摘要
目的探讨缩短的活化部分凝血活酶时间（APTT）与肺癌患者病情及预后的关系，为肺癌的诊断和治疗提供参考依据。方法收集278例初诊肺癌患者治疗前和70例体检健康者血浆APTT、纤维蛋白原（FIB）、D-二聚体（D—D）和抗凝血酶（AT）测定结果，观察患者治疗前深静脉血栓（DVT）发生率，远端和淋巴结转移率以及1年内生存率等指标，分别以ROC曲线和Logistic回归分析缩短的APTT对患者DVT形成和肺癌转移的诊断价值和危险因素。结果APTT缩短组FIB和D—D浓度显著高于而AT水平显著低于APTT正常组和延长组（P〈0．01）；APTT缩短组患者治疗前DVT发生率和肺癌转移率显著高于APTT正常组和延长组（P〈0．05）；缩短的APTT诊断治疗前DVT和肺癌转移的ROC曲线下面积为0．898（95％CI：0．848～0．948）和0．812（95％C1：0．738～0．885），cutoff值分别为20．1s和19．5s，敏感度为73．68％和70．16％，特异性为71．04％和81．17％。1年死亡组中，治疗前APTT缩短患者比例显著高于存活组（P〈0．05），死亡组治疗前DVT发生率和肺癌转移率显著高于存活组（P〈0．01）。Logistic回归显示，缩短的APTT是治疗前DVT发生和肺癌转移的危险因素（p=1．65和1．72，OR=8．65，95％cI：5．78～10．35和OR=9．11，95％CI：6．12～10．98）。结论缩短的APTT可作为肺癌患者DVT形成和癌细胞转移以及预后不良的预测因子。
Objective To investigate the relationship between shortened activated partial thromboplastin time （APTT） and the dis- ease condition and prognosis of lung cancer patients, and to provide reference for diagnosis and treatment of lung cancer. Individuals were included to detect the plasma APTT, fibrinogen （ FIB）, D - dimer （ D - D） and antithrombin （AT） before treatment, the incidence of deep vein thrombosis （DVT） , distant and lymph node metastasis before treatment , and one - years survival were observed. The Receiver operating characteristic （ROC） curve and logistic regression were used to analyze the diagnostic efficiency and risk factors of deep venous thrombosis （DVT） and tumor metastasis, respectively. Results The FIB and D - D levels in APTT shortened group were significantly higher than the normal and prolonged APTT groups, while the AT level were significantly lower in APTT shortened group （P 〈 0.01 ）. The incidence of DVT and lung cancer metastasis before treatment in APTT shortened group was significantly higher than that in the normal and prolonged APTT groups （P 〈0.05）. The area under ROC curve was 0. 898（95% CI：0. 848 -0.948） and 0. 812 （95% CI：0. 738 - 0. 885 ） （P 〈 0.05 ） for APTT to diagnosis DVT and tumor metastasis before treatment, and the cutoff values were 20.1 seconds and 19.5 seconds, the sensitivity was 73.68% and 70. 16% 8, and the specificity was 71.04% and 81. 17% , respectively. In one - year death group, percent of patients with shortened APTT before treatment was significantly higher than that in one - year survival group （P 〈 0. 05） , and the incidence of DVT and tumor metastasis before treatment in death group was significantly higher than that in the survival group （P 〈0. O1 ）. Logistic regression analysis showed that shortened APTT was the risk factor of deep venous thrombosis （DVT） and tumor metastasis before treatment. Conclusion Shortened APTT can be used as a predicting factor for DVT and tumor metastasis before treatment and a poor prognosis of lung cancer patients.
出处
《医学研究杂志》
2016年第11期129-132,共4页
Journal of Medical Research
关键词
肺癌
缩短的APTT
深静脉血栓
转移
预后
Lung cancer
Shortened APTT
Deep vein thrombosis
Metastasis
Prognosis
