The Study On Correlation Between Peripheral Blood Hypercoagulability And Clinical Features Of Gastric Cancer

Objective:To study the changes of peripheral blood hypercoagulable state and related blood coagulation indexes in patients with gastric cancer,analyze the correlation with their clinicopathological features,and explore the risk factors that may lead to blood hypercoagulability,in order to provide guidance for the clinical treatment of patients with gastric cancer.Methods:This study collected the clinicopathological data of gastric cancer diagnosed by pathology in the Department of Gastrointestinal Oncology,affiliated Hospital of Qin Hai University from January 2020 to October 2021.Collect case data on admission,including general clinical data(age,sex,smoking history,hyperlipidemia,hypertension,diabetes,cardiovascular disease,lung disease,liver disease,kidney disease,basic stomach disease).Pathological data(location,pathological type,degree of differentiation,pathological stage,tumor size,number of lymph node metastasis,Lauren classification,tumor thrombus,human epidermal growth factor receptor 2),perfect laboratory indicators at admission(white blood cell count,red blood cell count,plasma prothrombin time,activated partial thromboplastin time,fibrinogen content,D-dimer,platelet count).According to the diagnostic criteria of blood hypercoagulable state,patients with gastric cancer were divided into hypercoagulable group and non-hypercoagulable group,and the clinicopathological features of the two groups were compared.the correlation between laboratory coagulation index and clinicopathological characteristics and the risk factors of blood hypercoagulable state in patients with gastric cancer were analyzed.Results:1.A total of 280 patients with gastric cancer were included according to the inclusion and exclusion criteria,including 74 in the high coagulation group and 206 in the non-high coagulation group.2.The results showed that there were significant differences in age,smoking history,hyperlipidemia,diabetes,lung disease,liver disease and kidney disease between the hypercoagulable group and the non-hypercoagulable group(p < 0.05).There were significant differences in pathological stage,differentiation,vascular tumor thrombus,tumor size,white blood cell count,red blood cell count,activated partial thromboplastin time,fibrinogen content,D-dimer and platelet count between the two groups(p < 0.05).There was no significant difference in sex,hypertension,cardiovascular disease,history of gastric disease,location of tumor,pathological type,degree of differentiation,number of lymph node metastasis,Lauren classification,human epidermal growth factor receptor 2 positive or not,plasma prothrombin time between high coagulation group and non-high coagulation group.3.In the coagulation correlation analysis,the plasma prothrombin time and activated partial thromboplastin time were relatively shortened in the group with hyperlipidemia and liver disease(p < 0.05).The content of fibrinogen and D-dimer were significantly increased in patients with age ≥ 60 years old,pathological stageⅣ and positive vascular thrombus group(p < 0.05).PLT increased in different degrees in diabetes mellitus group,pathological stage group,tumor size Ⅳ≥ 4.6cm group and vascular tumor thrombus positive group.4.The results of binary logistic regression analysis showed that they had smoking history(OR0.302,95%CI [0.097-0.936],p < 0.05),pathological stage IV(OR 0.091,95% CI [0.018-0.464],p < 0.464),positive vascular thrombus(OR0.173,95%CI [0.034-0.887],p < 1.973),leukocytosis(OR 1.466,95% CI[1.089-1.973]).Increased fibrinogen(OR3.737,95%CI [1.970-7.087],p < 7.087),increased D-dimer(OR 1.841,95% CI [1.215-2.790],p < 2.790),and increased platelet count(OR 1.027,95% CI [1.018-1.037],p < 0.05)were risk factors of hypercoagulable state in the blood of patients with gastric cancer.Conclusion:1.The age,diabetes mellitus,hyperlipidemia,lung disease,liver disease,kidney disease,degree of differentiation,tumor size and red blood cell count in patients with gastric cancer were correlated with blood hypercoagulability.2.The older diabetic patients with larger tumor,later pathological stage and positive vascular thrombus,the more likely to have abnormal blood coagulation.3.Smoking history,pathological stage Ⅳ,positive vascular cancer thrombus,elevated leukocyte,fibrinogen,D-dimer and platelet count were the independent risk factors of blood hypercoagulable state in patients with gastric cancer.