| Background and Purpose: Over 50% malignant tumor patients had abnormal coagulation functions.Those patients were in hypercoagulative states and the kind hypercoagulative state could constitute to the formation of the thrombus,and the thromboembolism remained to be the second mortality factor for those patients with malignant tumors.Moreover,the thrombus could strengthen the aggressivity and invasiveness of the cells of malignant tumors,increase the partial organizational infiltration from the cells of malignant tumors and stimulate the distant metastasis of tumor cells.The lung cancer was one of the most common malignant tumors,and with its high morbidity,it threatensed human health seriously.Nowadays,those studies related to the coagulative states of lung cancer patients were few and most of them used conventional coagulation tests.This research carried on thrombelastogram(TEG)examinations on those patients who had lung cancer and positive diseases in lungs,to learn the states of their coagulation functions before operations and provide gist for thrombus prevention after operations.Methods: This study gathered 170 patients from the department of chest surgery in DaPing Hospital affiliated to No.3 Military Medical University who received operational therapy from January to November in the year of 2014.There were 111 male cases and 59 female cases and they were aged from 39 to 74(56+7.49).According to the results of pathological diagnosis after operation,those patients were divided into lung cancer group and lung benign disease group.And before operation,they were examined in these aspects of TEG,blood routine,and the function of conventional coagulation,to compare patients' indexes of laboratory examinations in the two groups and analyze the laboratory features and clinical features of lung cancer patients' coagulative states.Results: 1?170 patient cases were enrolled into this study,among which there were 100 lung cancer cases(48 cases of squamous and 52 cases of adenocarcinoma),and these patients were aged from 39~74(57.52±7.75).There were 66 males cases and 34 female cases in the group of lung cancer.Their physique index was(21.36±2.21)kg/m2 and their operation time length was(189.34±45.13)min.As to the TNM stage,there were 51 cases in ? stage,32 cases in ?stage and 17 in ?stage.And there were 33 case with lymphatic metastasis and 67 cases without lymphatic metastasis.The benign disease group had 70 patient cases,and these patient were aged from 41 to 71(55.70±7.00.There were 45 male cases and 25 female cases.Their physique index was(21.71±1.96)kg/m2 and their operation time length was(189.17±38.92)min.Between the two patient groups,there was no statistical differences in general information,such as the gender,the age,the physique index and operation time length(p>0.05).2?Compared with the benign disease group,in lung cancer group,the TEG's R value and K value became smaller obviously(p<0.01),and the values of Angel,MA,and CT became wider obviously.As to he function of conventional coagulation,other indexes had no statistical differences(p>0.05),except for the FIB difference's statistical significance(p<0.01).This indicated that lung cancer patients were in the hypercoagulative state.3?Among the 100 cases of lung cancer patients,55 cases of hypercoagulative patients were detected by the conventional coagulation function and thrombocyte and 79 cases of hypercoagulative patients were detected by TEG.TEG detection rate was higher than that of the conventional coagulation function and thrombocyte,so,they had some differences in statistics(p<0.05).4?In the group of lung cancer,all TEG's parameters had no statistical differences between genders(p>0.05).The age group was divided into two sub-groups which were the group of less than 60 years old and the group of more than or being equal to 60 years old,and all TEG's parameters had no statistical differences between the two age groups too(p>0.05).Moreover,there was no statistical differences between squamous carcinoma and adenocarcinoma(p>0.05).5?In the comparison of different pathological stages of the lung cancer,all TEG's parameters had statistical differences between the first stage and the third,as well as between the second stage and the third stage(p<0.05),but they had no statistical differences between the first stage and the second stage(p>0.05).6?In the TEG comparison between with lymphatic metastasis and without lymphatic metastasis in lung cancer group,the K value,Angel value and MA value had statistical differences(p<0.05),but other parameters had no statistical differences(p>0.05).7?The venous thromboemboslism recurrence rate after operation was 8% around for the patients with lung cancer,and the thrombus often happened on those patients whose pathological stages were late comparatively after operation and who suffered lymphatic metastasis.And before operation,all TEG parameters between the phlebothrombosis positive group of and the phlebothrombosis negative group had no differences in statistics(P<0.05).Conclusion: 1?Patients with lung cancer were in hypercoagulative state and if a patient's stage was more advanced and suffered lymphatic metastasis,the patient's hypercoagulative state would be more obvious.2 ? TEG's comparatively traditional coagulation function and blood routine examination could comprehensively reflect the state of coagulation function in body and evaluate the hypercoagulative state more precisely.3?After operation,patients with lung cancer could suffer phlebothrombosis easily,and after operation,the venous thromboemboslism could happen on these patients,which were caused by the obvious hypercoagulative state,the advanced stage and lymphatic metastasis dangerously.Thus,the anti-coagualtive therapeutic schedule should be made after operation,which should be in accordance with patients' clinical features and indexes of laboratory examinations,in order to prevent the occurrence of the thrombus and its complication,uplift lung cancer patients' life quality and improve the prognosis. |
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