摘要
目的:探讨血栓弹力图(TEG)指标在评估胰腺癌患者凝血功能状态及其鉴别诊断的应用价值。方法:选取120例被确诊为胰腺肿瘤患者,根据2019版WHO胰腺肿瘤分类标准分为:胰腺癌患者组为试验组,共57例,其中低分化组21例、中高分化组36例;胰腺良性和低度恶性肿瘤患者组为良性对照组,共63例;另外选取64名健康体检者作为正常对照组。回顾性分析患者入院时的TEG、常规凝血功能和糖类抗原199(CA199)结果,将试验组与对照组进行比较分析、胰腺癌患者组参数间进行相关性分析、胰腺癌患者低分化组与中高分化组比较分析、TEG参数和CA199用于鉴别良恶性胰腺肿瘤ROC曲线分析。结果:胰腺癌患者组TEG参数:凝血形成时间(K值)、凝血形成速率(α角)、凝血最终强度(MA值)、最大剪切模量强度(G值)、纤维蛋白原(FIB)、CA199值与正常对照组、良性对照组比较均差异有统计学意义(P<0.05);胰腺癌患者组K值、α角、MA值、G值均与FIB、PLT存在显著相关性(P<0.05);胰腺癌低分化组与中高分化组间结果差异无统计学意义(P>0.05)。TEG参数联合CA199鉴别胰腺肿瘤良恶性的敏感度比单独CA199鉴别具有显著性提高(81.6%vs 69.4%)。结论:TEG能更好的评估胰腺癌患者的凝血功能状态,联合CA199可更有效地鉴别诊断胰腺肿瘤的恶性程度。
Objective:To investigate the value of thromboelastogram(TEG)in the evaluation of coagulation function and differential diagnosis in patients with pancreatic cancer.Methods:A total of 120 patients with pancreatic tumor in our hospital were selected.According to 2019 WHO classification of pancreatic tumor,the patients were divided into two groups:57 patients with pancreatic cancer was experimental group,including 21 cases in the low differentiation group and 36 cases in the middle and high differentiation group;63 patients with benign or low-grade malignant tumor were benign control group.In addition,64 healthy people were selected as normal control group.The TEG,routine coagulation tests and carbohydrate antigen 199(CA199)results were retrospectively analyzed.We compared the experimental group with the control group,analyzed the correlation between the parameters of the pancreatic cancer patients group,and compared the low differentiation group and the medium and high differentiation group of the pancreatic cancer group.In addition,ROC curve analysis was used to identify benign and malignant pancreatic tumor by TEG parameters and CA199.Results:There were significant differences in coagulation formation time(K value),coagulation formation rate(αangle),final coagulation strength(MA value),maximum shear modulus strength(G value)and fibrinogen(FIB)value between pancreatic cancer group and normal control group,benign control group(P<0.05).The K value,αangle,MA value and G value were significantly correlated with FIB and PLT in pancreatic cancer group(P<0.05).In addition,there was no correlation between the degree of differentiation of cancer cells and coagulation parameters.The sensitivity of TEG parameters combined with CA199 was significantly higher than that of CA199 alone(81.6%vs 69.4%).Conclusion:TEG could better evaluate the coagulation function of patients with pancreatic cancer.Combined with CA199,TEG could more effectively differentiate the malignant degree of pancreatic tumor.
作者
王利民
王平
刘善凤
王琳
WANG Limin;WANG Ping;LIU Shanfeng;WANG Lin(Department of Clinical Laboratory,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430022,China)
出处
《临床血液学杂志》
CAS
2021年第4期225-228,共4页
Journal of Clinical Hematology
关键词
血栓弹力图
胰腺肿瘤
鉴别诊断
thromboelastogram
pancreatic tumor
differential diagnosis
