肿瘤患者凝血及纤溶分子标志物的变化

目的:探讨肿瘤患者凝血及纤溶分子标志物的变化情况。方法:正常对照组35例,子宫肌瘤组18例,恶性肿瘤组86例,其中肺癌19例,食管癌19例,胃癌22例,结直肠癌26例。采用双抗体夹心酶免疫法(ELISA)检测患者凝血及纤溶分子的血浆含量,并进行比较。结果:与正常对照组比较,各种恶性肿瘤术前组织因子(TF)、凝血酶-抗凝血酶复合物(TAT)、尿激酶型纤溶酶原激活物(u-PA)、尿激酶型纤溶酶原激活物受体(u-PAR)和纤溶酶-抗纤溶酶复合物(PAP)的血浆含量显著升高,差异均有统计学意义(P<0.05~0.01),组织因子途径抑制物(TFPI)水平与正常对照组比较差异无统计学意义;术后恶性肿瘤组TF、TAT、u-PAR及PAP水平有所下降,但仍高于正常对照组;子宫肌瘤组术前各指标与正常对照组比较,差异无统计学意义。结论:恶性肿瘤存在明显的凝血、纤溶激活状态。TF、TAT、u-PA、u-PAR及PAP可以作为良、恶性肿瘤鉴别的辅助指标,u-PA、u-PAR可以作为判断预后的指标。

Variation of coagulation and fibrinolytic molecular markers in tumor patients

Objective: To investigate the variation of coagulation and fibrinolytic molecular markers in tumor patients.Methods: The plasma levels of tissue factor(TF) and its inhibitor(TFPI),thrombin-antithrombin complex(TAT),urokinase-type plasminogen activator(u-PA) and its receptor(u-PAR),as well as plasmin-antiplasmin complex(PAP),were measured using ELISA in 18 patients with hysteromyoma and 86 patients with malignant tumors including lung cancer 19,esophageal cancer 19,gastric cancer 22,and colorectal carcinoma 26.Results: Compared to normal controls,the level of TF,TAT,u-PA,u-PAR,and PAP in group of malignant tumor were significantly higher(P<0.05).The level of TFPI has no difference between them.However,all these parameters did not vary in patients with uterus myoma.Conclusion: Activation of coagulation and fibrinolysis existed in patients with malignant tumor.TF,TAT,u-PA and u-PAR might also be clinical useful markers for tumor determination and u-PA and u-PAR for tumor prognosis.