摘要
目的探讨胃癌患者循环肿瘤细胞与凝血指标及预后的关系。方法收集103例未经治疗的胃癌患者,检测其循环肿瘤细胞数及6项凝血指标,并进行随访,对统计的结果进行分析。结果6项凝血指标与年龄、性别、肿瘤原发部位无关。不同分化程度、TNM分期以及远处转移状态的患者之间D-D、PLT水平的差异均有统计学意义(P<0.05)。FIB水平可能与远处转移状态有一定关系,但差异无统计学意义(P>0.05)。在103例胃癌患者中,共有CTC阴性41例,CTC阳性62例。CTC阳性组中D-D、PLT水平明显高于CTC阴性组(P<0.05)。Logistics回归分析提示CTC阳性率和D-D、PLT水平均有明显关系。不同D-D、CTC水平患者的OS具有显著差异(P<0.01)。采用Cox回归模型提示血浆D-D水平是胃癌患者预后的独立预测因素。结论血液高凝状态可能促进了胃癌CTC的远处转移。治疗前检测CTC指标对预测胃癌患者的预后有重要意义。
Objective To investigate the relationship between circulating tumor cells,coagulation parameters and prognosis of gastric cancer.Methods 103 patients with gastric cancer who had not been treated or had been treated were recruited for this retrospective study.The number/count/enumeration of circulating tumor cells and six coagulation indexes were detected.Patients were followed up.Then the statistical results were analyzed.Results Six coagulation parameters were not related to age,sex and primary site of tumors.There were significant differences in D-D and PLT levels among patients with different differentiation,TNM stage and distant metastasis(P<0.05).FIB level may be related to distant metastasis,but there was no significant difference(P>0.05).In 103 cases of gastric cancer,there were 41 cases of CTC negative(<2),62 cases of CTC positive(2 or more).The levels of D-D and PLT in CTC positive group were significantly higher than those in CTC negative group(P<0.05).Logistic regression analysis showed that the positive rate of CTC was significantly correlated with D-D and PLT.There were significant differences in OS between patients with different D-D and CTC levels(P<0.01).Cox regression model suggested that plasma D-D level was an independent risk factor for prognosis of gastric cancer patients(HR=2.369,95%CI:1.704-3.293,P<0.05).Conclusion Hypercoagulable state of blood may promote distant metastasis of CTC in gastric cancer.Detection of CTC before treatment is of great significance in predicting the prognosis of gastric cancer patients.
作者
杨汉
陈怡璋
崔笑雯
陈楠
汤翠菊
YANG Han;CHEN Yizhang;CUI Xiaowen(The First Hospital of Nanjing,Nanjing,210000)
出处
《实用癌症杂志》
2020年第4期615-619,共5页
The Practical Journal of Cancer
基金
国家重点研发项目(编号:2017YFC1308900)。
关键词
胃癌
循环肿瘤细胞
D-二聚体
血小板
预后
Gastric cancer
Circulating tumor cells
D-dimer
Platelets
Prognosis
