| Background Cancer incidence and mortality are increasing year by year,especially lung cancer,its incidence in the world first.A number of studies have demonstrated that distant metastases and thrombosis in patients with malignant tumor death.2015 two major causes of the American Society of Clinical Oncology(American Society of Clinical Oncology,ASCO)clinical guidelines for lung cancer,gastric cancer,etc.patients are required to change of blood coagulation function monitoring during the whole hospitalization,regularly assess the risk of thrombosis,anticoagulation therapy,can prolong the survival time of patients,improve the quality of life at present.Clinicians have not paid enough attention to the phenomenon of thrombosis associated with malignant tumor,affecting the quality of life and shortening the patient's survival time.Objective To investigate the changes of coagulation indexes in patients with lung cancer,and to find the related factors of thrombosis in patients with lung cancer,and to analyze the relationship between thrombosis and prognosis of patients with lung cancer?Methods Blood coagulation index were retrospectively analyzed from January 1,2015 to December 31,2016 in the 152 Central Hospital of PLA,316 cases of lung cancer patients and 254 healthy subjects.The overall situation of the sample from January 2015 to December 2016 in the first 52 Central Hospital of PLA,316 cases of lung cancer patients,including 205 cases of male,female 111 cases;at the age of 35-85 between average65.49±12.01years;lung cancer group according to the platelet count is divided into 85cases: increased platelet elevated group(26.9%),platelet count in 231 cases of normal group(73.1%);according to whether the D-dimer increased is divided into: D-dimer group increased in 222 cases(70.3%),D-dimer normal group(29.7%);94 cases were grouped according to pathological types: 127 cases of adenocarcinoma(40.2%),101 cases of squamous cell carcinoma(32%),88 cases of small cell lung cancer(27.8%);according to the clinical stage of tumor were divided into I~II group and III~IV group;the control group from January 2015 to December 2016 in healthy people in our hospital physical examination of 254 people,of which 145 were male,109 females;age range in 35-84 years old,average 63.17±10.14 years.The clinical data in our hospital medical record statistical objects,including platelets(Platelet,PLT),prothrombin time(Prothrombin,time,PT),activated partial thromboplastin time(Activated partial thromboplastin time,APTT),fibrinogen(Fibrinogen,FIB),D-dimer(D-D)and the level of gender,age,pathological types of lung cancer,divided Phase(I~II,III~IV).SPSS 17 statistical software was used for data processing,comparison between groups using U test samples,P<0.05 for the difference was statistically significant,P<0.01 was statistically significant.The follow-up of all lung cancer patients in this study,the main way to telephone follow-up,outpatient and inpatient etc.follow up.From the beginning of February 1,2015,the deadline for February 31,2017,the shortest follow-up time of 6 months,the longest follow-up time of24 months.The follow-up period died of other causes,or lost of cut-off survivor,were counted as censored data.Using Logistic regression analysis,the survival curve was drawn by Kaplan-Meier method;the survival rate compared with log-rank test;multivariate analysis using COX proportional hazards regression model.P<0.05 the difference was statistically significant.Results1.The rate of abnormal cases of the lung cancer group compared with the control group:The abnormal case of blood coagulation function was194 in total 316 cases of lung cancer group,the abnormal rate was 61.4%;46 cases of blood coagulation function was abnormal in Control group 254 cases,the abnormal rate was 18.1%,the difference was significant and has statistical significance(P < 0.01).2.The comparison of the blood coagulation indexes between the malignant tumor group and control group:The PT,TT,APTT,Fib and D-dimer content of Malignant tumor patients positive rate were significantly increased compared with control group,the difference is significant statistically significant(P < 0.01);PLT content does not change significantly compared with control group,the difference has no statistical significance(P > 0.05).3.Lung cancer patients with different platelet,D-dimer level Concurrent vein thrombosis:The case of platelet count abnormal of lung cancer of 85 Concurrent VTE was12 cases(14.1%),The case of platelet count normal of lung cancer of 231 Concurrent VTE was 11 cases(4.8%),the difference between the two group have statistical significance(P <0.001);D-dimer levels of 222 cases of VTE was 20 cases(9.0%),The cases of VTE was 3cases(3.2%)of D-dimer normal level of 94 case,and the statistically was significant difference(P < 0.001).4.Distribution of VTE in patients with lung cancer:127 cases was adenocarcinoma(40.2%),101 cases was squamous cell carcinomas(32.0%)and 88 cases was small cell lung cancer(7.8%)of 316 cases of lung cancer patients.VTE in adenocarcinoma patients13 cases(10.2%),squamous cell carcinomas in patients with VTE 6 cases(5.9%),small cell lung cancer patients found VTE 4 cases(4.5%),adenocarcinoma and squamous cell and small-cell lung cancer group difference was statistically significant(P < 0.05),a group of patients with squamous carcinoma and there was no statistically significant difference in patients with small cell lung cancer group,(P > 0.05).5.The survival of patients with VTE group and non VTE group with Lung cancer was different :Patients with lung cancer merger VTE median survival time was 20.5 months;Lung cancer patients with VTE with not the median survival time for 23 months.To compare two groups of patients using the Log-rank survival,VTE survival time and the VTE group statistical difference(P < 0.001).6.Survival analysis of patients with lung cancer Multiple factors analysis of survival analysis using Cox proportional hazards regression analysis.P<0.05 or less of the main variables(including TNM staging,PT?APTT? Fib?PLT?D-dimer)was incorporated into the analysis;By comparing the Log-rank research shows that ?-? stage than I ~ ?patients,survival significantly shortened(P < 0.01);A significant rise in D-dimer statistically have significant adverse effects on total survival(P < 0.01).Conclusion1.The patients with lung cancer was the crowd with a greater incidence of coagulant function abnormality;2.The lung cancer patients of deep vein thrombosis' median survival time has decreased compare with the lung cancer patients who has not deep vein thrombosis;3.D-dimer rise and decline is closely related to the survival of patients with lung cancer. |
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