| 沈淑蓉,郑文球,黄颖鹏.胃癌伴继发性血小板增多症患者的临床病理特征和生存分析[J].肿瘤学杂志,2014,20(10):823-828. |
| 胃癌伴继发性血小板增多症患者的临床病理特征和生存分析 |
| The Clinicopathologic Features and Survival of Gastric Cancer Patients with Secondary Thrombocytosis |
| 投稿时间：2014-03-17 |
| DOI：10.11735/j.issn.1671-170X.2014.10.B009 |
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| 中文关键词: 胃肿瘤 血小板增多 临床病理学 生存期 |
| 英文关键词:gastric neoplasms thrombocytosis clinicopathology survival |
| 基金项目: |
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| 中文摘要: |
| 摘 要：［目的］ 探讨胃癌继发血小板增多患者的临床病理特征和预后情况。［方法］ 对血小板增多的胃癌患者与胃良性病变患者，以及血小板正常的胃癌患者的临床病理特征和生存情况进行分析。［结果］ 血小板计数> 400×109/L的胃癌患者86例，占6.92%（86/1243）。胃癌组和胃良性病变组中继发血小板增多的发生率差异明显（P=0.021）；血小板增多的发生率与胃癌患者肿瘤直径（P=0.007，OR=2.755，95%CI：1.657~3.424）、TNM分期（P<0.001，OR=1.899，95%CI：1.582~2.655）、浸润深度（P=0.011，OR=2.654，95%CI：1.943~3.673）有关；对患者血液凝固状态的影响上，血小板增多的患者更容易发生凝血酶原时间下降（χ2=4.092，P=0.043）、纤维蛋白原增高（χ2=5.358，P=0.021）和D?鄄二聚体增高（χ2=7.019，P=0.008）的可能。胃癌血小板增多患者的中位生存时间（17个月）明显短于胃癌血小板正常患者（26个月），且生存率差异有统计学意义（P=0.012）。术前高血小板（RR=1.545， 95%CI：1.064~2.242，P=0.022）是一个影响胃癌预后的独立因素。［结论］ 胃癌患者继发性血小板增多与肿瘤直径、浸润深度、分期有关。胃癌术前继发血小板增多可以作为一个预后不良的参考指标。 |
| 英文摘要: |
| Abstract：［Purpose］To investigate the clinicopathologic features and prognosis of gastric cancer patients with secondary thrombocytosis. ［Methods］ Clinicopathologic features and survival of secondary thrombocytosis in patients with gastric cancer，in patients with benign gastric disease，and gastric cancer patients with normal platelet count were analyzed. ［Results］ There were 6.92% (86/1243) of gastric cancer patients diagnosed as thrombocytosis with platelet count >400×109/L. The incidence rate of thrombocytosis was significantly different between benign gastric disease and gastric cancer(P=0.021). The incidence of thrombocytosis was associated with the size of tumor(P=0.007，OR=2.755，95%CI：1.657～3.424)，TNM staging(P<0.001，OR=1.899，95%CI：1.582～2.655) and invasive degree (P=0.011，OR=2.654，95%CI：1.943～3.673). And thrombocytosis also effected blood coagulation via prothrombin time (χ2=4.092，P=0.043)，D-dimer (χ2=7.019，P=0.008) and fibrinogen (χ2=5.358，P=0.021). The median survival of gastric cancer patients with thrombocytosis was statistically shorter than that of patients with normal platelet count(17months vs 26months，P=0.012). Thrombocytosis preoperation acted as an independent prognostic factor of gastric cancer patients (RR=1.545，95%CI：1.064～2.242，P=0.022). ［Conclusion］ The incidence of secondary thrombocytosis in gastric cancer relates to the size of tumor，TNM staging and invasive degree. Preoperative thrombocytosis may be as an indicater of poor prognosis in gastric cancer patients. |
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