Clinical Study Of Coagulation Changes In Patients With Imaging Presentation Of Mixed Ground Glass Nodules

ObjectiveIt has founded that patients with malignant tumors,especially lung cancer,have abnormal coagulation and are often in a hypercoagulable state,which not only predisposes to thrombotic disease,but also is closely related to tumor progression and prognosis.Prethrombotic state(PTS)is prevalent in the rapidly increasing lung cancer patients [1].With the improvement and broad application of CT technology,the detection rate of the ground-glass nodule(GGN)has improved dramatically,among which mixed ground-glass nodule(mGGN)is often closely associated with early-stage lung cancer,mostly adenocarcinoma.This study retrospectively analyzed the changes in coagulation and fibrinolytic marker levels in patients with pulmonary imaging manifesting as ground-glass nodule shadow and healthy physical examiners,as well as the changes in thromboelastography parameters and clinical significance in patients with nodules.Methods:Patients with mGGN detected by thin-layer CT examination at Baiqiuen Hospital in Shanxi Province from October 2020 to October 2022 were selected for retrospective analysis,and 145 met the criteria according to the inclusion and exclusion criteria,and were divided into 126 cases in the mGGN malignant group and 19 points in the mGGN benign group according to the pathological diagnosis,and 49 healthy physical examiners were selected as the control group.The coagulation function indexes were compared among the three groups,and the coagulation fibrinolytic function indexes and thromboelastography parameters were compared between the mGGN malignant and benign groups,as well as the coagulation function indexes among the patients with different pathological stages in the malignant group.The data of all patients were established as a database and analyzed by SPSS 26.0 statistical software,and P < 0.05 indicated that the difference was statistically significant.Results:1.The values of PT,APTT,TT,and Fib were statistically different between the mGGN and normal control groups(P<0.05).PT and APTT in the mGGN collective were considerably longer than in the normal control group;the difference was statistically relevant(P<0.05),while TT time was shorter than in the healthy control group;the difference was statistically meaningful(P<0.05);and Fib levels were significantly elevated;the difference was statistically meaningful(P<0.05).The difference was statistically meaningful(P<0.05),however the difference between the D-dimer level and that of the normal participants was not statistically meaningful.It suggests that the dynamic equilibrium of coagulation,anticoagulation,and fibrinolytic system in mGGN patients is disrupted,and the coagulation function of lung cancer patients is altered at the GGN stage.2.TAT and TM levels were significantly different between malignant and non-malignant mGGN(P<0.05).Within that malignant mGGN sample,t AT and TM levels were significantly higher than in the benign control group(P <0.05);suggesting that malignant mGGN patients are more likely to form thrombus compared with benign nodule patients.t-PAIC and PIC values were raised,although there was no significant distinction between them.(P>0.05),suggesting that the coagulation-fibrinolytic balance was altered in malignant patients at the GGN stage,and a shift toward thrombosis occurred.3.Angle of Angle,Cl value,and MA value were slightly increased in the mGGN malignant group compared with the benign group(P>0.05),The K value and R-value were both reduced in comparison to the nonmalignant group(P>0.05),although this distinction was not statistically meaningful.It indicates that the degree of abnormal coagulation function did not show significant differences between nonmalignan and malignant nodules.4.When the changes of coagulation indexes in the mGGN malignant group were analyzed after grouping them according to different pathological periods,the differences were not statistically significant(P>0.05),suggesting that the coagulation function of early stage lung cancer patients who presented with mixed ground glass nodules had already changed at the Tis-I stage,but there were not any significant variations between the coagulation indices of AAH/AIS,MIA,and IAC in this investigation.Conclusion:In patients with early-stage lung tumors,systemic coagulation is already disturbed at the location of ground glass nodules,and the dynamic balance of the coagulation system is already disrupted and it may be in a hypercoagulable state,but no statistically significant differences in coagulation were seen between benign and malignant nodules and between the different types of malignant lesions.