| 摘要: |
| 目的观察非小细胞肺癌（NSCLC）患者血浆狼疮抗凝物质（LAC）水平，探讨LAC与患者血液高凝状态及病情进度的关系。方法测定165例NSCLC患者、44例肺良性疾病患者和40例健康体检者血浆标准化LAC比值（NLR）、D-二聚体（D-D）、抗凝血酶（AT）、纤维蛋白原（FIB）和凝血因子VIII（FVIII∶C）水平，分析NLR与其余4者的相关性以及各指标对深静脉血栓（DVT）预测的价值，观察患者DVT发生率、肺癌转移率以及1年内病死率等指标。结果NSCLC组NLR、D-D、FIB、FVIII∶C水平明显高于正常对照组和良性对照组，AT水平低于该两组（均P＜0.01）。在总体和并发DVT的NSCLC中，NLR与D-D、FIB和FVIII∶C均呈高度正相关，与AT呈高度负相关（P＜0.01）；NLR预测DVT的ROC曲线下面积为0.911（95%CI：0.846~0.976），均高于其余指标，其灵敏度为80.6%，特异度为79.5%。有转移组、并发DVT组和1年内死亡组NLR分别高于无转移组、无并发DVT组和1年内存活组（均P＜0.01）。NLR升高组肺癌转移率、DVT发生率和1年内病死率均高于NLR正常组（均P＜0.05）；1年内死亡组肿瘤转移率和DVT发生率均显著高于1年内存活组（P＜0.05）。结论LAC是评价小细胞肺癌患者血液高凝状态的敏感指标，并在病情评估和预后判断均有重要意义。 |
| 关键词: 非小细胞肺癌 狼疮抗凝物质 高凝状态 病情 |
| DOI：10.12056/j.issn.1006-2785.2017.39.03.2016-192 |
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| Association of plasma lupus anticoagulant level with hypercoagulable status and disease progression in patients with non-small cell lung cancer |
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WANG Qian, ZHONG Yifang, ZHOU Ying
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Lishui People's Hospital
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| Abstract: |
| Objective To investigate the association of plasma lupus anticoagulant(LAC) level with hypercoagulable status
and disease progression in patients with non-small cell lung cancer (NSCLC). Methods The plasma levels of normalized LAC ratio(NLR), D-dimer(D-D), antithrombin(AT). fibrinogen (FIB) and coagulating factor VIII were measured in 165 NSCLC patients, 44 patients with benign lung diseases, and 40 healthy volunteers. The incidence of DVT, lung cancer metastasis, and mortality within 1 year was observed. The correlation between NLR and other indicators, and the predicting value of above indicators for deep venous thrombosis (DVT) were analyzed. Results In NSCLC group, LAC, D-D, FIB and FVIII:C levels were significantly
higher, AT level was significantly lower than those in healthy control group and benign lung disease group (P＜0.01). In NSCLC
patients, there was a positive correlation between NLR and D-D, FIB, or FVIII∶C levels, and negative correlation between NLR and AT level (P＜0.01). The area of ROC curve of NLR in predicting DVT was 0.911 (95%CI: 0.846-0.976), which was higher than that of other four indicators for DVT prediction. In metastatic cancer group, complicated DVT group, and fatal group, NLR was significantly higher than that in non- metastatic cancer, non-DVT, and survival patients within 1 year, respectively (P＜0.01). The incidence of cancer metastasis, complicated DVT and mortality within 1 year was increased in patients with higher NLR (P＜0.05).
The incidence of metastasis and DVT in patients who died within 1 year was significantly higher than that in survival patients (P＜ 0.05). Conclusion LAC is a sensitive indicator for assessment of hypercoagulable status, and for prediction of disease progression in patients with non-small cell lung cancer. |
| Key words: Non-small cell lung cancer Lupus anticoagulant Hypercoagulable state Disease condition |
