血浆TAT、PIC、TM及t-PAIC联合检测诊断肝癌血栓的临床价值

目的探究血浆凝血酶抗凝血酶复合物(TAT)、纤溶酶-α2纤溶酶抑制物复合物(PIC)、血栓调节蛋白(TM)及组织纤溶酶原激活物-抑制剂1复合物(t-PAIC)联合检测诊断肝癌血栓的临床价值。方法选取2019年1月至2020年6月该院收治的142例肝癌患者作为研究对象,按照是否形成静脉血栓分为血栓组(35例)和无血栓组(107例),收集患者临床资料,检测两组血浆TAT、PIC、TM及t-PAIC水平,以及其联合检测对肝癌血栓的诊断价值。结果两组患者血清空腹血糖(FBG)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平比较,差异均无统计学意义(P>0.05);血栓组血浆D-二聚体(D-D)、纤维蛋白降解产物(FDP)水平高于无血栓组,差异有统计学意义(P<0.05),两组血浆抗凝血酶Ⅲ(AT-Ⅲ)、纤维蛋白原(FIB)水平比较,差异无统计学意义(P>0.05);血栓组血浆TAT、PIC、TM、t-PAIC水平均高于无血栓组,差异均有统计学意义(P<0.05);Pearson相关性分析显示,血浆TAT、PIC、TM、t-PAIC水平与血浆FDP、D-D水平呈正相关(r=0.275~0.457,P<0.05),与血浆FIB、AT-Ⅲ水平无明显相关性(P>0.05);血浆TAT、PIC、TM、t-PAIC诊断肝癌患者形成静脉血栓的受试者工作特征曲线下面积(AUC)分别为0.754、0.550、0.672、0.650,联合诊断的AUC为0.915,灵敏度和准确度均高于单项检测,差异有统计学意义(P<0.05)。结论血浆TAT、PIC、TM及t-PAIC联合检测肝癌血栓优于单项检测,具有较好的临床诊断价值。

Clinical value of combined TAT,PIC,TM and t-PAIC in the diagnosis of liver cancer thrombosis

Objective To explore the clinical value of the combined detection of plasma thrombin antithrombin complex(TAT),plasmin-α2 plasmin inhibitor complex(PIC),thrombomodulin(TM)and tissue plasminogen activator-plasminogen activator inhibitor complex(t-PAIC)in the diagnosis of liver cancer thrombosis.Methods A total of 142 patients with liver cancer admitted to the hospital from January 2019 to June 2020 were divided into thrombosis group(35 cases)and non-thrombosis group(107 cases)according to the formation of venous thrombosis.The clinical data were collected,and TAT,PIC,TM and t-PAIC levels in the two groups and their combined diagnostic value of for liver cancer thrombosis were analyzed.Results There was no significant difference in serum fasting blood glucose(FBG),total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)levels between the two groups(P>0.05).The plasma fibrinogen degraded product(FDP)and D-dimer(D-D)levels in the thrombosis group were higher than those in the non-thrombosis group,and the difference was statistically significant(P<0.05),the difference between plasma AntithrombinⅢ(AT-Ⅲ)and fibrinogen(FIB)levels of the two groups were not significantly different(P>0.05).The plasma TAT,PIC,TM,t-PAIC levels in the thrombosis group were higher than those in the non-thrombosis group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that plasma TAT,PIC,TM and t-PAIC levels were positively correlated with plasma FDP and D-D levels(r=0.275-0.457,P<0.05),but had no significant correlation with plasma FIB and AT-Ⅲlevels(P>0.05).The area under curve(AUC)of plasma TAT,PIC,TM,t-PAIC in the diagnosis of hepatic cancer patients with venous thrombosis were 0.754,0.550,0.672,0.650,and the AUC of combined detection was 0.915,and the sensitivity and accuracy of combined detection were higher than those of the single detection method(P<0.05).Conclusion The combined detection of plasma TAT,PIC,TM and t-PAIC for liver cancer thrombosis is superior to the single detection method,and has good clinical diagnostic value.