[1]胡永伟,白永颖,张靖华.乳腺癌患者血浆凝血参数的变化及临床意义[J].医学信息,2023,36(04):113-117.[doi:10.3969/j.issn.1006-1959.2023.04.022]
　HU Yong-wei,BAI Yong-ying,ZHANG Jing-hua.Changes and Clinical Significance of Plasma Coagulation Parameters in Patients with Breast Cancer[J].Journal of Medical Information,2023,36(04):113-117.[doi:10.3969/j.issn.1006-1959.2023.04.022]
点击复制

乳腺癌患者血浆凝血参数的变化及临床意义()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年04期
页码:
113-117
栏目:
论著
出版日期:
2023-02-15

文章信息/Info

Title:
Changes and Clinical Significance of Plasma Coagulation Parameters in Patients with Breast Cancer
文章编号:
1006-1959（2023）04-0113-05
作者:
胡永伟; 白永颖; 张靖华
（浙江大学医学院附属妇产科医院检验科，浙江 杭州 310006）
Author(s):
HU Yong-wei; BAI Yong-ying; ZHANG Jing-hua
(Department of Clinical Laboratory,Women′s Hopital,School of Medicine,Zhejiang University,Hangzhou 310006,Zhejiang,China)
关键词:
乳腺癌; 凝血参数; 乳腺良性病变
Keywords:
Breast cancer; Coagulation parameters; Benign breast lesions
分类号:
R730.43；R737.9
DOI:
10.3969/j.issn.1006-1959.2023.04.022
文献标志码:
A
摘要:
目的 分析乳腺癌患者术前凝血参数的变化及其临床意义。方法 选取2020年8月-2021年11月在浙江大学医学院附属妇产科医院收治的乳腺癌患者320例为乳腺癌组，另选取乳腺良性病变患者584例为对照组。收集所有研究对象的凝血参数，包括血浆凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）、凝血酶时间（TT）和纤维蛋白原（Fib），分析上述凝血参数与乳腺癌患者的一般临床资料、不同临床病理特征、TNM分期、分子亚型的关系。结果 乳腺癌组APTT、TT水平低于对照组，Fib高于对照组，差异有统计学意义（P＜0.05），两组PT水平比较，差异无统计学意义（P＞0.05）；≥50岁患者PT、APTT水平低于＜50岁患者，TT和Fib水平高于＜50岁患者，差异有统计学意义（P＜0.05）；肿瘤＞2 cm患者Fib水平高于肿瘤≤2 cm患者，差异有统计学意义（P＜0.05）；乳腺癌发生远处转移患者的PT水平高于未发生转移患者，差异有统计学意义（P＜0.05）；不同肿瘤类型、淋巴结转移情况及TNM分期凝血指标比较，差异无统计学意义（P＞0.05）；浸润性乳腺癌患者病理特征分析结果显示，PR阴性状态患者的Fib水平高于PR阳性状态患者，TT水平低于HER2阳性状态患者，差异有统计学意义（P＜0.05）；HER2过表达型TT水平高于Luminal A型、Luminal B型及三阴型，差异有统计学意义（P＜0.05）；不同ER状态及Ki-67凝血指标比较，差异无统计学意义（P＞0.05）。结论 乳腺癌患者血液处于高凝状态，存在凝血和纤溶系统的失衡，检测凝血指标对于判断乳腺癌病理特征具有重要意义。
Abstract:
Objective To analyze the changes and clinical significance of preoperative coagulation parameters in patients with breast cancer.Methods A total of 320 patients with breast cancer admitted to the Women′s Hopital,School of Medicine,Zhejiang University from August 2020 to November 2021 were selected as the breast cancer group, and 584 patients with benign breast lesions were selected as the control group. The coagulation parameters of all subjects were collected, including plasma prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (Fib). The relationship between the above coagulation parameters and the general clinical data, different clinicopathological features, TNM stage and molecular subtypes of breast cancer patients was analyzed.Results The levels of APTT and TT in the breast cancer group were lower than those in the control group, and Fib was higher than that in the control group, and the difference was statistically significant (P<0.05), while there was no significant difference in PT level between the two groups (P>0.05). The levels of PT and APTT in patients ≥50 years old were lower than those in patients <50 years old, the levels of TT and Fib were higher than those in patients <50 years old, and the differences were statistically significant (P<0.05). The level of Fib in patients with tumor >2 cm was higher than that in patients with tumor ≤2 cm, and the difference was statistically significant (P<0.05. The PT level of patients with distant metastasis of breast cancer was higher than that of patients without metastasis, and the difference was statistically significant (P<0.05). There was no significant difference in coagulation indexes between different tumor types, lymph node metastasis and TNM staging (P>0.05). The results of pathological characteristics analysis of invasive breast cancer patients showed that the Fib level of PR negative patients was higher than that of PR positive patients, and the TT level was lower than that of HER2 positive patients, and the difference was statistically significant (P<0.05). The TT level of HER2 overexpression type was higher than that of Luminal A type, Luminal B type and triple negative type, and the difference was statistically significant (P<0.05). There was no significant difference in different ER status and Ki-67 coagulation indexes (P>0.05).Conclusion The blood of breast cancer patients is in hypercoagulable state, and there is an imbalance between coagulation and fibrinolysis system. Detection of coagulation indicators is of great significance for judging the pathological characteristics of breast cancer.

参考文献/References:

[1]Winters S,Martin C,Murphy D,et al.Breast Cancer Epidemiology, Prevention, and Screening[J].Progress in Molecular Biology and Translational Science,2017,151:1-32.[2]雷珍珍,陈鹏,江思源,等.基于SEER数据库的乳腺癌研究的文献计量学分析[J].医学信息,2021,34(1):15-20.[3]Sopik V.International variation in breast cancer incidence and mortality in young women[J].Breast Cancer Research and Treatment,2021,186(2):497-507.[4]王雪莲,郭宝良.PLR与乳腺癌预后的关系[J].医学信息,2020,33(6):40-42.[5]刘人杰.曲妥珠单抗治疗HER-2阳性中晚期乳腺癌的效果及对患者血清CEA、CA153水平的影响[J].医学信息,2021,34(16):125-127.[6]颜丙芳,夏兰兰,孟玮.乳腺癌患者血浆凝血四项水平的变化及临床意义[J].滨州医学院学报,2021,44(4):270-271,274.[7]Lei ZW,Guo D.Significant difference between coagulation parameters and clinicopathological characteristics in breast cancer[J].Blood Coagul Fibrin,2021,32(8):572-577.[8]单宏杰,肖迎利,马骖,等.肿瘤间质比在乳腺癌预后评估中的价值研究[J].蚌埠医学院学报,2019,44(12):1631-1633.[9]Ruf W,Graf C.Coagulation signaling and cancer immunotherapy[J].Thrombosis research,2020,191 Suppl 1:S106-S111.[10]Adelborg K,Larsen JB,Hvas AM.Disseminated intravascular coagulation: epidemiology, biomarkers, and management[J].Br J Haematol,2021,192(5):803-818.[11]Mukai M,Oka T.Mechanism and management of cancer-associated thrombosis[J].Journal of Cardiology,2018,72(2):89-93.[12]Asanuma K,Nakamura T,Hagi T,et al.Significance of coagulation and fibrinolysis markers for benign and malignant soft tissue tumors[J].BMC Cancer,2021,21(1):364.[13]Winter WE,Flax SD,Harris NS.Coagulation Testing in the Core Laboratory[J].Laboratory Medicine,2017,48(4):295-313.[14]Sun J,Han K,Xu M,et al.Blood Viscosity in Subjects With Type 2 Diabetes Mellitus: Roles of Hyperglycemia and Elevated Plasma Fibrinogen[J].Frontiers in Physiology,2022,13:827428.[15]刘秋颖,陈锋,崔婵娟,等.恶性肿瘤患者出现单纯凝血酶时间明显延长的原因探讨[J].检验医学,2018,33(10):967-968.[16]高鹰.乳腺癌生殖性危险因素与乳腺组织成分的关系[J].中华健康管理学杂志,2022,16(2):110.[17]Rhone P,Ruszkowska-Ciastek B,Bielawski K,et al.Comprehensive analysis of haemostatic profile depending on clinicopathological determinants in breast cancer patients[J].Bioscience Reports,2018,38(2):BSR20171657.[18]Wagner J,Rapsomaniki MA,Chevrier S,et al.A Single-Cell Atlas of the Tumor and Immune Ecosystem of Human Breast Cancer[J].Cell,2019,177(5):1330-1345.e18.[19]Waks AG,Winer EP.Breast Cancer Treatment: A Review[J].JAMA,2019,321(3):288-300.[20]Chen J,Colosimo M,Lim E.The management of HER2-positive early breast cancer: Current and future therapies[J].Asia-Pacific Journal of Clinical Oncology,2021,17 Suppl 6:3-12.

相似文献/References:

[1]董 云.SPECT/CT 双时相99mTc- MIBI断层显像 在乳腺癌诊断中的应用[J].医学信息,2018,31(05):147.[doi:10.3969/j.issn.1006-1959.2018.05.053]
　DONG Yun.Application of SPECT/CT Dual-phase 99mTc-MIBI Tomography in the Diagnosis of Breast Cancer[J].Journal of Medical Information,2018,31(04):147.[doi:10.3969/j.issn.1006-1959.2018.05.053]
[2]张 虎,张 涛,徐 芳,等.MRI在乳腺癌诊治中的研究进展[J].医学信息,2022,35(10):62.[doi:10.3969/j.issn.1006-1959.2022.10.015]
　ZHANG Hu,ZHANG Tao,XU Fang,et al.Research Progress of MRI in Diagnosis and Treatment of Breast Cancer[J].Journal of Medical Information,2022,35(04):62.[doi:10.3969/j.issn.1006-1959.2022.10.015]
[3]李建辉,祝旭龙.乳腺癌的治疗管理——把好生活质量关[J].医学信息,2018,31(13):1.[doi:10.3969/j.issn.1006-1959.2018.13.001]
[4]杨玉峰,李 强,曲国红,等.乳腺癌术前巴德枪穿刺检测ER、PR的临床研究[J].医学信息,2018,31(13):163.[doi:10.3969/j.issn.1006-1959.2018.13.050]
　YANG Yu-feng,LI Qiang,QU Guo-hong,et al.Clinical Study on Preoperative ER and PR Detection of Bard Gun Puncture in Breast Cancer[J].Journal of Medical Information,2018,31(04):163.[doi:10.3969/j.issn.1006-1959.2018.13.050]
[5]刘雪静,路 红,徐熠琳,等.乳腺影像与容积导航技术初步应用的临床分析[J].医学信息,2022,35(11):161.[doi:10.3969/j.issn.1006-1959.2022.11.043]
　LIU Xue-jing,LU Hong,XU Yi-lin,et al.Clinical Analysis of the Preliminary Application of Breast Imaging and Volume Navigation Technology[J].Journal of Medical Information,2022,35(04):161.[doi:10.3969/j.issn.1006-1959.2022.11.043]
[6]刘在波,修文娟.背阔肌皮瓣联合假体在乳腺癌改良根治术后乳房重建中的应用[J].医学信息,2019,32(02):127.[doi:10.3969/j.issn.1006-1959.2019.02.036]
　LIU Zai-bo,XIU Wen-juan.Application of Latissimus Dorsi Flap Combined with Prosthesis in Breast Reconstruction after Modified Radical Mastectomy for Breast Cancer[J].Journal of Medical Information,2019,32(04):127.[doi:10.3969/j.issn.1006-1959.2019.02.036]
[7]孟庆国,王佳雪,王斯佳.马来酸吡咯替尼对乳腺癌术后患者心脏功能的影响[J].医学信息,2019,32(02):152.[doi:10.3969/j.issn.1006-1959.2019.02.045]
　MENG Qing-guo,WANG Jia-xue,WANG Si-jia.Effect of Pyrrolidine Maleate on Cardiac Function in Patients after Breast Cancer Operation[J].Journal of Medical Information,2019,32(04):152.[doi:10.3969/j.issn.1006-1959.2019.02.045]
[8]刘 曼,厉玛倩倩,徐润润,等.延续性护理对乳腺癌术后化疗患者生活质量与 健康知识水平的影响[J].医学信息,2018,31(16):178.[doi:10.3969/j.issn.1006-1959.2018.16.057]
　LIU Man,LIMA Qian-qian,XU Run-run,et al.Effect of Continuous Nursing on Quality of Life and Health Knowledge of Postoperative Chemotherapy Patients with Breast Cancer[J].Journal of Medical Information,2018,31(04):178.[doi:10.3969/j.issn.1006-1959.2018.16.057]
[9]满枋霖,葛俊宏,林晓月,等.p21活化激酶在乳腺癌中的作用研究[J].医学信息,2019,32(06):35.[doi:10.3969/j.issn.1006-1959.2019.06.013]
　MAN Fang-lin,GE Jun-hong,LIN Xiao-yue,et al.The Role of p21 Activated Kinase in Breast Cancer[J].Journal of Medical Information,2019,32(04):35.[doi:10.3969/j.issn.1006-1959.2019.06.013]
[10]张天竺,宁 勇.长链非编码RNA调控乳腺癌发生发展的研究进展[J].医学信息,2019,32(12):40.[doi:10.3969/j.issn.1006-1959.2019.12.014]
　ZHANG Tian-zhu,NING Yong.Advances in Research on Long-chain Non-coding RNA Regulation of Breast Cancer Development[J].Journal of Medical Information,2019,32(04):40.[doi:10.3969/j.issn.1006-1959.2019.12.014]

更新日期/Last Update: 1900-01-01