The Correlative Analysis Between Coagulation Index In Peripheral Blood And Clinical Features Of Gastric Cancer

Objective：Analyze the relationship between coagulation index including APTT (Activated partial prothrombin time）,TT（Thrombin time）,PT（Prothrombin time）,FIB（Plasma fibrinogen）,PLT（Platelet）and DD(D-dimer body) in peripheral blood and clinical features of gastric cancer such as age,gender,clinical stage,et al,to further study its clinical significance, and study coagulation index changes before and after chemotherapy to guide rational intervention and reasonable treatment in patients with gastric cancer.Method:1. The185patients who met the inclusion criteria were collected from194cases hospitalized in the First Affiliated Hospital of Dalian Medical University from January2010to January2013,which confirmed to be gastric cancer by histopathology,including139males cases,46female cases,male to female ratio of3.02:1,with an average age of60.01±11.02years old.179people were confirmed byfor chronic gastritis,ulcer,gastric polyps or healthy people during the same period as the control group.Observe APTT,TT,PT,FIB,PLT and DD, then group by clinical features to make statistical analysis.2. Use biological activity to measure APTT, TT, PT, and FIB was measuredby PT-der assay,DD was applied by immunoturbidimetric method, PLT is tested in hematology analyzer XE-2100type (Japan Sysmex). 3. Observe APTT, TT, PT, FIB, PLT, DD in peripheral blood.Group according to different clinical characteristics and comparative statistical analysis. MeasureAPTT, TT, PT, FIB, PLT, DD of62cases of gastric cancer receiving chemotherapy before and72hours after chemotherapy,by comparing before and after chemotherapy coagulation indicators,to evaluate chemotherapy influence on coagulationfunction in patients with gastric cancer.4. All data are conducted by SPSS13.0statistical analysis software.Measurement data is in form of mean and standard deviation（x±s）, and independent sample t-test or t’-test after calibration is used between two groups, as for threeor more groups, single factor analysis of variance will be used for comparison, and we use the SNK-q inspection in each two following groups.All statistical results of P<0.05is considered statistically different,and P<0.01is considered statistically significant difference.Results:1. TT level of gastric cancer in peripheral blood was16.89±1.34,lower thanthe control group of17.19±1.05，there was significant difference(P=0.048);and FIB,PLT and DD count was significantly higher than the control group respectly(3.07±0.81vs.2.68±0.57,236.43±71.42vs.210.29±56.11,229.12±323.52vs.42.68±28.12)(P=0.000).2. APTT,TT,PT,FIB,DD and PLT was no significantly different in different parts and different types of pathology in gastric cancer(P>0.05).There was significant difference in genders of TT and PLT in gastric cancer group (P=0.017, P=0.034), TT and PLT in women were higher than men on average(17.30±1.55vs.16.75±1.24,260.15±65.50vs.228.58±71.78). FIB was statistically significant (P=0.037) between ages <60years and that≥60years in gastric cancer group,≥60age group is higher than the average level of <60age group(3.20±0.80vs.2.94±0.81); DD level is267.86±26.96,and≥60age group is higher than the averagelevel of183.24±22.45in <60age group, the difference was statistically significant(P=0.021). FIB and PLT were statistically significant different between differen t violations of average depth (P=0.018, P=0.025), which mucosa group were lower than the muscular infringement(2.86±0.68vs.3.18±0.85,218.44±49.87vs.245.28±78.60).The difference between PT and FIB levels with clinical was statistically significant (P=0.025, P=0.034); PLT and DD with clinical stage was significantly changed increasing trend, the difference was significant (P<0.01). Gastric differentiation between different groups and the control group was statistically significant (P=0.034, P=0.024) different in the average level of TT and PLT, of which the control group showed higher levels of TT in differentiation groups, and with the degree of differentiation of gastric cancer changing, the level of TT becomeshigher; PLT of gastric level is higher, and the higher the degree of differentiation, the lower PLT level is. Among gastric cancer metastasis group,DD and PLT difference was statistically significant (P=0.010, P=0.000), PLT and DD levels inmetastasis group were higher than those without metastasis.3.The PT,FIB,DD and PLT count level were positively correlated with TNMstage((P=0.028, P=0.000, P=0.000, P=0.001), and PLT count level was positively correlated with differentiation degree(P=0.029),while TT level was negatively correlated with differentiation degree (P=0.024).4.Gastric cancer patients`plasma fibrinogen and platelets were less72hoursafter chemotherapy than before chemotherapy(3.15±0.84vs.2.66±0.59,246.95±81.01vs.214.18±53.22), and there was statistically significance (P<0.01, P<0.01), other coagulation index was not statistically significant before and after chemotherapy (P>0.05).Conclusion:1.Gastric Cancer fibrinogen and D-dimer increased, which in the elderly (>60years), late clinical stage of gastric cancer patients in a hypercoagulable state is moreobvious and easier to happen thrombosis.2.Platelet count increase in patients with gastric cancer,showing that the female,poorly differentiated, late stages patients have an increasing risk of thrombosis.3.Patients with advanced gastric cancer prolonged prothrombin time,while prothrombin time shortened, suggesting bleeding more easily.4.Plasma fibrinogen and platelets would reduce in gastric cancer patients afterchemotherapy,which may increase the risk of thrombosis and bleeding in patients withgastric cancer.