Analysis of the Factors Associated with Abnormal Coagulation and Prognosis in Patients with Non-small Cell Lung Cancer
10.3779/j.issn.1009-3419.2014.11.04
- VernacularTitle:非小细胞肺癌患者凝血功能异常的相关因素与预后分析
- Author:
LI YANHUA
1
;
WEI SUJU
;
WANG JUNYAN
;
HONG LEI
;
CUI LIGE
;
WANG CAI
Author Information
1. 河北医科大学第四医院肿瘤内科
- Keywords:
Lung neoplasms;
Blood coagulation;
hTrombophilia;
Prognosis
- From:
Chinese Journal of Lung Cancer
2014;(11):789-796
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective hTe activation of coagulation and ifbrinolysis is frequently encountered among cancer patients. Such tumors are associated with high risk of invasion, metastases, and negative ifnal outcomes. Non-small cell lung cancer (NSCLC) accounts for approximately 80%to 85%of all lung malignancies. hTis study aims to investigate the prognostic value of blood coagulation tests for NSCLC and provide a reference to patients on the prevention and treatment of thrombophilia. Methods Data were collected from 604 cases of hospitalized patients with histologically conifrmed NSCLC from January 2009 to December 2012 at the Fourth Hospital of Hebei Medical University. Data included the related indexes of coagulation function in patients before treatment [(i.e., prothrombin time (PT), prothrombin time activity (PTA), interna-tional normalized ratio (INR), activated partial thromboplastin time (APTT), ifbrinogen (Fib), D-dimer, and platelet count)], as well as sex, age, pathological type, TNM stage, and lymph node status. Fitfy control subjects without cancer were included in the analysis. Statistical analysis was conducted by using SPSS 13.0 sotfware. Results hTe plasma level of all coagulation tests including D-dimer, Fib, PT, APTT, INR, and platelet counts revealed statistically signiifcant differences between the patient and control group (P<0.001 for all variables;P=0.001,5 and P=0.004,5 for Fib and platelet counts, respectively). hTe squamous subtype exhibited high plasma Fib levels (P<0.001) compared with adenocarcinoma cell lung cancer patients. Fib and PLT levels increased (P<0.001 and P=0.014, respectively), and aPTT decreased (P<0.001) in patients at stages III and IV compared with those in patients at stages I and II. aPTT decreased signiifcantly (P<0.001), and Fib and D-dimer levels increased (P<0.001 and P=0.048, respectively) in N1-3 patients with NSCLC compared with those of N0 patients. Prolonged PT and INR, high plasma Fib levels, and low PTA levels had statistically signiifcant adverse effects on survival (P=0.032, P=0.001, P<0.001, and P=0.005, respectively). Multivariate analyses revealed that only increased INR was associated with a decreased survival rate in the related indexes of coagulation function (P=0.017). Conclusion Patients who have lung adenocarcinoma and/or lymph node metastasis at advanced stages of NSCLC are prone to thrombophilia. Prolonged PT and INR was associated with poor prognosis, and elevated INR was independently associated with a decreased survival rate. PT and INR are promising prognos-tic markers of NSCLC.
