摘要
目的探讨接受根治性切除的结直肠癌患者术前血浆纤维蛋白原及D-二聚体水平与其临床病理特征及总生存率之间的关系。方法2002年1月至2003年12月天津医科大学附属肿瘤医院接受根治性手术具备完整临床病理资料的结直肠癌患者341例，男178例，女163例，年龄58（23—90）岁，随访时间64（5—89）个月。检测患者术前的血浆纤维蛋白原及D-二聚体水平，观察总生存率，采用Log-rank检验进行单因素分析，Cox比例风险回归模型进行多因素分析，探讨二者与临床病理特征及总生存率之间的关系。结果341例患者术前血浆纤维蛋白原水平为（3．7±0．7）g/L，D-二聚体为（0．49±0．18）mg／L。患者术前血浆纤维蛋白原水平与肿瘤分期、血管侵犯、术后远处转移和有无淋巴结转移均相关（均P〈0．01），但与组织学分级和浸润深度均无关（P=0．232、0．253）。患者5年生存率为64．5％（220／341）。患者术前D-二聚体水平与肿瘤分期、浸润深度和有无淋巴结转移均相关（P=0，013、0．007、0．001），但与组织学分级、血管侵犯和术后远处转移均无关（P=0．082、0．746、0．131），多因素分析显示术前纤维蛋白原水平（P=0．029）、组织学分级（P=0．001）和淋巴结转移（P=0．001）是独立的预后因子。结论结直肠癌患者术前纤维蛋白原和D-二聚体水平与病理分期相关，术前高纤维蛋白原水平与根治术后远处转移相关，总生存率较低，且是影响预后的独立因素。
Objective To explore the associations of preoperative plasma levels of fibrinogen and D-dimer with clinicopathologic parameters and overall survival in colorectal cancer patients after curative resection. Methods From January 2002 to December 2003, a total of 341 colorectal cancer patients underwent curative resection. And their relevant clinical data were reviewed. The median age was 58 years （range：23 -90 years） and the median follow-up period was 64 months （range：5 -89 months）. The preoperative plasma levels of fibrinogen and D-dimer were examined, the correlation of clinicopathologie findings and overall survival was analyzed. A Log-rank test was used for univariate analysis and a Cox regression model for multivariate analysis. Results The preoperative plasma levels of fibrinogen and D-dimer were （3.7±0. 7 ）g/L and （0. 49 ±0. 18） mg/L respectively. Elevated plasma levels of fibrinogen were associated with advanced tumor stage （ P = 0. 008 ） , venous invasion （ P = 0. 006 ）, postoperative distant metastases （ P 〈 0. 01 ） and lymph node involvement （ P = 0. 001 ）, but not with histologic grade （ P = 0. 232 ）, and invasion depth （ P = 0. 253 ）. The overall survial is 64. 5% （ 220/341 ）. Elevated plasma levels of D-dimer were associated with advanced tumor stage （ P = 0. 013 ） , invasion depth （ P = 0. 007 ） and lymph node involvement （ P = 0. 001 ）, but not with histologie grade （ P = 0. 082 ）, venous invasion （ P =0. 746） or postoperative distant metastases （P = 0. 131 ）. Multivariate analysis showed that preoperative plasma levels of fibrinogen （P =0. 029）, histologic grade （P =0. 001 ）, and lymph node involvement （P = 0. 001 ） were independent prognostic factors. Conclusions High preoperative plasma levels of fibrinogen and D-dimer are associated with clinicopathologic parameters. And a high preoperative plasma level of fibrinogen is associated with distant metastases and poor prognosis after curative resection in colorectal cancer patients.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第12期906-909,共4页
National Medical Journal of China
基金
国家自然科学基金（81101870）
