| Rectal cancer is one of the most common malignant tumors in the world. In our country, the incidence of rectal cancer increased year by year, most cancer patients diagnosed are already in advanced stage and lost the best operation time of treatment, but in recent years, the rapid development of radiotherapy technology and equipment, which brings new hope for patients with rectal cancer. Malignant tumor is easy to cause the activation of coagulation system in the body, further inducing thrombosis. The relationship between thrombosis and malignant tumor was found by Trousseau as early as 1865,and then a large number of studies show that cancer patients are mostly coagulation dysfunction, venous thrombosis incidence is as high as more than 10%. Venous thromboembolism is the second complications of the death of cancer patients. Fibrinogen(FIB) and two D- dimer(D-D) is the most common and sensitive index for blood coagulation. Different treatment ofmalignant tumor produce different effects of on coagulation function, the reports of domestic and foreign research mostly concentrated coagulation function effect on the operation treatment, Kodama J studies showed that the peak of the level of s Fb in cancer patients at the first day after operation, and reached the level of before the operation after 14 days. It is also reported that there is a certain correlation between chemotherapy and blood coagulation, chemotherapy easily lead to coagulation and fibrinolytic system dysfunction. But the influence of radiation therapy on coagulation function poorly, postoperative radiotherapy and chemotherapy combined effects on coagulation almost no relevant reports at home and abroad. The pathological types of colorectal cancer, the incidence of adenocarcinoma accounted for about 85%, The related research reports,in digestive system tumor, the most easy occurrence of coagulation dysfunction is adenocarcinoma, especially in colorectal cancer. In addition, because of long-term retention of artificial fistula after Miles operation for rectal cancer patients, there may be some effect on coagulation function. Now, with the status of radiation therapy in the treatment of malignant tumors have become increasingly prominent, the study of radiotherapy affect coagulation will be very important in analyzing the change of coagulation in the process of radiotherapy, and prevention related complications of thrombosis in treatment, At the same time, Understanding whether the changing in coagulation reference for judging the efficacy of radiotherapy. The present experiment was designed based on the above background.objectivePreliminary explore the impact of the level of plasma fibrinogen(FIB) and Ddimer(D-D) in rectal cancer patients after surgery before and after radiotherapy; Analysis the changing of the level of plasma fibrinogen(FIB) and D- dimer(D-D) in rectal cancer patients after surgery before and after concurrent radiotherapy and chemotherapy; To Investigate the difference of Plasma fibrinogen and D- dimer between Patients with rectal cancer after surgery and normal control group.Materials and methods1 Patient selection: Selecting 58 patients with rectal cancer after surgery in department of Radiation Oncology of First Affiliated Hospital of Zhengzhou University during from September 2013 to December 2014 period. All patients, who with II, III stage and adenocarcinoma of rectal after Miles mode operation, recovered well, including male 31 cases, female 27 cases, aged 45 ~ 74 years old, mean age 60.24 years, of which 37 patients received concurrent Radiotherapy and chemotherapy and 21 patients received radiotherapy alone.Choosing 35 volunteers Coming from healthy outpatient medical center as a healthy control group.2 Methods of treatment: All patients were treated by Three dimensional conformal RT; patients of concurrent chemotherapy Unified use of 5-fluorouracil(5-Fu).3 Measurement of Plasma FIB and D-D: All enrolled patients with rectal cancer were measured plasma FIB and D-D before therapy. FIB and D-D of patients would be measured again after therapy and reviewing within three months. Immune turbidimetric method was used to measure plasma D-dimer; solidification method was used to measure fibrinogen.4 Statistical Methods: All the experimental data were analyzed by using software package of SPSS17.0. Statistical description of all measurement data to be expressed as mean ± standard deviation. Using t-test, paired t test and Wilcoxon test analyze according to the distribution of data types in each group and among groups. Count data using χ2 test, Recent efficiency compared using Fisher’s exact test. Test level a = 0.05, P <0.05 considered statistically significant.Results1 The level of plasma fibrinogen and D- dimmer in rectal cancer patients after surgery have nothing to do with the sex and In different pathological staging(P>0.05).(Aged 60 years as a dividing point), the level of FIB and D-D in ≥60 years group is higher than <60 years group, the difference was statistically significant(P<0.05). No differences of gender between age groups gender(P>0.05).2 The average age through t test, the gender through χ2 test, the difference between rectal cancer after surgery group and the healthy control group was not statistically significant(P>0.05). The level of plasma fibrinogen and D- dimmer in rectal cancer patients after surgery is higher than healthy control group(P<0.05).3 Analysis the changing of the level of plasma fibrinogen and D- dimmer in mere radiotherapy group: the level of plasma fibrinogen and D- dimmer after radiotherapy is higher than before radiotherapy(P<0.05). There was no difference of the level of plasma fibrinogen and D- dimmer between the healthy control group and after radiotherapy or reviewing within three months(P>0.05).4 Analysis the changing of the level of plasma fibrinogen and D- dimer before and after concurrent radiotherapy and chemotherapy:the level of plasma fibrinogen and D- dimmer after concurrent radiotherapy and chemotherapy is higher than before concurrent radiotherapy and chemotherapy(P<0.05)。The level of plasma fibrinogen and D- dimmer of reviewing within three months is lower than before concurrent radiotherapy and chemotherapy,but is higher than the healthy control group(P<0.05).5 Comparing the level of plasma fibrinogen and D- dimmer in two different therapy groups: The difference of the level of plasma fibrinogen and D- dimmer between before concurrent radiotherapy and chemotherapy and mere radiotherapy was not statistically significant(P>0.05). The level of plasma fibrinogen and Ddimmer after concurrentradiotherapy and chemotherapy is higher than before mere radiotherapy(P<0.05).6 Comparing the short-term effect: Reviewing after the end of treatment within 3 months, in the 37 patients of concurrent radiotherapy and chemotherapy, 35 cases in effect, 2 cases of relapse; in the 21 patients of mere radiotherapy, 20 cases in effect, 1 case of relapse. the difference of the short-term effect between the group was not statistically significant(P>0.05).Conclusions1 Radiotherapy can reduce the level of plasma fibrinogen and D- dimmer in rectal cancer patients after surgery; Radiotherapy can decrease the fibrinolytic hyperfunction and the hypercoagulability state; changes of the level of plasma fibrinogen and D- dimmer after radiotherapy have great effect on the prognosis of rectal cancer patients after surgery.2 Concurrent radiotherapy and chemotherapy in rectal cancer patients after surgery can increase the level of plasma fibrinogen and D- dimmer, result in the fibrinolytic hyperfunction and the hypercoagulability state and long duration; It has certain guiding significance for the thrombosis risk assessment in the clinical course of treatment.3 The level of plasma fibrinogen and D- dimmer in rectal cancer patients after surgery is higher than the healthy group. The hypercoagulability state and fibrinolytic hyperfunction exists in them.4 The level of plasma fibrinogen and D- dimmer in rectal cancer patients after surgery have nothing to do with the sex, but age-related, the older, the higher levels in plasma. |
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