中国综合临床
中國綜閤臨床
중국종합림상
Clinical Medicine of China
2015年
10期
871-875
,共5页
田文%高敬华%李永生%张菁华%李际君%刘春玲
田文%高敬華%李永生%張菁華%李際君%劉春玲
전문%고경화%리영생%장정화%리제군%류춘령
纤维蛋白原%肺癌%预后%生存期
纖維蛋白原%肺癌%預後%生存期
섬유단백원%폐암%예후%생존기
Fibrinogen%Lung cancer%Prognosis%Survival duration
目的 探讨纤维蛋白原与肺癌之间的关系及其临床意义.方法 收集2011-2013年就诊于沧州市中心医院的121例肺癌患者(肺癌组)和37名健康体检者(对照组)的血浆凝血酶原时间(PT)、部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)、血小板(PLT)进行检测.分析肺癌患者的临床特征、治疗方法、疗效、生存期与纤维蛋白原水平的关系.结果 (1)肺癌患者纤维蛋白原分别为ⅡA期(2.001±0.813) g/L、ⅡB期(2.191±0.827) g/L、ⅢA期(3.121±2.016) g/L,ⅢB(4.174±0.595) g/L、Ⅳ期(4.332±1.534) g/L,其中ⅡA期和Ⅳ期比较差异有统计学意义(P＜0.001),其他分期中无统计学意义(P均＞0.05).(2) ECOG评分2分的纤维蛋白原平均水平明显高于其他组;ECOG评分0分患者的平均纤维蛋白原水平为(3.780±1.731) g/l (95％CI3.122～4.439,P＜0.001);ECOG评分1分(4.182±1.661) g/L(95％CI3.583～4.781,P＜0.001);ECOG评分2分(4.725±2.153) g/L(95％CI4.007～5.443,P＜0.001).(3)对接受化疗或放疗而没有手术的81例患者进行评价,部分缓解的39例患者纤维蛋白原水平为(4.005±1.177) g/L,病情稳定的42例与病情进展的17例分别为(3.192±0.479)g/L和(7.530±1.885) g/L,纤维蛋白原水平在病情进展组显著升高,差异有统计学意义(P=0.015).(4)肺癌患者纤维蛋白原与临床分期(r=0.529,P=0.008)、ECOG分期(r=0.273,P=0.031)、疗效(r=0.529,P=0.012)呈正相关.(5)肺癌组和对照组比较,纤维蛋白原水平明显高于对照组[(2.891±0.484) g/L与(3.586±1.692) g/L,t=-4.620,P＜0.05],其他凝血参数均无统计学意义(P均＞0.05).(6)随访2年后,存活患者的纤维蛋白原平均水平是(3.531±1.482) g/L,而死亡患者纤维蛋白原平均水平(3.725±2.063) g/L,两组间有统计学意义(P=0.015).结论 在筛查肺癌患者和预测转移、进展、治疗反应和生存方面,检测纤维蛋白原可能是一种经济和简单的方法,其有望成为临床上选择治疗方案和评估预后的理想标记物.
目的 探討纖維蛋白原與肺癌之間的關繫及其臨床意義.方法 收集2011-2013年就診于滄州市中心醫院的121例肺癌患者(肺癌組)和37名健康體檢者(對照組)的血漿凝血酶原時間(PT)、部分凝血活酶時間(APTT)、凝血酶時間(TT)、纖維蛋白原(Fib)、血小闆(PLT)進行檢測.分析肺癌患者的臨床特徵、治療方法、療效、生存期與纖維蛋白原水平的關繫.結果 (1)肺癌患者纖維蛋白原分彆為ⅡA期(2.001±0.813) g/L、ⅡB期(2.191±0.827) g/L、ⅢA期(3.121±2.016) g/L,ⅢB(4.174±0.595) g/L、Ⅳ期(4.332±1.534) g/L,其中ⅡA期和Ⅳ期比較差異有統計學意義(P＜0.001),其他分期中無統計學意義(P均＞0.05).(2) ECOG評分2分的纖維蛋白原平均水平明顯高于其他組;ECOG評分0分患者的平均纖維蛋白原水平為(3.780±1.731) g/l (95％CI3.122～4.439,P＜0.001);ECOG評分1分(4.182±1.661) g/L(95％CI3.583～4.781,P＜0.001);ECOG評分2分(4.725±2.153) g/L(95％CI4.007～5.443,P＜0.001).(3)對接受化療或放療而沒有手術的81例患者進行評價,部分緩解的39例患者纖維蛋白原水平為(4.005±1.177) g/L,病情穩定的42例與病情進展的17例分彆為(3.192±0.479)g/L和(7.530±1.885) g/L,纖維蛋白原水平在病情進展組顯著升高,差異有統計學意義(P=0.015).(4)肺癌患者纖維蛋白原與臨床分期(r=0.529,P=0.008)、ECOG分期(r=0.273,P=0.031)、療效(r=0.529,P=0.012)呈正相關.(5)肺癌組和對照組比較,纖維蛋白原水平明顯高于對照組[(2.891±0.484) g/L與(3.586±1.692) g/L,t=-4.620,P＜0.05],其他凝血參數均無統計學意義(P均＞0.05).(6)隨訪2年後,存活患者的纖維蛋白原平均水平是(3.531±1.482) g/L,而死亡患者纖維蛋白原平均水平(3.725±2.063) g/L,兩組間有統計學意義(P=0.015).結論 在篩查肺癌患者和預測轉移、進展、治療反應和生存方麵,檢測纖維蛋白原可能是一種經濟和簡單的方法,其有望成為臨床上選擇治療方案和評估預後的理想標記物.
목적 탐토섬유단백원여폐암지간적관계급기림상의의.방법 수집2011-2013년취진우창주시중심의원적121례폐암환자(폐암조)화37명건강체검자(대조조)적혈장응혈매원시간(PT)、부분응혈활매시간(APTT)、응혈매시간(TT)、섬유단백원(Fib)、혈소판(PLT)진행검측.분석폐암환자적림상특정、치료방법、료효、생존기여섬유단백원수평적관계.결과 (1)폐암환자섬유단백원분별위ⅡA기(2.001±0.813) g/L、ⅡB기(2.191±0.827) g/L、ⅢA기(3.121±2.016) g/L,ⅢB(4.174±0.595) g/L、Ⅳ기(4.332±1.534) g/L,기중ⅡA기화Ⅳ기비교차이유통계학의의(P＜0.001),기타분기중무통계학의의(P균＞0.05).(2) ECOG평분2분적섬유단백원평균수평명현고우기타조;ECOG평분0분환자적평균섬유단백원수평위(3.780±1.731) g/l (95％CI3.122～4.439,P＜0.001);ECOG평분1분(4.182±1.661) g/L(95％CI3.583～4.781,P＜0.001);ECOG평분2분(4.725±2.153) g/L(95％CI4.007～5.443,P＜0.001).(3)대접수화료혹방료이몰유수술적81례환자진행평개,부분완해적39례환자섬유단백원수평위(4.005±1.177) g/L,병정은정적42례여병정진전적17례분별위(3.192±0.479)g/L화(7.530±1.885) g/L,섬유단백원수평재병정진전조현저승고,차이유통계학의의(P=0.015).(4)폐암환자섬유단백원여림상분기(r=0.529,P=0.008)、ECOG분기(r=0.273,P=0.031)、료효(r=0.529,P=0.012)정정상관.(5)폐암조화대조조비교,섬유단백원수평명현고우대조조[(2.891±0.484) g/L여(3.586±1.692) g/L,t=-4.620,P＜0.05],기타응혈삼수균무통계학의의(P균＞0.05).(6)수방2년후,존활환자적섬유단백원평균수평시(3.531±1.482) g/L,이사망환자섬유단백원평균수평(3.725±2.063) g/L,량조간유통계학의의(P=0.015).결론 재사사폐암환자화예측전이、진전、치료반응화생존방면,검측섬유단백원가능시일충경제화간단적방법,기유망성위림상상선택치료방안화평고예후적이상표기물.
Objective To investigate the relationship among the plasma levels of fibrinogen and the lung cancer,and its clinical significance.Methods From 2011 to 2013,121 cases newly diagnosed lung cancer patients(lung cancer group) and 37 cases healthy individuals(control group) were evaluated.The patients had no history of coagulation system disorders or anticoagulant therapy.Plasma prothrombin time (PT), activated partial thromboplastin time(APTT), thrombin time (TT), fibrin original (FIB), platelet (PLT) of the patients were obtained.The relationship between the plasma levels of fibrinogen and clinical characteristics, therapy modalities (surgery, chemotherapy and radiotherapy), therapy outcomes and survival durations of the patients were analyzed.Results (1) Serum levels of fibrinogen at stage Ⅱ A, stage Ⅱ B, stage Ⅲ A, stage Ⅲ B, stage Ⅳ were (2.001±0.813) g/L, (2.191±0.827) g/L, (3.121 ±2.016) g/L, (4.174±0.595) g/L, (4.332 ± 1.534) g/L, a significant difference was observed between the fibrinogen levels of patients with stage Ⅱ A and those with stage Ⅳ disease (P＜0.001), and there were no significant differences among other stages (P＞0.05).(2)The mean fibrinogen level was significantly higher in the patient group with ECOG performance status 2 than in the other groups(r=0.613,P＜0.05).The mean fibrinogen level was (3.780±1.731) g/L (95％CI,3.122-4.439,P＜0.001) in the group with ECOG 0, (4.182 ± 1.661) g/L(95％CI 3.583-4.781 ,P＜0.001) in the group with ECOG 1 ,and (4.725±2.153) g/L(95％CI,4.007-5.443,P＜0.001) in the group with ECOG 2.(3) The treatment responses of 81 patients who received chemotherapy and/or radiotherapy without surgical intervention were evaluated, serum levels of fibrinogen in 39 patients with partial remission (PR) were (4.005 ±1.177) g,/L,42 patients with stable disease(SD) were (3.192±0.479) g/L, 17 patients with progressive disease(PD) were (7.530± 1.885) g/L,fibrinogen levels were found to be significantly higher in cases with progression,and the difference was significant(P =0.015).(4)Correlation analysis on fibrinogen and chnical indicator: clinical stage (r =0.529, P =0.008), ECOG score (r =0.273, P =0.031), therapy response (r =0.529, P=0.012) were positively correlated with fibrinogen levels.(5)Fibrinogen levels in patients with lung cancer were higher than those of the control group ((2.891 ± 0.484) g/L vs.(3.586± 1.692) g/L, t =-4.620, P ＜0.05), and the difference was statistically significant (P＜0.01).(6)The survival duration was significantly longer in patients with lower fibrinogen levels(321 d vs.435 d,P＜0.05).The mean fibrinogen concentration in patients who were still alive at the end of a 2-year follow-up was (3.531 ± 1.482) g/L, whereas the meanfibrinogen level of patients who died was (3.725± 2.063) g/L, and the difference between the two groups was significant(P =0.015).Conclusion The results suggest that Fibrinogen plasma levels might be useful to predict the clinical outcome and survival of patients with lung cancer.
