多层螺旋CT和VEGF、MK在甲状腺良恶性肿瘤中的诊断价值

目的探讨多层螺旋计算机体层摄影(CT)在甲状腺良恶性肿瘤中的应用价值及血管内皮生长因子(VEGF)、中期因子(MK)在甲状腺良恶性肿瘤中的表达情况。方法选取65例甲状腺肿瘤患者作为研究对象,对其行多层螺旋CT,并采用免疫组化EnVision法检测甲状腺良恶性肿瘤中VEGF、MK的表达水平。以病理学诊断结果为"金标准",分析多层螺旋CT在甲状腺良恶性肿瘤中的应用价值以及VEGF、MK在不同性质甲状腺肿瘤中的表达差异。结果经病理结果证实,65例甲状腺肿瘤患者中,恶性肿瘤16例(乳头状癌12例、滤泡癌3例、髓样癌1例),良性肿瘤49例(结节性甲状腺肿29例、甲状腺囊肿16例、甲状腺炎4例);多层螺旋CT对甲状腺良恶性肿瘤的诊断符合率与病理结果比较,差异无统计学意义(P﹥0.05)。甲状腺良性肿瘤CT灌注参数中的血流量、血容量均高于甲状腺恶性肿瘤,平均通过时间短于甲状腺恶性肿瘤,表面通透性低于甲状腺恶性肿瘤(P﹤0.05);甲状腺良恶性肿瘤的达峰时间比较,差异无统计学意义(P﹥0.05)。VEGF、MK在甲状腺恶性肿瘤中的阳性表达率均明显高于甲状腺良性肿瘤(P﹤0.01)。结论在甲状腺良恶性肿瘤的诊断中,多层螺旋CT效果确切,且VEGF、MK在甲状腺良恶性肿瘤中的表达水平存在差异,可作为首选的生物分子标志物在临床中推广使用。     

化疗对肺癌患者凝血功能的影响作用及意义分析

目的：探讨化疗对肺癌患者凝血功能的影响及其临床意义。方法检测40例肺癌住院化疗患者（病例组）及同期体检健康人群40例（健康组）的凝血功能相关指标：凝血酶原时间（ PT）、纤维蛋白原（ FIB）、部分活化凝血酶原时间（APTT）、血小板计数（PLT）、血小板压积（PCT）、平均血小板体积（MPV）、血小板分布宽度（PDW）。结果肺癌患者（病例组）化疗前PT、FIB、APTT、PLT、PCT、MPV、PDW值均显著大于健康组（ P＜0．05）。不同临床分期、病理类型肺癌患者的PT、FIB、APTT、PLT、PCT、MPV、PDW值比较差异均不显著（ P＞0．05）。40例肺癌患者化疗前与化疗后PT、FIB、APTT、PLT、PCT、值比较差异显著（P＜0．05）,化疗后较化疗前均有所改善,MPV、PDW值在化疗前后差异不显著（P＞0．05）。结论晚期肺癌患者存在凝血功能异常,与肿瘤临床分期、病理类型无明显相关性;通过化疗可逐步改善患者的凝血功能。     

肿瘤患者死亡前血小板四项参数的变化和意义

 回顾性研究了一组晚期肿瘤患者死亡前不同时期血小板计数(PLT)、血小板平均体积(MPV)、血小板压积(PCT)和血小板分布宽度(PDW)的变化, 探讨其临床意。     

恶性肿瘤合并血栓形成的血小板参数变化临床研究

 目的 研究血小板参数在恶性肿瘤及恶性肿瘤合并血栓形成的变化，以便早期干预。方法 统计分析该院2002年7月至2004年3月恶性肿瘤住院患者200例，选择应用同一血细胞分析仪测定血小板参数患者共168例。分为血栓组和非血栓组。测定血小板计数（Plt）、血小板压积（PCT）、血小板平均体积（MPV）、血小板分布宽度（PDW）。结果 血栓组与非血栓组比较Plt明显增高，PCT增加明显，MPV、PDW增加无统计学意义；血栓组较正常对照组比较Plt明显增高，PCT 减小明显，MPV明显增高、PDW增加无统计学意义；非血栓组较正常对照组比较Plt及PCT明显减小，MPV、PDW增加无统计学意义。结论 血小板参数Plt、PCT、MPV，可作为恶性肿瘤合并血栓形成的早期预防指标，以便早期进行干预。     

吸烟指数与肺癌患者凝血指标的相关性

目的观察不同吸烟指数肺癌患者凝血指标的变化,探讨吸烟对肺癌患者凝血功能的影响。方法选取2010年7月至2015年7月间北京市朝阳区中医医院收治的130例肺癌患者。回顾性收集患者的临床资料,按照吸烟指数(每天吸烟支数×吸烟年数)分为4组,其中不吸烟者为0组(32例),吸烟指数<200支年为1组(30例),吸烟指数200~400支年为2组(33例),吸烟指数>400支年为3组(35例)。观察各组患者间凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)、血小板计数(PLT)、血小板比容(PCT)、平均血小板体积(MPV)和血小板分布宽度(PDW)的水平,比较各组间的差异。结果随着吸烟指数的增加,PT和APTT均逐渐降低,FIB、D-D、PLT和PCT水平均逐渐升高,组间差异均有统计学意义(均P<0.05)。而MPV和PDW随吸烟指数的增加,组间均无明显变化,差异无统计学意义(P>0.05)。结论吸烟可导致肺癌患者PT和APTT明显降低,与吸烟指数呈明显负相关。吸烟可导致FIB、D-D和PLT明显升高,与吸烟指数呈明显正相关。随着吸烟指数的增加,肺癌患者的血液高凝状态逐渐加重。     

小细胞肺癌患者血清血管内皮生长因子和外周血细胞检测的意义

目的探讨血清血管内皮生长因子(VEGF)在小细胞肺癌(SCLC)患者中检测的临床意义及外周血白细胞(WBC)、血小板(PLT)和血红蛋白(Hb)与血清VEGF水平之间的关系。方法采用酶联免疫吸附方法检测未经任何治疗的SCLC患者血清VEGF浓度,常规检测外周血WBC、PLT和Hb含量。结果SCLC患者血清VEGF的浓度是493±334.8ng/L,将SCLC患者以血清VEGF平均浓度作临界值分成两组,发现与患者的临床分期有明显的相关性(P<0.05),SCLC患者血清VEGF低水平组的生存期比高水平组明显要长,有显著意义(P<0.05);相关分析表明,SCLC患者PLT计数和Hb含量分别与血清VEGF的浓度呈一定的相关性(r=0.464,P<0.05;r=-0.388,P<0.05)。结论SCLC患者血清VEGF浓度与生存期有明显的相关性,也许可以作为一预后因子,同时血清VEGF也与PLT计数、Hb含量具有明显的相关性。     

血清血管内皮生长因子在肝癌介入栓塞后的表达

目的探讨血清血管内皮生长因子(VEGF)在肝癌栓塞化疗(TACE)后的表达水平和临床意义。方法分析63例肝细胞肝癌患者的血管造影结果和VEGF血清表达水平,采用ELISA法检测40例TACE前后患者血清VEGF的变化。结果 43例肿瘤富血管患者血清VEGF水平高于20例肿瘤乏血管患者[(136.80±52.13)pg/mlvs(62.30±31.17)pg/ml,P<0.05];患者肝动脉栓塞治疗前后血清VEGF分别为(87.41±43.16)pg/ml和(128.42±43.12)pg/ml,P<0.05.其中有36例患者血清VEGF水平在肝动脉栓塞治疗后升高,第二次血管造影发现27例新生肿瘤血管的患者血清VEGF水平显著升高(179.13±66.27)pg/ml。血清VEGF浓度明显升高的患者介入治疗疗效较差。结论肝癌TACE后肿瘤细胞表达VEGF增强,血清VEGF是影响肝癌栓塞化疗效果的因素之一。     

MPV和PCT测定在恶性肿瘤患者反复血小板输注中的应用

目的 探讨血小板（PLT）减少时,肿瘤患者血小板参数MPV和PCT测定的变化规律。方法 采用SE9000全自动血液分析仪对56例反复输入血小板的恶性肿瘤患者进行血小板计数（PC）、血小板平均体积（MPV）和血小板压积（PCT）的分析比较,并同时对52例正常体检者进行血小板参数的测定。结果 反复输入血小板有效的恶性肿瘤患者,其MPV和PCT与反复输入血小板无效的恶性肿瘤患者比较,差异有统计学意义（P〈0．01,P〈0．05）,与正常对照组比较差异无统计学意义（P〉0．05）,反复输入血小板无效的恶性肿瘤患者与正常对照组比较,差异有统计学意义（P〈0．01）。结论 对于多次输注血小板的恶性肿瘤患者,除考虑患者体内易产生PLTAb导致PLT输注无效外,输注PLT前还应对患者的血小板参数进行密切观察,保证PLT输注的有效性。     

血管内皮生长因子在上皮性卵巢癌中的临床病理研究

目的研究血管内皮生长因子(VEGF)在上皮性卵巢癌组织中的表达状况并分析其与临床病理参数之间的关系。方法采用免疫组化、原位杂交技术分别检测31例上皮性卵巢癌、17例卵巢上皮性良性肿瘤及5例正常卵巢组织中VEGF蛋白质及核酸表达水平。结果上皮性卵巢癌组织中VEGF和VEGF mRNA阳性表达率分别为51.6%(16/31)和48.4%(15/31),与良性肿瘤相比有显著性差异(P<0.05)。上皮性卵巢癌中VEGF阳性表达率分别与淋巴结转移及腹水量密切相关(P<0.05),而在不同组织类型、病理分级及临床分期中无明显差异(P>0.05)。恶性肿瘤患者生存状况与癌组织中VEGF阳性表达率亦无相关性(P>0.05)。结论VEGF蛋白质及其mRNA在上皮性卵巢癌中高水平表达,且其阳性率与淋巴结转移及腹水量密切相关,可作为卵巢癌侵袭性评估的指标之一,为VEGF及其受体作为卵巢癌的治疗靶点提供科学依据。     

乳腺癌患者中转录因子特化蛋白1和血管内皮生长因子的表达及临床意义

目的 检测乳腺癌患者中转录因子特化蛋白-1(Sp-1)、血管内皮生长因子(VEGF)的表达,分析其临床意义.方法 选取乳腺癌患者60例作为实验组,乳腺良性肿瘤作为对照组,酶联免疫吸附法检测血液中VEGF、Sp1含量,免疫组织化学法检测组织VEGF、Sp1表达,分析二者水平变化与临床病理特征的关系.结果 实验组血清中VEGF、Sp1水平较对照组升高,差异有统计学意义(P<0.05);实验组癌组织中VEGF、Sp1阳性率较癌旁组织、对照组升高,差异有统计学意义(P<0.05);VEGF、Sp1水平与肿瘤病理类型、分化程度、原发灶大小、淋巴结转移、其他脏器远处转移、放疗、化疗有关(P<0.05),与年龄、PS评分无关(P>0.05).结论 在乳腺癌患者的血清及组织中均存在VEGF、Sp1的高度表达,二者的水平与乳腺癌病理类型、分化程度、原发灶大小、淋巴结转移、其他脏器远处转移、放疗、化疗有关.     

Evaluation of Platelet Indices in Lung Cancer Patients

Background: In this study, we aimed to determine platelet indices such as platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), Plateletcrit (PCT) platelet count (PLT) in lung cancer cases, and evaluate any relationships between these parameters and stage or histologic types. Materials and Methods: This retrospective study covered 44 lung cancer patients and 47 healthy subjects. Platelet indices including PLT, PCT, MPV, PDW were estimated and compared with normal subjects. The results were evaluated statistically. Results: The PDW value was significantly higher in the cancer group compared to the control group; however, the values for PCT and MPV were lower. Conclusions: We suggest potential use of platelet indices in diagnosis of lung cancer.     

血小板相关参数对恶性肿瘤合并静脉血栓栓塞的诊断价值

目的：探讨血小板相关参数对恶性肿瘤合并静脉血栓栓塞的诊断价值。方法：恶性肿瘤118例,其中血栓组58例,非血栓组60例,60例门诊健康体检者作为正常对照组,比较各组外周血血小板参数特点。结果：入院时检测血栓组血小板平均体积（MPV）及血小板分布宽度（PDW）分别为（8．7±1．0）fl、（12．6±1．4）％,非血栓组MPV及PDW分别为（8．8±1．3）fl、（12．8±1．4）％,正常对照组MPV及PDW分别为（8．0±1．1）fl、（11．5±1．9）％,血栓组及非血栓组外周血MPV及PDW水平要显著高于正常对照组（P＜0．05）。血栓组于血栓检出时检测MPV及PDW分别为（10±1．6）fl、（14．1±1．8）％,同期检测非血栓组MPV及PDW分别为（9．28±1．6）fl、（13．3±1．6）％,血栓组MPV及PDW要显著高于非血栓组（P＜0．05）,两次检测血栓组外周血MPV及PDW变化的百分比要显著高于非血栓组（P＜0．05）。结论：血栓组患者外周血MPV、PDW及其变化百分比明显增高,提示这些指标对早期预测恶性肿瘤并发血栓形成有重要作用。     

Haematologic Parameters in Metastatic Colorectal Cancer Patients Treated with Capecitabine Combination Therapy

Background: The standard treatment in the metastatic colorectal cancer consists of 5-FU based infusionalregimens. However, with oral fluoropyrimidines, equal tumor responses may be obtained. Capecitabine causesmacrocytosis of the cells by inhibition of DNA synthesis. In this context, a relationship was found between meancorpuscular volume (MCV) and response to therapy in breast cancer patients treated with Capecitabine, butwhether this relationship also pertains in colorectal cancer has not been established. Materials and Methods: Atotal of 102 metastatic colorectal cancer patients treated with a oxaliplatin (XELOX)±Bevacizumab combinationwere retrospectively evaluated. Patients were randomized into three groups. Hematological parameters (MCV,MPV, PCT, PLT, NLR) were recorded retrospectively, before treatment and after 3 cycles of chemotherapy.Results: After three cycles of therapy, 20 (19.6%) patients had progressive disease (PD), 41 (40.1%) hadstable disease (SD), and 41 (40.1%) demonstrated a partial response (PR). In 62 (60.7%) treatment was withcapesitabin plus XELOX therapy, and in 40 (39.2%) it was XELOX-Bevacizumab combination therapy. Therewas no difference among three groups before the treatment in terms of MCV, MPV, PCT, PLT, and NLR.MCV showed significant increase in chemotherapy response groups (PR and SD). In addition, a significantdecrease was observed for platelet count in chemotherapy response groups. While NLR decrease was seen inonly a PR group, PCT decrease was observed in all three groups. PCT and PLT values were higher in patientsreceiving Bevacizumab. Conclusions: PLT, PCT, MPV, and NLR values were decreased due to Capecitabinebasedchemotherapy, however MCV was increased. PCT and PLT values were higher in patients who receivedBevacizumab than those who did not. MCV, PLT, and NLR can be considered as important factors in predictingresponse to colorectal carcinoma treatment.     

动态观察乳腺癌手术前后血小板参数及凝血功能变化对病情发展及疗效评价的意义

目的探讨乳腺癌手术前后血小板参数及凝血功能变化对病情发展的临床意义。方法用全自动血球计数仪SF-3000以及凝血仪检查乳腺癌80例和良性乳腺疾病80例术前及术后全血以及凝血功能。结果乳腺癌患者术前组PLT、MPV与对照组差异无统计学意义（P〉0．05）,而与术后组差异有统计学意义（P〈0．05）;PDW差异无统计学意义（P〉0．05）;术后组与对照组PLT、MPV差异有统计学意义（P〈0．05）,而PCT及PDW差异无统计学意义（P〉0．05）;乳癌手术前后凝血酶原时间（PT）差异无统计学意义（P〉0．05）,而纤维蛋白原含量（FiB）术后明显高于术前（P〈0．05）;活化部分凝血酶原时间（APTT）术后明显低于术前（P〈0．05）。结论动态观察乳腺癌手术前后血小板参数可能作为一个新的预后因子,而凝血功能变化可作为判断患者病情发展及疗效评价的参考指标,对防治乳腺癌具有重要的临床意义。     

Platelet Indices May be Useful in Discrimination of Benign and Malign Endometrial Lesions,and Early and Advanced Stage Endometrial Cancer

Background: The aim of this study was to investigate the predictive value of white blood cells (WBC),the neutrophil to lymphocyte ratio (NLR), platelet indices including mean platelet volume (MPV), plateletdistribution width (PDW), platelet crit (PCT) and platelet to lymphocyte ratio (PLR) in discrimination betweenbenign and malign endometrial lesions, and early and advanced stage endometrial adenocarcinomas. Materialsand Methods: Data for 105 patients undergoing total abdominal or vaginal hysterectomy for benign uterinediseases and 114 patients surgically staged for endometrium adenocarcinoma at Ondokuz Mayis University,Department of Gynecology and Obstetrics, between 2008 and 2014, were collected. Parameters were preoperativeand postoperative complete blood counts in the week prior to surgery with differentials including WBC, plateletcount, platelet indices (MPV, PCT, PDW), NLR and PLR. Pathologic evaluations for both benign and malignendometrium lesions, grade of endometrium adenocarcinoma, tumor stage, presence of lymphovascular spaceinvasion (LVI) were retrospectively analyzed. Results: Regarding definitive factors in discriminating patientswith endometrium cancer from those with benign diseases, MPV was significantly increased in the malign groupwhereas there was a significant decrease in the PDW value compared to the benign group. The best cut-off valuein differentiation of the benign and malign groups, malign cases were found to increase over the value of 7.54for MPV, and under 37.8 for PDW. When definitive factors in discrimination of early stage endometrium cancerfrom advanced stage disease and LVI in the malign group were evaluated according to the ROC analysis, nosignificant relation was detected between blood parameters and the stage and the LVI of the disease. Conclusions:MPV and PDW may have predictive value in the discrimination of benign and malign endometrium diseases.Nevertheless, since there have been few reports on this topic, further large-scale prospective studies are necessary.     

Relations of Platelet Indices with Endometrial Hyperplasia and Endometrial Cancer

Background: Platelets are blood elements thought to play a role in the immune system and therefore tumordevelopment and metastasis. Platelet activation parameters such as mean platelet volume (MPV), plateletdistribution width (PDW), and plateletcrit (PCT) can be easily evaluated with the whole blood count and havebeen studied as markers of systemic inflammatory responses in various cancer types. Our aim in this study wasto evaluate the correlation between endometrial pathologies and MPV, PDW and PCT. Materials and Methods:A total of 194 patients who presented to our clinic with abnormal vaginal bleeding were included in our study.The patients were divided into 3 groups (endometrial hyperplasia, endometrial cancer, control) according to theirpathology results. The groups were compared for MPV, PDW, and PCT values obtained from the blood samplestaken on endometrial biopsy day. Results: The endometrial cancer patients were the oldest group (p=0.04).There was no significant difference between the three groups in terms of white blood cell count (WBC), plateletcount (PC), and hemoglobin (Hb) level. The highest MPV (p<0.001), PDW (p=0.002), and PCT (p<0.001) levelswere in the endometrial cancer group, and the lowest levels were in the control group. Conclusions: The easyevaluation of platelet parameters in patients who are suspected of having endometrial pathology is a significantadvantage. We found MPV, PDW, and PCT to be correlated with the severity of endometrial pathology with thehighest values in endometrial cancer. Studies to be conducted together with different laboratory parameters willfurther help evaluate the diagnosis and severity of endometrial cancer and precursor lesions.     

口腔颌面部肿瘤患者外周血淋巴细胞粘附分子（CD44）测定的初步研究

目的:研究粘附分子CD44与某些恶性肿瘤的发生和转移的关系。方法:作者应用流式细胞免疫学方法(FCMI),对45例口腔颌面部肿瘤患者的外周血淋巴细胞粘附分子CD44进行了定量研究,结果:CD44在口腔颌面部肿瘤患者外周血淋巴细胞的表达明显增高,良性肿瘤患者术后CD44与健康组无差异(P>0.05);恶性肿瘤患者术前、术后CD44的含量均高于健康组,14例颈部转移患者的CD44与无转移者比较有显著性差异(P<0.001)。结论:外周血淋巴细胞粘附分子CD44可作为早期诊断口腔颌面部恶性肿瘤、监测肿瘤复发和转移的一个生物学标志物。     

肿瘤相关易栓症患者实验室指标的变化及临床意义

目的:探讨活化部分凝血活酶时间（activated partial thromboplastin time,APTT）、凝血酶原时间（prothrombin time,PT）、凝血酶时间（thrombin time,TT）、纤维蛋白原（fibrinogen,FIB）、D-二聚体（D-dimer,D-D)、红细胞（red blood cell,RBC）、血红蛋白（hemoglobin,HGB）、红细胞压积（hematocrit,HCT）、血小板（platelet,PLT）、平均血小板体积（mean platelet volume,MPV）及球蛋白（globulin,GLO）、甘油三酯（triglyceride,TG）、高密度脂蛋白（high density lipoprotein,HDL）在肿瘤相关易栓症患者中的变化及临床意义。方法:病例组136例,分为肿瘤组76例,包括非霍奇金淋巴瘤（non-Hogkin lymphoma,NHL）19例、胃癌（gastric cancer,GC）30例、肺癌（lung cancer,LC）27例。均为初治病例,于化疗后1月纳入统计。非肿瘤-深静脉血栓形成组（non-tumor deep vein thrombosis,NT-DVT）60例,均为确诊的下肢DVT患者,抗凝治疗后2周纳入统计。对照组90例,来自本院门诊健康体检者。经全自动血凝仪、全自动血球仪及全自动生化分析仪检测APTT、PT、TT、FIB、D-D、RBC、HGB、HCT、PLT、MPV及GLO、TG、HDL水平变化。结果:肿瘤组患者化疗前D-D表达水平升高（P＜0.05）,化疗后下降（P＜0.05）。肿瘤组患者化疗前HDL表达水平下降（P＜0.05）,化疗后升高（P＜0.05）。肿瘤组患者化疗前FIB、PLT、GLO表达水平升高（P＜0.05）。NT-DVT组治疗前APTT、FIB、D-D表达水平升高（P＜0.05）,治疗后APTT延长（P＜0.05）,FIB、D-D下降（P＜0.05）。结论:D-D、FIB、PLT、GLO、HDL水平是反映肿瘤相关易栓症患者血栓前状态的良好指标。     

放疗对头颈部恶性肿瘤患者的心血管疾病危险因素水平的影响

目的 探讨放疗对头颈部恶性肿瘤患者的心血管疾病危险因素水平的影响.方法 以经病理确诊为头颈部恶性肿瘤并接受放疗的40例患者作为观察组;以病理确诊为头颈部恶性肿瘤但还未接受放疗的40例患者作为对照组.比较两组的收缩压(SBP)与舒张压(DBP)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白-胆固醇(LDL-C)、高密度脂蛋白-胆固醇(HDL-C)、空腹血糖(FPG)和体重指数(BMI)水平.结果 观察组的SBP、DBP、TC、TG、LDL-C和FPG水平均明显高于对照组(P<0.05),观察组的HDL-C水平明显低于对照组(P<0.05),两组的BMI差异不明显(P>0.05);放疗前后观察组高血压、血脂异常、超重或肥胖以及糖尿病的患病例数差异不具有统计学意义(P>0.05),但放疗后例数均略多于放疗前.结论 放疗会影响头颈部恶性肿瘤患者CVD危险因素水平,CVD危险因素水平的监测可为对头颈部恶性肿瘤患者的CVD防治提供一定参考.     

恶性肿瘤患者化疗前后血小板功能的变化观察

目的:观察恶性肿瘤患者化疗前后血小板计数及血小板功能的变化,了解化疗对恶性肿瘤患者血小板功能的影响.方法:采用比浊法和电阻抗法利用血小板聚集仪测定63名恶性肿瘤患者化疗前后血小板聚集功能.结果:恶性肿瘤患者化疗后血小板计数明显降低,差异有统计学意义(P<0.05);血小板聚集率较化疗前亦明显下降,差异有统计学意义,(P<0.05);且化疗前后血小板计数差值与血小板聚集功能差值呈正性相关(P<0.05).结论:化疗药物会导致恶性肿瘤患者血小板聚集功能下降,可能会增加患者的出血风险.