摘要
目的检测乳腺癌患者常规凝血功能指标,分析其与临床病理特征的关系。方法对2010年3月至2011年5月在本科住院的539例乳腺癌患者行常规凝血功能检查,患者均为女性,中位年龄46岁。检测项目包括凝血酶原时间(prothrombin time,PT)、PT百分比(prothrombin time%,PT%)、凝血酶源时间国际标准化比值(prothrombin time interna-tional normalized ratio,PT INR)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、APTT测定值比(activa-ted partial thromboplastin time Ratio,APTT Ratio)、凝血酶时间(thrombin time,TT)、纤维蛋白原(fibrinogen,Fib)和D-二聚体(D-dimer,D-D),并以102例乳腺良性疾病患者作为对照,比较两组患者间凝血指标的差异,并分析凝血指标和乳腺癌患者临床病理特征的关系。结果与乳腺良性疾病患者相比,乳腺癌患者APTT[(24.28±3.21)s vs(25.89±3.76)s,P<0.05]缩短、APTT Ratio降低[(0.88±0.12)vs(0.94±0.14),P<0.05)],Fib[(2.82±0.67)g/L vs(2.45±0.46)g/L,P<0.05]、D-D[122(144)ng/ml vs 97(57)ng/ml,P<0.05]水平显著升高,TT时间延长[(16.88±1.24)s vs(16.61±1.28)s,P<0.05)]。对乳腺癌患者临床病理因素分析发现:T4、T3组分别与T1、T2组比较,Fib水平显著升高(P<0.05),有淋巴结转移者较无淋巴结转移者Fib水平高(P<0.05)局部复发和转移性乳腺癌患者Fib水平较Ⅰ～Ⅲ期浸润性乳腺癌患者显著升高(P<0.05)。ER、PR阳性或阴性乳腺癌患者,两组凝血指标变化未发现差异。免疫组化HER-2(+)和HER-2(+++)的乳腺癌患者,凝血指标水平无显著差异。结论乳腺癌患者容易出现血液高凝状态,T4、T3期肿瘤有淋巴结转移或局部复发和转移性乳腺癌患者Fib水平较高。
Objective To analyze the correlation between coagulation parameters and clinicopathological characteristics in patients with breast cancer. Methods A total of 539 cases of patients with breast cancer who admitted in our center from March 2010 to May 2011 were enrolled in this study. They were all female, with a median age of 46. Another 102 age-matched patients with benign breast disease who admitted at the same time served as control. The routine blood function test was performed in them to detect coagulation parameters including prothrombin time （ PT）, percentage activity （ PT% ）, prothrombin time international normalized ratio （PT INR）, activated partial thromboplastin time （APTT）, thrombin time（ TT）, fibrinogen （Fib） and D-dimer （D-D）. The correlation between coagulation parameters and clinicopathological characteristics in patients with breast cancer was analyzed. Results Those patients with breast cancer had shorter AtrFT （24.28 ± 3.21 vs 25.89 ± 3.76 s, P 〈 0.05 ） and lower APTT Ratio （0.88 ± 0.12 vs0. 94 ± 0.14, P 〈 0.05 ）, increased Fib （2.82 ±0.67 vs 2.45 ±0.46 g/L, P 〈0.05）, D-D levels （122 ±144 vs 97 ±57 ng/ml, P 〈0.05）, and longer TT （ 16.88 ±1.24 vs 16.61 ± 1.28 s, P 〈 0.05 ） when compared with benign breast disease. A higher Fib level was found in patients with T3/T4 tumor than with T1/T2 tumor （P 〈 0.05 ）, in those with lymph node metastasis than those without （P 〈 0.05 ）, as well as in patients with tumor local recurrence or metastasis than those in grade Ⅰ toⅢ （P 〈 0.05）. While there was no difference in coagulation parameters in breast cancer patients positive or negative to estrogen receptor （ER） and progesterone receptor （PR）, and those with mildexpression of human epidermal growth factor receptor 2 （HER-2） and with strong expression. ConclusionBreast cancer patients are prone to be in hypercoagulable state. A higher level of Fib is found in patients with a T3/T4 tumor, lymph node metastasis and tumor local recurrence or metastasis.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2012年第21期2184-2187,共4页
Journal of Third Military Medical University
基金
国家自然科学基金(81102030)~~
关键词
乳腺肿瘤
凝血功能
高凝状态
breast neoplasms
coagulation
hypercoagulability
