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Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:

2019 06

Page:

1047-1051

Research Field:

Publishing date:

Info

Title:

The influence of radio-chemotherapy on coagulation parameters in patients with advanced solid malignant tumors

Author(s):

Pan Wei¹; Chen Hui¹; Shi Jinning²; Tu Yanling¹; Fu Jinping¹; Xu Le¹; Wang Xia¹

1.Department of Radiation Oncology;2.Department of Hematology,The Affiliated Jiangning Hospital of Nanjing Medical University,Jiangsu Nanjing 211101,China.

Keywords:

coagulation function parameters; solid malignant tumor; radio-chemotherapy; D dimer; thrombus precursor protein

PACS:

R730.5

DOI:

10.3969/j.issn.1672-4992.2019.06.035

Abstract:

Objective:To find out sensitive coagulation function monitoring parameters through observing the dynamic changes of coagulation parameters during radio-chemotherapy in patients with (local) advanced malignant tumors.Methods:A total of 93 patients with stage Ⅲ-Ⅳ solid malignant tumor who received radio-chemotherapy with tumor regression in our hospital in the period between 11/2016 to 3/2018 were selected.Coagulation parameters such as PT (prothrombin time),APTT (activated partial thromboplastin time),FIB (fibrinogen),D dimer and TpP (thrombus precursor protein) before,in and after treatment were recorded and analyzed.Results:Pretreatment abnormality of D dimer and TpP existed in 33.3%（31/93） and 72%（67/93） of all the patients respectively.D dimer and TpP was correlated to each other significantly(P=0.00).D dimer ［(1.22±1.43）,（1.28±1.13）,（1.59±1.46） mg/L］ and TpP［(5.89±3.55）,（7.18±3.71）,（8.33±4.22） mg/L］ increased gradually as treatment begins (P＜0.05).While no significant changes in PT,APTT and FIB were found during treatment (P＞0.05).In subgroup analysis,D dimer ［(2.75±1.61）,（1.72±0.99）,（2.53±1.71） mg/L］ firstly decreased significantly(P＜0.05) and then raised obviously again after treatment in the group of 31 patients with pretreatment abnormal D dimer.Conclusion:Coagulation function abnormality can be found frequently in solid malignant tumors which is featured with elevated D dimer and TpP.Radio-chemotherapy further aggravated the abnormality of D dimer and TpP,inducing hypercoaglutabe state.D dimer and TpP are sensitive indicators for anticoagulant intervention aiming to prevent thromobgenesis during radio-chemotherapy.

References:

［1］Donadini MP,Squizzato A,Ageno W.Treating patients with cancer and acute venous thromboembolism［J］.Expert Opin Pharmacother,2016,17(4):535-543.
［2］Wang Jianling,Yang Jia,Song Yujia.Clinical efficacy of chemotherapy in the treatment of advanced non-small cell lung cancer patients and influence of patients' coagulation［J］.Modern Oncology,2015,23(17):2440-2442.［王建玲,杨嘉,宋玉嘉.化疗对晚期非小细胞肺癌患者凝血四项的影响［J］.现代肿瘤医学,2015,23(17):2440-2442.］
［3］Qi Yan,Li Xuemei,Xu Chunyuan.Clinical value of thromboelastography in evaluating malignancy thrombophilia and the effects on coagulation of chemotherapy［J］.Chin J Lab Diagn,2017,21(4):592-594.［亓艳,李雪梅,徐春园.血栓弹力描记术在评价恶性肿瘤病人凝血功能及化疗对凝血功能影响的价值［J］.中国实验诊断学,2017,21(4):592-594.］
［4］Yu Qianqian,Li Hongling.Coagulation parameters change after chemotherapy in NHL patients［J］.Journal of Ningxia Medical University,2015,27(2):150-153.［于倩倩,李红玲.非霍奇金淋巴瘤患者化疗前后凝血指标的变化［J］.宁夏医科大学学报,2015,27(2):150-153.］
［5］Tang Hao,Li Xuan.Effect of chemotherapy on coagulation function in advanced gastric cancer［J］.Chin J Hermorth,2015,25(4):454-456.［汤皓,李烜.化疗对晚期胃癌凝血功能的影响［J］.中国癌症杂志,2015,25(4):454-456.］
［6］Li Junyan,Chen Guorong.Effect of chemotherapy on the coagulation function of patients with advanced lung cancer and its clinical significance［J］.Mordern Oncology,2017,25(17):2572-2554 .［李君艳,陈国荣.化疗对晚期肺癌患者凝血功能的影响及临床意义［J］.现代肿瘤医学,2017,25(17):2572-2554.］
［7］Ren Lin,Qi Xiaowei,Zhang Fan.Relationship between change of blood coagulation indexes and efficacy after neoadjuvant chemotherapy［J］.Chin J Breast Dis,2018,11(2):92-96.［任林,齐晓伟,张帆.乳腺癌患者新辅助化疗后凝血相关指标变化与化疗疗效的关系［J］.中华乳腺病杂志,2018，11(2):92-96.］
［8］Gao Tong,Guo Yan,Wang Yun,et al.Three dimensional conformal radiotherapy of different dosages on malignant tumor patients with coagulant function influence［J］.Chin J Diffic and Compl Cas,2013,12(6):446-447.［高彤,郭燕,王筠,等.不同剂量三维适形放疗对恶性肿瘤患者凝血功能的影响［J］.疑难病杂志，2013,12(6):446-447.］
［9］Geng Chong,Zhang Xuguang,Guo Feng,et al.A study of relation between systemic blood coagulation and leukopenia in local irradiation［J］.The Practical Journal of Cancer,2013,28(2):127-129. ［耿冲,张旭光,郭峰,等.放疗局部照射中全血功能与白细胞减少的关系［J］.实用癌症杂志,2013,8(2):127-129.］
［10］Rak J,Yu JL,Luyendyk J,et al.Oncogenes,trousseau syndrome,and cancer-related changes in the coagulome of mice and humans［J］.Cancer Res,2006,66(22):10643-10646.
［11］Wang Zenghui,Ding Mei,Ma Zhenling,et al.The value of regular monitoring of coagulation parameters for prognosis and recurrence in post-chemotherapeutic breast cancer patients［J］.J Clin Surg,2015,23(11):827-829.［王增辉,丁梅,马振玲,等.定期监测乳腺癌患者凝血指标对患者预后及化疗后复发的判定价值［J］.临床外科杂志,2015,23(11):827-829.］
［12］Zhu Jianhua.Changes of coagulation and fibrinolysis function and PLT in patients with lung cancer before and after chemotherapy［J］.Chin J Prim Med Pharm,2016,23(19):3014-3017.［朱建华.肺癌患者化疗前后凝血、纤溶功能相关指标和血小板计数变化分析［J］.中国基层医药,2016,23(19):3014-3017.
［13］Wang Zhi,Chen Qiliang,Li Junxiao,et al.The impact of venorelbine plus cisplatin chemotherapy on coagulation markers in non-small cell lung cancer patients［J］.Mordern Oncology,2016,24(10):1545-1549.［王直,陈其亮,李军孝,等.长春瑞滨联合顺铂化疗对非小细胞肺癌患者凝血功能的动态影响及意义［J］.现代肿瘤医学,2016,24(10):1545-1549.］
［14］Zang Yuqin,Liu Diping,Bu Yuqing,et al.D-dimer, fibrinogen and platelet levels in elderly patients with advanced non-small cell lung cancer［J］.Chinese Journal of Gerontology,2015,35(22):6583-6584.［臧玉芹,刘柢平,步玉晴,等.D-二聚体、纤维蛋白原、血小板水平评估老年晚期非小细胞肺癌放疗的效果［J］.中国老年学杂志,2015,35(22):6583-6584.］
［15］Wei Wenning,Guo Tao,Zhu Jianfang,et al.Clinical significance of thrombus precursor protein in cancer patients［J］.Chin J Intern Med,2006,45(12):1026.［魏文宁,郭涛,祝建芳,等.恶性肿瘤血栓前体蛋白水平改变的临床意义［J］.中华内科杂志，2006,45(12):1026.］

Memo

Memo:

南京市江宁区科技发展项目（编号：2017Db05）

Common functions

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