Abnormal Coagulation Parameters in Patients with Early Colorectal Cancer and Its Clinical Significance
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摘要:
目的 探讨凝血指标在早期结直肠癌患者中的表达及其临床意义。 方法 本研究是病例对照研究，收集2010年1月1日至2018年12月31日在昆明医科大学第一附属医院经肠镜下取材病理检查证实为ECC的患者，比较早癌组和对照组在凝血相关指标之间的差异。 结果 早癌组与对照组在PT、PTR、FIB、TT、APTT、PLT、MPV上差异有统计学意义，与对照组比较，早癌组患者的PT、PTR、TT、APTT、MPV值均低，FIB、PLT值升高（均P < 0.05），FIB和MPV是ECC的独立危险因素。 结论 ECC患者存在凝血系统异常，似乎需要预防性抗血小板和抗凝治疗，但抗血小板治疗和抗凝治疗的时间以及用药的种类和方式还有待进一步研究。 Abstract:Objective Our aim was to investigate the expression and significance of coagulation markers in patients with early colorectal cancer. Methods This study was conducted by the case-control study to collect data from patients with early colorectal cancer confirmed by pathological examination at the First Affiliated Hospital of Kunming Medical University from January 1, 2010 to December 31, 2018, and the difference of coagulation-related indexes was compared between the early cancer group and the control group. Results Compared with the control group, PT, PTR, FIB, TT, APTT, PLT, MPV in the early cancer group were lower than those in the control group, and the values of PT, PTR, TT, APTT, MPV were higher than those in the control group （P < 0.05）, showing that FIB and MPV were independent risk factors for early colorectal cancer. Conclusion Abnormalities in the coagulation system are also present in patients with early colorectal cancer. It seems that patients with early colorectal cancer need prophylactic antiplatelet and anticoagulant therapy, but the time of anti-platelet therapy and anti-coagulant therapy, as well as the types and methods of medication, need to be further studied. -
Key words:
- Early colorectal cancer /
- Colorectal cancer /
- Coagulation index
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表 1 早癌组与对照组人口学特征（
$\bar x \pm s $ ）Table 1. Demographic characteristics of early cancer group and control group （
$\bar x \pm s $ ）参数 早癌组（n = 384例） 对照组（n = 384例） t/χ2 P 男性 [n（%）] 188（49.0） 203（52.9） 1.172 0.279 年龄（岁） 58.27 ± 12.87 57.20 ± 13.02 1.146 0.252 
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表 2 早癌组与对照组凝血指标水平的比较
Table 2. Comparison of coagulation indexes between early cancer group and control group
指标 早癌组（n = 384例） 对照组（n = 384例） t/z P FDP（mg/L） 1.90（1.20，5.23） 1.50（1.00，2.30） −2.991 1.000 D-D（mg/L） 0.53（0.31，1.46） 0.43（0.31，0.59） −2.578 0.181 AT-Ⅲ（%） 88.50（79.00，99.25） 90.50（82.75，98.00） −0.690 0.490 PT（s） 12.90（12.50，13.60） 13.40（12.90，13.90） −6.112 < 0.001* PTR（%） 1.00（0.96，1.05） 1.03（0.99，1.08） −6.714 < 0.001* FIB（g/L） 3.79（2.40，3.30） 3.18（2.78，3.81） −7.650 < 0.001* TT（s） 17.30（16.50，18.30） 17.80（16.70，18.76） −3.374 0.001* APTT（s） 36.90（34.40，39.90） 38.90（35.70，41.88） −5.188 < 0.001* PLT（109/L） 232.53 ± 89.26 221.22 ± 63.90 2.000 0.046* PCT（%） 0.24（0.20，0.28） 0.24（0.20，0.27） −0.465 0.642 MPV（fL） 10.70 ± 1.17 10.87 ± 1.08 −2.079 0.038* PDW（fL） 12.30（11.00，14.70） 12.60（11.20，14.30） −0.891 0.373 注：* P < 0.05，差异具有统计学意义.
FDP，纤维蛋白原降解产物；D-D，D二聚体；AT-III，抗凝血酶III；PT，凝血酶原时间；PTR，凝血酶原时间比值；FIB，纤维蛋白原；TT，凝血酶时间；APTT，活化部分凝血活酶时间；PLT，血小板；PCT，血小板压积；MPV，平均血小板体积；PDW，血小板分布宽度。
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表 3 ECC与观察指标关系的多因素logistic回归分析
Table 3. The relationship between ECC and observation index by multiple logistic regression analysis
指标 系数B 系数标准差SE P值 Exp（B） 95% CI 下限 上限 FIB（g/L） 0.450 0.121 < 0.001 1.568 1.237 1.987 MPV（fL） −0.253 0.096 0.009 0.776 0.643 0.938
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