Application Of Coagulation And Fibrinolysis Indicators Combined With Tumor Markers In The Staging Assessment Of Non-Small Cell Lung Cancer

Objective:The purpose of this study is to explore the value of coagulation,fibrinolysis and tumor markers in the staging evaluation and diagnosis of non-small cell lung cancer.Methods:Collect 100 patients who were pathologically diagnosed as non-small cell lung cancer at the Second Department of Respiratory and Critical Care Medicine,Department of Thoracic Surgery,and Department of Medical Oncology in the Hospital from September 2020 to December 2022,and record the patient’s age,gender,smoking history,coagulation,fibrinolysis,tumor markers,and first visit chest CT,head CT or MRI,abdominal CT or abdominal ultrasound,whole body superficial lymph nodes ultrasound,whole body bone scan,all patients were staged according to the International TNM staging Standard for Lung Cancer(eighth Edition)as the experimental groups.At the same time,the age,sex,smoking history,blood coagulation,fibrinolytic indicators and tumor markers of 50 patients who were pathologically diagnosed as benign lung tumors in the same period were collected as the control group.Statistical methods were used to study the differences and correlations between the experimental group and the control group,as well as the differences and correlations between the coagulation,fibrinolytic indexes and tumor markers in the subgroups of patients with different TNM stages within the experimental group.Subsequently,the diagnostic efficacy of coagulation,fibrinolysis indicators and tumor markers single and combined indicators for NSCLC were evaluated.Results:1.There were statistically significant differences in gender and smoking history between the experimental group and the control group(P<0.05),but there was no difference in age(P>0.05).There were no differences in age,gender,and smoking history among the subgroups of clinical stages within the experimental group.(P>0.05)2.The levels of FDP,D-dimer,PT,INR,FIB,APTT,PLT,CEA,CA125,CYFRA21-1,and SCC in the experimental group were higher than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference between AT III and TT(P>0.05).3.There were significant differences in FDP,D-dimer,PT,INR,PTR,FIB,APTT,PLT,CEA,CA125,CYFRA21-1,and SCC among experimental groups of different clinical stages(P<0.05),but there was no significant difference in AT III and TT between the experimental groups at different clinical stages(P>0.05).FDP,D-dimer,INR,PTR,FIB,PLT,CEA,CA125,CYFRA21-1,SCC were positively correlated with clinical stage(P<0.05),PT was negatively correlated with clinical stage,and the difference was not statistically significant(P>0.05).4.There were significant differences in FDP,D-dimer,PT,FIB,PLT,CEA,CA125,CYFRA21-1,and SCC during different T scores(P<0.05).There was no significant difference in AT III,INR,PTR,TT,APTT during different T scores(P>0.05).FDP,D-dimer,PT,FIB,PLT,CEA,CA125,CYFRA21-1,SCC were positively correlated with T stage(P<0.05).5.FDP,D-dimer,FIB,PLT,CEA,CA125,CYFRA21-1,SCC were significantly different among different N stages(P<0.05).AT-III,PT,INR,PTR,TT,APTT had no significant difference among different N stages(P>0.05).FDP,D-dimer,FIB,PLT,CEA,CA125,CYFRA21-1,SCC were positively correlated with N stage(P<0.05).6.FDP,D-dimer,FIB,CEA,CA125,CYFRA21-1,SCC were significantly different among different M stages(P<0.05).There was no significant difference in AT III,PT,INR,PTR,TT,APTT among different M stages(P>0.05).FDP,D dimer,FIB,CEA,CA125,CYFRA21-1,SCC were positively correlated with M stage(P<0.05).7.ROC curve:The ROC curve analysis of NSCLC shows that the maximum cut-off points are:FDP:1.9mg/L,D dimer:0.32mg/L,PT:12.65s,INR:0.98,FIB:3.02g/L,PLT:261.5x10~9/L,CEA:3.08ng/ml,CA125:23.45U/ml,CYFRA21-1:3.55ng/ml,SCC:1.56ng/ml.Sensitivity:FIB>CYFRA21-1>D-dimer>PT>CEA>FDP>CA125>PLT>INR>SCC,specificity:SCC>CA125>CEA>CYFRA21-1>D-dimer>PLT=FDP>FIB>INR>PT.The sensitivity and AUC of FDP,D-dimer,PT,INR,FIB,PLT combined with CEA,CA125,CYFRA21-1,SCC are higher than those of single indicators.The results of the ROC curve for early stage(I,II)NSCLC show:sensitivity:FIB>D-dimer=CA125>CYFRA21-1>SCC>FDP>CEA>PLT;specificity:CYFRA21-1>CEA>CA125=FDP=PLT>D-dimer>FIB>SCC;AUC:CYFRA21-1>FIB>CA125>D-dimer>FDP>CEA>PLT>SCC.Conclusions:1.The levels of FDP,D-dimer,FIB,PLT,CEA,CA125,CYFRA21-1,and SCC were higher than those in the control group,and the difference was statistically significant(P<0.05),suggesting that the blood of NSCLC patients showed Hypercoagulable state and elevated levels of CEA,CA125,CYFRA21-1,and SCC.2.There are significant differences in FDP,D-dimer,FIB,PLT,CEA,CA125,CYFRA21-1,and SCC among different clinical stages,T stages,N stages,and M stages(P<0.05).The high expression of fibrinolytic and tumor markers tends to appear in late stage NSCLC patients.In addition,AT III,PT,INR,PTR,TT,APTT are different in different T,N or M stages,the above results may help to evaluate the clinical stage and prognosis of patients.3.FDP,D-dimer,PT,INR,FIB,PLT,CEA,CA125,CYFRA21-1,and SCC alone may provide limited help in the diagnosis of NSCLC,but combined application of coagulation/fibrinolysis indicators(FDP,D-dimer,PT,INR,FIB,PLT)and tumor markers(CEA,CA125,CYFRA21-1,SCC)can better predict NSCLC.In addition,the increase of FDP,D-dimer,FIB,PLT,CEA,CA125,CYFRA21-1,and SCC may indicate early NSCLC and help early screening of tumors.