Study On The Correlation Of Abnormal Coagulation Function In Lung Cancer Patients

Background and purpose:lung cancer is the leading cause of morbidity and mortality in all kinds of malignant tumors.Lung cancer patients often have activation of coagulation system and fibrinolytic system,which makes the blood in a hypercoagulable state,which not only increases the risk of thrombosis,but also benefits the invasion and metastasis of tumor cells.The purpose of this study was to retrospectively analyze the correlation between coagulation function index and its clinicopathological characteristics in patients with lung cancer,and to explore the significance of detection of coagulation function in predicting the occurrence of thrombus in patients with lung cancer,so as to provide reference for the prevention,diagnosis and treatment of hypercoagulability in patients with lung cancer.Methods:1.This study choose between January 2017 and December 2019,for the first time in the second affiliated hospital of Kunming medical university confirmed by cytology or pathology of thoracic surgery clinical data of 251 cases of patients with lung cancer,the information included in on blood coagulation function in patients with lung cancer related indicators(PLT,PT,PTR,INR,APTT,FIB,TT),age,gender,pathological type,TNM stage,tumor size,lymph node metastasis or not,etc.At the same time,this study selected 120 non-cancer patients who visited the second affiliated hospital of Kunming medical university at the same time as the control group.First,the differences in blood coagulation indexes between the lung cancer group and the control group were compared statistically.2.Then,the age,gender,pathological type,TNM stage,tumor size,lymph node status of the lung cancer group were compared with the coagulation indicators.3.Finally,the relationship between PLT,FIB and INR and the correlation between them and the clinicopathological features of lung cancer were further analyzed to draw a conclusion.4.Clinical data of all patients were entered into the database,and SPSS22.0 statistical software was used for analysis.Measurement data meeting normal distribution were described by mean ±standard deviation,t-test was used for inter-group comparison,Median was used for skew distribution,and non-parametric test(mann-whitney U test)was used for inter-group comparison.Chi-square(X2)test was performed on the counting data.The correlation among PLT,FIB and INR and their correlation with clinicopathological characteristics were analyzed by rank correlation method.P<0.05 was considered statistically significant.Results:1.The differences of PLT,PT,PTR,INR,APTT and FIB in the lung cancer group were statistically significant compared with the control group(P<0.05).2.The differences of PT,PTR,INR,APTT and FIB in the lung cancer group≥60 years old were statistically significant(P<0.05).There were statistically significant differences in the prolongation of PT,APTT,TT and the elevation of INR and PTR in male patients with lung cancer compared with female patients(P<0.05),indicating that male patients had a more active coagulation cascade than female patients,and there was a significant statistical correlation between the gender of lung cancer with thrombosis(P<0.05).The coagulation index level of small-cell lung cancer was higher than that of non-small-cell lung cancer,but there was no statistical significance(P>0.05).The level of squamous cell carcinoma was higher than that of adenocarcinoma(except TT)(P<0.05).TNM staging Ⅲ-Ⅳ more Ⅰ-Ⅱ higher PLT and FIB level of patients with lung cancer,there are statistically significant(P<0.05),the rest of the indicators no significant difference(P>0.05).The FIB level of lung cancer with tumor size≥5cm significantly increased,with significant statistical difference(P<0.05),and no statistical difference in other indicators(P>0.05).The coagulation indexes of PLT and FIB with lymph node metastasis were significantly higher than those without lymph node metastasis(P<0.05).3.There were significant statistical correlations among PLT,FIB and INR(P<0.05).There was a statistical correlation between PLT and TNM stage and lymph node status of lung cancer(P<0.05),but no significant correlation between PLT and gender,age and pathological type(P>0.05).4.There was a significant statistical correlation between FIB and the gender,age,pathological type,TNM stage,lymph node status,and tumor size of lung cancer patients(P<0.05).5.There was a statistical correlation between INR level and gender,age,pathological type,tumor stage,and tumor size(P<0.05),but no correlation between FIB and lymph node metastasis(P>0.05).Conclusion:1.The dynamic balance between the blood coagulation system and the fibrinolysis system is lost in patients with lung cancer,resulting in the hypercoagulability of blood.2.Age,male,60 or more lung squamous carcinoma,TNM stage for Ⅲ-Ⅳ,tumor 5 cm or more,lymph node metastasis of lung cancer patients with coagulant function abnormality,prone to high blood coagulation state,increase the risk of thrombosis.3.The increased level of platelets was related to the later TNM stage and lymph node metastasis in patients with lung cancer.4.The fibrinogen level is closely related to the clinicopathological characteristics of lung cancer patients,and high fibrinogen level is conducive to the progress of lung cancer.5.INR increased with age,male,60 or more squamous cell carcinomas,tumor 5 cm or more,Ⅲ-Ⅳ period of lung cancer patients,should be alert to the occurrence of chronic DIC.6.Timely detection of coagulation function of lung cancer patients and timely individualized and systematic low molecular weight heparin anticoagulation therapy are conducive to improving the hypercoagulability of lung cancer patients’blood.