TNM分期分为早期(Ⅰ-Ⅱ)和晚期(Ⅲ-Ⅳ)肿瘤组,同时选取100名健康体检者作为对照组,对比分析各组受试者外周血凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-Dimer)、纤维蛋白(原)降解产物(FDP)、抗凝血酶(AT)、血小板计数和NLR检测结果。

结果

与对照组比较,早和晚期肿瘤组患者PT均延长(P<0.01),APTT均缩短(P<0.05或P<0.01),FIB、D-Dimer、FDP水平和NLR均升高(P<0.01);与对照组比较,晚期肿瘤组患者TT缩短(P<0.05),AT活性降低(P<0.05),血小板计数升高(P<0.05);与早期肿瘤组患者比较,晚期肿瘤组患者PT延长(P<0.01),TT缩短(P<0.01),FIB、D-Dimer、FDP水平和NLR升高(P<0.01)。与对照组比较,各类型肿瘤组患者PT均延长(P<0.05或P<0.01),除食管癌外的不同类型肿瘤组患者APTT均缩短(P<0.05或P<0.01),肺癌、卵巢癌和食管癌患者TT均缩短(P<0.05或P<0.01),各类型肿瘤组患者FIB、D-Dimer和FDP水平均升高(P<0.05或P<0.01),结直肠癌、食管癌和胰腺癌患者AT活性降低(P<0.05),晚期卵巢癌患者血小板计数升高(P<0.01),各类型肿瘤组患者NLR均升高(P<0.05或P<0.01)。

结论

恶性肿瘤患者在治疗前主要表现为APTT缩短及FIB、D-Dimer水平和NLR升高,晚期肿瘤患者还可表现为血小板计数升高和AT降低,提示肿瘤患者止凝血功能紊乱,易并发血栓事件。

关键词: 恶性肿瘤, 凝血指标, 凝血状态, 中性粒细胞/淋巴细胞比值

Abstract: Objective

To detect the coagulation indexes, platelet count and neutrophil/lymphocyte ratio (NLR) in the peripheral blood of patients with malignant tumors before clinical treatment, and to explore their evaluation values in the patient’s coagulation state.

Methods

A total of 354 patients with malignant tumors(74 cases of cervical cancer, 65 cases of lung cancer, 55 cases of ovarian cancer, 50 cases of colorectal cancer, 43 cases of gastric cancer, 35 cases of esophageal cancer and 32 cases of pancreatic cancer) were selected as tumor group and divided into early stage (Ⅰ-Ⅱ) and late stage (Ⅲ-Ⅳ) tumor groups according to TNM stage. At the same time, 100 healthy patients were selected as control group. The prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT),fibrinogen (FIB), D-dimer (D-Dimer), fibrin or fibrinogen degradation products (FDP), antithrombin (AT), platelet count and NLR of the subjects in various groups were compared and analyzed.

Results

Compared with control group, PT in early and late stage tumor groups were prolonged (P<0.01), APTT were shortened (P<0.05 or P<0.01), and FIB, D-Dimer, FDP levels and NLR were all increased (P<0.01);compared with control group, TT of the patients in late tumor group was shortened (P<0.05), AT was decreased (P<0.05), and platelet count was increased (P<0.05);compared with early stage tumor group, PT of the patients in late tumor group was prolonged (P<0.01), TT was shortened (P<0.01), and FIB, D-Dimer, FDP levels and NLR were increased (P<0.01).Compared with control group, PT of the patients in all tumor groups were prolonged (P<0.05 or P<0.01), APTT were shortened in different types of tumor groups except esophageal cancer (P<0.05 or P<0.01), TT of the patients with lung cancer, ovarian cancer, and esophageal cancer were shortened(P<0.05 or P<0.01), FIB, D-Dimer and FDP in all tumor groups were increased(P<0.05 or P<0.01), AT of the patients with colorectal cancer, esophageal cancer, and pancreatic cancer were decreased (P<0.05), the platelet count of the patients with advanced ovarian cancer was increased (P<0.01), and NLR in all tumor groups were increased(P<0.05 or P<0.01).

Conclusion

In the patients with malignant tumors before treatment, the main indicators of peripheral blood are shortened APTT, increased FIB and D-Dimer levels and NLR, and the patients with advanced tumors also show increased platelet count and decreased AT, indicating that tumor patients have disorder of hemostasis and coagulation function and are prone to thrombotic events.

Key words: Malignant tumor, Coagulation index, Coagulation state, Neutrophil/lymphocyte ratio

中图分类号: 

  • R730.43