大肠癌患者术前纤维蛋白原、血小板与临床病理和预后的相关研究

目的探讨大肠癌患者行肿瘤切除术前的纤维蛋白原(FIB)和血小板(PLT)联合指标F PLT与大肠癌临床病理特征及预后的关系。方法回顾性分析2012年2月至2014年2月在西南医科大学附属医院接受肿瘤切除术的244例大肠癌的临床病理资料,并进行术后随访;分析大肠癌患者FIB和PLT与其临床病理特征的关系,通过ROC曲线确定FIB和PLT的最佳截断值,根据最佳截断值将FIB、PLT组成联合指标F PLT评分,并据此评分将本组244例患者分为0分组51例、1分组68例、2分组115例。分析F PLT评分与大肠癌患者临床病理特征的关系,采用Cox回归分析影响大肠癌患者预后的因素,并比较3组患者的生存率。结果① 不同浸润深度、淋巴结转移、远处转移及TNM分期大肠癌患者的术前FIB和PLT差异有统计学意义(P<005),不同大肠癌病理等级患者的PLT水平差异有统计学意义(P=0004)。② 大肠癌的浸润深度越深、有淋巴结转移及远处转移、TNM分期晚的患者其F PLT评分较浸润深度浅、无淋巴结转移及远处转移、TNM分期早的患者高,差异有统计学意义(P<005);③ 病理等级差、有远处转移、病理分期晚、术前FIB和PLT升高的患者预后较差(P<005);④ 术前F PLT评分越高,其5年生存率越低,差异有统计学意义(P<005)。结论术前FIB和PLT与大肠癌患者的预后密切相关,通过术前F PLT评分可较早筛查出高危患者并给予个体化治疗从而改善预后。

Prognostic Value of Preoperative fibrinogen and platelet Levels in Patients with colorectal cancer

Abstract: Objective: To investigate the relationship of combined preoperative plasma levels of fibrinogen and platelet (F-PLT)with the prognosis of patients with colorectal cancer(CRC). Methods: The clinical data of 244 patients with (CRC) who were operated in our department from February 2012 to February 2014 were retrospectively. The relationship between FIB and PLT and clinicopathological features of CRC was analyzed. ROC curve was used to select the cutoff value of fibrinogen and platelet.According to the best cutoff value and scoring standard,fibrinogen and platelet were combined to form an index (F-PLT) .The relationship between F-PLT score and clinicopathological features of patients with (CRC) was analyzed. The Cox proportional hazards model was used to analyze the factors affecting the prognosis of patients with CRC, and the survival rates of the three groups were compared.Results:.1.Preoperative plasma FIB and PLT levels were closely related to the depth of invasion, lymph node metastasis, distant metastasis and pathological stage of CRC (P<0.05). PLT was also closely related to the pathological grade of CRC (p=0.004);2.F-PLT score was closely related to tumor invasion depth, lymph node metastasis, distant metastasis and pathological stage of CRC (P < 0.05). 3.Multivariate analysis found that the worse the pathological grade, the distant metastasis, the later the pathological stage, preoperative elevated FIB and PLT levels before surgery were associated with poor prognosis (P<0.05). 4. The higher the preoperative F-PLT score, the lower the 5-year survival rate, and the difference was statistically significant (P <0.05). Conclusion:Preoperative FIB and PLT are closely related to the prognosis of patients with CRC. Preoperative F-PLT score may improve the prognosis by screening high-risk patients earlier and giving individualized treatment.