乳腺癌凝血纤溶指标与生物学行为关系的研究

目的研究乳腺癌凝血纤溶异常与其转移、激素受体状态、分期等生物学行为的密切关系。方法检测30例乳腺癌血浆6项凝血和纤溶指标，统计分析其变化与淋巴结转移、细胞增殖、受体状态等的关系。结果良性对照组与乳腺癌组FiB由（3．05±0．44）g／L增高至（3．39±0．52）g/L（P〈0．05）、D—Di由（0．27±0．06）μg／ml增高至（0．36±0．16）μg／ml（P〈0．05）、PAI-1由（26．14±3．30）ng／ml增高至（34．59±3．68）ng／ml（P〈0．01），差异均有统计学意义。腋窝淋巴结转移阳性者的血浆FiB（3．70±0．47）g／L和PAI-1（37．36±2．71）ng／ml较无转移者增多（P〈0．05）；细胞增殖抗原Ki67表达≥30％者PAI-1含量增加（36．40±3．57）ng/ml（P〈0．05）。t-PA含量在不同激素受体状态下的差别有统计学意义（P〈0．05）。不同TNM病理分期乳腺癌患者之间APTF（P〈0．01）、FiB（P〈0．01）、D—Di（P〈0．05）和PAI（P〈0．05）差异有统计学意义。结论凝血纤溶指标与乳腺癌增殖、转移、分期等生物学行为有密切关系，可作为判断预后和术后复发转移的监测指标，并有利于血栓前状态的判断。

Relation between coagulation-fibrinolysis indexes and biological behavior of breast cancer

Objective To study the relation between coagulation-fibrinolysis and metastasis, hormone receptor and TNM stage of breast cancer. Methods The plasm levels of six coagnlation-fibrinolysis indexes of 30 breast cancer patients were tested, which included activated partial thromboplastin time （APTT）, fibrinogen （FIB）, D-dimer（D-Di）, tissue type plasminogen activator （t-PA）and plasminogen activator inhibitor-1 （PAI- 1 ）. Statistic analysis of the relation between the changes of these indexes and metastasis, hormone receptor and breast cancer cell proliferation was performed. Results There were statistically significant differences between the malignant and benign breast disease in FIB（3.05 ±0. 44） g/L vs（3.39 ±0. 52） g/L（P 〈0. 05） ,D-Di（0. 27 ±0. 06 ） μg/ml vs （ 0. 36 ± 0. 16 ） μg/ml （ P 〈 0. 05 ） and PAI-1 （ 26. 14± 3.30 ） ng/ml vs （ 34. 59 ± 3.68 ） ng/ml （P 〈 0.01 ）. The levels of plasma FIB （3.70 ±0. 47 ）g/L and PAI-1 （37.36±2.7 l ）ng/ml in metastasis group were higher than those in the non-metastasis group （ P 〈 0.01 ）. Significantly higher levels of PAI-1 （36.40 ±3.57） ng/ml（ P 〈 0. 05 ）in expression of Ki67≥ 30% in the patients with lymph node involvement were seen. Conclusion Coagnlation-fibrinolysis indexes were related to the proliferation, invasion, metastasis and clinical stage of breast cancer and it can serve as an important marker for predicting breast cancer＇s biological behavior and prognosis.