CAJ | 학술논문

目的回顾性分析肺癌患者血浆D-二聚体(D-dimer,D-D)、纤维蛋白原(fibrinogen,FIB)水平,探讨肺癌患者高凝状态的临床特征.方法检测223例肺癌初治患者血浆D-D及FIB水平,按性别、年龄、类型、分期进行分组比较并比较化疗前后D-D、FIB水平.结果 223例患者中D-D水平升高129例(57.8％),FIB水平升高97例(43.5％);伴有远处转移的患者142例,D-D水平升高100例(70.4％),FIB水平升高74例(52.1％).D-D、FIB水平在不同性别、年龄分组中,差异无统计学意义(P＞0.05).病理分型分组中,腺癌组D-D水平较鳞癌组、小细胞癌组明显升高(P＜0.05),鳞癌组FIB水平较腺癌组高(P＜0.05).非小细胞肺癌中,随着分期的升高,D-D水平相应升高(P＜0.05),Ⅳ期患者D-D水平较Ⅲ期患者高(P＜0.05),各分期FIB水平比较,差异无统计学意义(P＞0.05).小细胞肺癌中,广泛期D-D、FIB水平较局限期高(P＜0.05).化疗后,有效组(完全缓解及部分缓解)D-D、FIB水平较治疗前下降(P＜0.05);稳定组无明显变化(P＞0.05);进展组较治疗前明显上升(P＜0.05).结论肺癌患者普遍存在高凝状态,以腺癌、晚期,尤其是伴有远处转移者明显.化疗缓解时高凝状态有所缓解,进展时高凝状态较前加重,因此D-D、FIB可以作为评估化疗疗效的间接指标,也可以作为监测肺癌高凝状态变化的指标.
목적 회고성분석폐암환자혈장D-이취체(D-dimer,D-D)、섬유단백원(fibrinogen,FIB)수평,탐토폐암환자고응상태적림상특정.방법 검측223례폐암초치환자혈장D-D급FIB수평,안성별、년령、류형、분기진행분조비교병비교화료전후D-D、FIB수평.결과 223례환자중D-D수평승고129례(57.8％),FIB수평승고97례(43.5％);반유원처전이적환자142례,D-D수평승고100례(70.4％),FIB수평승고74례(52.1％).D-D、FIB수평재불동성별、년령분조중,차이무통계학의의(P＞0.05).병리분형분조중,선암조D-D수평교린암조、소세포암조명현승고(P＜0.05),린암조FIB수평교선암조고(P＜0.05).비소세포폐암중,수착분기적승고,D-D수평상응승고(P＜0.05),Ⅳ기환자D-D수평교Ⅲ기환자고(P＜0.05),각분기FIB수평비교,차이무통계학의의(P＞0.05).소세포폐암중,엄범기D-D、FIB수평교국한기고(P＜0.05).화료후,유효조(완전완해급부분완해)D-D、FIB수평교치료전하강(P＜0.05);은정조무명현변화(P＞0.05);진전조교치료전명현상승(P＜0.05).결론 폐암환자보편존재고응상태,이선암、만기,우기시반유원처전이자명현.화료완해시고응상태유소완해,진전시고응상태교전가중,인차D-D、FIB가이작위평고화료료효적간접지표,야가이작위감측폐암고응상태변화적지표.
Objective To analyse the levels of D-dimer and fibrinogen (FIB) in lung cancer patients,and discuss the clinical characteristics in lung cancer patients with hypercoagulable state.Methods The levels of plasm D-dimer and FIB in 223 lung cancer patients were detected and compared,grouping them by gender,age,pathological type,and clinical stage.The levels of D-dimer and FIB before and after chemotherapy were compared.Results Lung cancer patients with high-level D-dimer and high-level FIB accounted for 57.8％ and 43.5％,respectively.The ratio was higher in metastasis patients (70.4％,52.1％,respectively).The D-dimer level in adenocarcinoma patients was higher than other types,the level of FIB in patients with squamous cell lung cancer was higher than that in patients with adenocarcinoma (P ＜ 0.05).In non-small cell lung cancer,D-dimer level increased as stage progressed.D-dimer level in stage Ⅳ was higher than that in stage Ⅲ (P ＜0.05).There was no statistical significance in FIB level among all stages (P ＞ 0.05).In small cell lung cancer,the levels of D dimer and FIB in extensive disease were higher than those in limited disease.The D-dimer,FIB levels after chemotherapy depended on lesions remission,when tumor got complete or partial response,it declined;vice versa.Conclusions Lung cancer has a high risk of hypercoagulability,especially in adenocarcinoma patients,advanced stage,in patients who have distant metastasis.After chemotherapy,the levels of D-dimer and FIB are correlated with the tumor remission,so D-dimer and FIB are indirect indexes to estimate the chemotherapeutic effect and hypercoagulable state of lung cancer.