血栓分子标志物在弥漫大B细胞淋巴瘤中的检测及临床意义

目的 探讨血栓分子标志物在弥漫大B细胞淋巴瘤（DLBCL）中的检测及临床意义。方法 收集DLBCL患者60例血标本，其中初治组23例、缓解组24例、未缓解组13例；淋巴瘤并发血栓组23例，未并发血栓组37例。选取同期健康体检者46例作为对照组。化学免疫分析法检测各组血浆中血栓调节蛋白（TM）、纤溶酶-α2纤溶酶抑制剂复合物（PIC）、组织型纤溶酶原激活物-抑制剂-1复合物（t-PAIC）和凝血酶-抗凝血酶Ⅲ复合物（TAT）水平，全自动生化分析仪检测淋巴瘤组血清中乳酸脱氢酶（LDH）水平。比较血栓分子标志物在各组间的差异以及预后因素分析。结果 淋巴瘤患者血浆TM、PIC水平明显高于健康对照组（P<0.05）；初治和未缓解组TM、PIC水平均明显高于缓解组（P<0.05）；淋巴瘤并发血栓组TM、PIC、TAT水平均明显高于未并发血栓组（P<0.05）。血浆TM、PIC与DLBCL患者预后密切相关，PIC是独立预后因素（P<0.001）。TM、PIC与LDH预后指标有相关性（P<0.01）。结论 DLBCL患者血浆TM、PIC水平明显升高，有望作为DLBCL疗效及预后判断指标。

Detection and Clinical Significance of Thrombus Molecular Markers in Diffuse Large B-cell Lymphoma

Objective To investigate the detection and clinical significance of thrombus molecular markers in diffuse large B-cell lymphoma (DLBCL). Methods We collected the blood specimens of 60 patients with DLBCL, involving 23 cases in the initial treatment group, 24 cases in the remission group and 13 cases in the non-remission group, 23 cases in the thrombus group and 37 cases in the non-thrombus group. We selected 46 healthy people in the same period as the control group. The levels of thrombomodulin (TM), plasmin-α2 plasmin inhibitor complex (PIC), tissue plasminogen activator-plasminogen activator inhibitor-1 complex (t-PAIC) and thrombin-antithrombin Ⅲ complex (TAT) in plasma were detected by chemical immunoassay, and the levels of lactate dehydrogenase (LDH) in serum was detected by automatic biochemical analyzer. We analyzed the differences of thrombus molecular markers among groups and prognostic factors. Results The levels of TM and PIC in plasma of lymphoma patients were higher than those in health control group (P<0.05). The levels of TM and PIC in the initial treatment and non-remission groups were significantly higher than those in the remission group (P<0.05). The levels of TM, PIC and TAT in thrombus group were higher than those in nonthrombus group (P<0.05). TM and PIC levels in plasma were closely related to the prognosis of DLBCL patients. PIC was an independent prognostic factor (P<0.001). TM and PIC levels were correlated with LDH prognostic indicators in lymphoma patients. Conclusion TM and PIC levels in plasma are significantly increased in DLBCL patients. They are expected to be the indicators for effectiveness and prognosis of DLBCL patients.