中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2013年
12期
1067-1070
,共4页
包润发%束翌俊%董平%顾钧%吴向嵩%李茂岚%翁昊%丁倩%吴文广
包潤髮%束翌俊%董平%顧鈞%吳嚮嵩%李茂嵐%翁昊%丁倩%吳文廣
포윤발%속익준%동평%고균%오향숭%리무람%옹호%정천%오문엄
胆囊肿瘤%血液凝固试验%纤维蛋白原%预后%因素分析,统计学
膽囊腫瘤%血液凝固試驗%纖維蛋白原%預後%因素分析,統計學
담낭종류%혈액응고시험%섬유단백원%예후%인소분석,통계학
Gallbladder neoplasms%Blood coagulation tests%Fibrinogen%Prognosis%Factor analysis,statistical
目的 探讨胆囊癌患者凝血功能变化与临床病理特征间的关系.方法 回顾2007年1月至2013年6月收治的64例胆囊癌患者(胆囊癌组)和60例胆囊炎患者(对照组)的血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、凝血酶时间(TT).比较胆囊癌患者凝血功能的变化及上述指标与胆囊癌患者预后的关系.结果 与对照组比较,胆囊癌组患者APTT明显缩短[(29.0±4.2)s,t=-4.265,P=0.000],PT[(11.5±1.4)s]、TT[(15.3±3.5)s]延长(t=2.521、4.147,P＜0.05)、Fib明显升高[(4.1 ±0.9)g/L,t=4.365,P=0.000].中、低分化腺癌患者Fib高于高分化腺癌患者(F=4.069,P=0.022),有淋巴结转移患者Fib明显高于无淋巴结转移者(t=2.640,P=0.010),TNMⅡ～Ⅳ期患者Fib明显高于0～Ⅰ期患者(t=3.003,P＜0.01).胆囊癌患者伴高纤维蛋白原血症比例(32/64)明显高于对照组(11/60,x2=13.709,P＜0.01).且与胆囊癌Fib正常者相比,在肿瘤分化程度(x2=7.760)、浸润深度(x2=10.573)、淋巴结转移情况(x2=6.063)及病理分期(x2=5.851)差异均有统计学意义(P＜0.05).胆囊癌伴高纤维蛋白原血症患者与胆囊癌Fib正常患者中位生存率分别为8.63个月和16.73个月,1、3年生存率分别为64.7％、14.9％和74.9％、21.1％,差异有统计学意义(P＜0.05).结论 胆囊癌患者血清Fib水平在术前辅助评估疾病进展及预后等方面有一定的临床应用价值.
目的 探討膽囊癌患者凝血功能變化與臨床病理特徵間的關繫.方法 迴顧2007年1月至2013年6月收治的64例膽囊癌患者(膽囊癌組)和60例膽囊炎患者(對照組)的血漿凝血酶原時間(PT)、活化部分凝血活酶時間(APTT)、纖維蛋白原(Fib)、凝血酶時間(TT).比較膽囊癌患者凝血功能的變化及上述指標與膽囊癌患者預後的關繫.結果 與對照組比較,膽囊癌組患者APTT明顯縮短[(29.0±4.2)s,t=-4.265,P=0.000],PT[(11.5±1.4)s]、TT[(15.3±3.5)s]延長(t=2.521、4.147,P＜0.05)、Fib明顯升高[(4.1 ±0.9)g/L,t=4.365,P=0.000].中、低分化腺癌患者Fib高于高分化腺癌患者(F=4.069,P=0.022),有淋巴結轉移患者Fib明顯高于無淋巴結轉移者(t=2.640,P=0.010),TNMⅡ～Ⅳ期患者Fib明顯高于0～Ⅰ期患者(t=3.003,P＜0.01).膽囊癌患者伴高纖維蛋白原血癥比例(32/64)明顯高于對照組(11/60,x2=13.709,P＜0.01).且與膽囊癌Fib正常者相比,在腫瘤分化程度(x2=7.760)、浸潤深度(x2=10.573)、淋巴結轉移情況(x2=6.063)及病理分期(x2=5.851)差異均有統計學意義(P＜0.05).膽囊癌伴高纖維蛋白原血癥患者與膽囊癌Fib正常患者中位生存率分彆為8.63箇月和16.73箇月,1、3年生存率分彆為64.7％、14.9％和74.9％、21.1％,差異有統計學意義(P＜0.05).結論 膽囊癌患者血清Fib水平在術前輔助評估疾病進展及預後等方麵有一定的臨床應用價值.
목적 탐토담낭암환자응혈공능변화여림상병리특정간적관계.방법 회고2007년1월지2013년6월수치적64례담낭암환자(담낭암조)화60례담낭염환자(대조조)적혈장응혈매원시간(PT)、활화부분응혈활매시간(APTT)、섬유단백원(Fib)、응혈매시간(TT).비교담낭암환자응혈공능적변화급상술지표여담낭암환자예후적관계.결과 여대조조비교,담낭암조환자APTT명현축단[(29.0±4.2)s,t=-4.265,P=0.000],PT[(11.5±1.4)s]、TT[(15.3±3.5)s]연장(t=2.521、4.147,P＜0.05)、Fib명현승고[(4.1 ±0.9)g/L,t=4.365,P=0.000].중、저분화선암환자Fib고우고분화선암환자(F=4.069,P=0.022),유림파결전이환자Fib명현고우무림파결전이자(t=2.640,P=0.010),TNMⅡ～Ⅳ기환자Fib명현고우0～Ⅰ기환자(t=3.003,P＜0.01).담낭암환자반고섬유단백원혈증비례(32/64)명현고우대조조(11/60,x2=13.709,P＜0.01).차여담낭암Fib정상자상비,재종류분화정도(x2=7.760)、침윤심도(x2=10.573)、림파결전이정황(x2=6.063)급병리분기(x2=5.851)차이균유통계학의의(P＜0.05).담낭암반고섬유단백원혈증환자여담낭암Fib정상환자중위생존솔분별위8.63개월화16.73개월,1、3년생존솔분별위64.7％、14.9％화74.9％、21.1％,차이유통계학의의(P＜0.05).결론 담낭암환자혈청Fib수평재술전보조평고질병진전급예후등방면유일정적림상응용개치.
Objective To study the relationship between the change of coagulation and the clinicopathologic characteristics in patients with gallbladder cancer.Methods The 64 gallbladder cancer patients (GBC group) and 60 cholecystitis patients (control group) had been reviewed from January 2007 to June 2013.The prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (Fib),and thrombin time (TT) had been measured and compared between patients of GBC group and control group.The relationship of coagulation function and prognosis were analyzed.Results Compared with control group,APTT in GBC group ((29.0 ± 4.2) s) was significantly shortened (t =-4.265,P =0.000) and PT ((11.5 ± 1.4) s),TT ((15.3 ± 3.5) s),Fib ((4.1 ± 0.9) g/L) were significantly increased in GBC group (t =2.521,4.147 and 4.365,all P ＜ 0.05).The level of Fib was higher in patients with medium or poor-differentiated tumor cells (F =4.069,P =0.022),lymph metastasis (t =2.640,P =0.010) and advanced staging (Ⅱ-Ⅳ) (t =3.003,P ＜ 0.01) than those of well-differentiated,non-lymph metastasis and early staging (0-Ⅰ).The ratio of gallbladder cancer with hyperfibrinogenemia (32/64) was significantly higher than control group (11/60,x2 =13.709,P ＜ 0.01).In GBC group,compared with normal Fib patients,hyperfibrinogenemia patients showed significantly difference in clinicopathologic characteristics (x2 =5.851-10.573,P ＜ 0.05).The average survival period of hyperfibrinogenemia patients and normal Fib patients were 8.63 months and 16.73 months.The 1-,3-year survival rate of patients with hyperfibrinogenemia were significantly lower than those with normal Fib (64.7％,14.9％ vs.74.9％,21.1％,P ＜ 0.05).Conclusion Preoperative plasma level of Fib might be a new promising biomarker in patients with gallbladder cancer for evaluating disease progression and prognosis.
