Research On The Related Factors Of Hypercoagulability In Sclc Patients And The Correlation Of Hypercoagulability With Chemotherapeutic Efficacy

Objective: To investigate the complication of hypercoagulability in small cell lung cancer(SCLC) patients, analyze the clinical and laboratory features of SCLC patients who combined with hypercoagulability. And to evaluate the impact of chemotherapy on hypercoagulability and the value of the related coagulation indexes for forecasting the chemotherapeutic efficacy, further guiding the prevention and treatment of hypercoagulability in SCLC patients.Methods: In this study, 185 cases of SCLC patients that who were diagnosed and initial treated in the Second Affiliated Hospital of Dalian Medical University from January 2011 to March 2014 were collected. The data included the related coagulation indexes of hypercoagulability(including Fbg, PLT, APTT, PT, TT, INR)before treatment,age, sex, stage, smoking status, weight loss, complicating diseases, level of tumor markers(including CEA, NSE, CYFRA21-1), status of liver metastasis, brain metastasis,bone metastasis and lymph node metastasis, presence of pleural effusion, etc.51 patients with SCLC received chemotherapy and checked the related coagulation indexes after the second and the fourth cycles of chemotherapy, then, evaluate the efficacy according to the method of RECIST. We establish a database of all the data and then analysis the data statistically using SPSS17.0 statistical software. Measurement data were described as mean±standard deviation( SX ?), t test was used to compare the indexes between two groups and single factor analysis of variance was used to compare the indexesamong groups, P<0.05 was considered statistically significant.Results: 1.118 cases among the 185 cases of SCLC patients at the time of diagnosis have been combined with hypercoagulability, the incidence of hypercoagulability was 63.78%. According to the level of incidence, Fbg elevated were in 111 cases of SCLC patients(60.00%), PLT elevated were in 34 cases of SCLC patients(18.38%), TT droped were in 4 cases of SCLC patients( 2.16%), APTT droped were in 4 cases of SCLC patients(2.16%), INR droped were in 3 cases of SCLC patients(1.62%)and PT droped was in 1 case of SCLC patient(0.54%).2.APTT in female patients with SCLC was significantly lower than that in male patients, P<0.05, the difference was statistically significant.3.PLT and APTT were lower in age≥60 years old group with SCLC than that in age<60 years old group, P<0.05, the differences were statistically significant.4.There were no significant differences of the coagulation indexes in SCLC patients with different levels of smoking and weight loss(P>0.05).5.Fbg in SCLC patients with hyperlipidemia was significantly higher than that in patients without hyperlipidemia, P<0.05. However, there were no significant differences of the coagulation indexes in SCLC patients with or without hypertension group,the same as in SCLC patients with or without diabetic group(P>0.05).6.Fbg in extensive stage patients with SCLC was higher than that in limited stage patients, P<0.05, the difference was statistically significant.7.NSE elevated group had a higher level of PLT than NSE normal group(P<0.05).APTT in CYFRA21-1 elevated group was lower compared with CYFRA21-1 normal group(P<0.05). However, there were no significant differences of the coagulation indexes in SCLC patients between CEA elevated group and CEA normal group(P>0.05).8.PLT and Fbg were higher in SCLC patients without liver metastasis than that in patients with liver metastasis(P<0.05). But there were no significant differences of the coagulation indexes in SCLC patients with or without the metastasis of brain, bone or lymph node(P> 0.05).9.PLT, PT, INR, Fbg and APTT were higher in SCLC patients with pleural effusion than that in patients without pleural effusion(P<0.05).10.PLT, PT, INR and APTT in SCLC patients after the second cycle of chemotherapy were lower than that before chemotherapy(P<0.05). PLT, PT, INR, Fbg,APTT and TT in SCLC patients after the fourth cycle of chemotherapy were lower than that before chemotherapy(P<0.05). TT and Fbg in SCLC patients after the fourth cycle of chemotherapy were lower than that after the second cycle of chemotherapy(P<0.05).11.The effective group according to the curative effect evaluation after the second cycle of chemotherapy had a lower level of Fbg than ineffective group(P=0.036). The effective group according to the curative effect evaluation after the fourth cycle of chemotherapy also had a lower level of Fbg than ineffective group(P=0.012).Conclusion: 1.The coagulation index abnormalities of SCLC patients checked with Fbg and PLT increased majority. They generally have been combined with hypercoagulability at the time of diagnosis.2.female, age≥60 years old, hyperlipidemia, extensive stage, NSE elevated,CYFRA21-1 elevated, without liver metastasis and with pleural effusion were clinical risk factors for hypercoagulability.3.The role of chemotherapy on hypercoagulability in SCLC patients was dual function, and the more numbers of cycles of chemotherapy in SCLC patients received,the more obvious of hypercoagulability, the higher risk of thrombosis and secondary bleeding.4.The lower level of plasma Fbg in SCLC patients after chemotherapy suggest that the curative effect of chemotherapy was better, it may be of a certain clinical significance for forecasting the chemotherapeutic efficacy.