凝血及血脂相关指标对子宫内膜癌应用价值的探讨

Discussion on the Application Value of Coagulation and Blood Lipid in Endometrial Carcinoma

摘要: 目的：通过回顾性分析凝血指标、血浆D-二聚体、血小板及血脂指标在子宫内膜良恶性患者中的差异，来探讨这些指标跟子宫内膜癌分期和分化程度之间的相关性。方法：对2015年1月至2019年3月就诊于我院妇科经术前诊刮或术后病理结果证实为子宫内膜癌患者92例和子宫内膜不伴有不典型增生的92例患者的临床病理资料进行回顾性分析。结果：子宫内膜癌组纤维蛋白原(fibrinogen FIB)、D-二聚体(D-dimer D-d)、胆固醇(cholesterol TC)及血小板(platelet PLT)水平明显高于子宫内膜不伴有不典型增生的对照组(P < 0.05)；且FIB及D-二聚体水平随着分化级别的提高及病理分期的增加而增加(P < 0.05)，而子宫内膜癌患者的部分凝血活酶时间(activated partial thrombopiastin time APTT)水平及高密度脂蛋白(high density lipoprotein HDL)低于子宫内膜不伴有不典型增生的对照组(P < 0.05)。结论：高血脂状态可作为子宫内膜癌高危人群的预警指标，而凝血异常可作为评估子宫内膜癌恶性程度或预后的重要参考指标。为预防子宫内膜癌的发生、发展及抗血栓治疗提供依据。

Abstract: Objective: To retrospectively analyze the difference of the blood coagulation function, D-dimer, platelet and blood lipid between patients with endometrial carcinoma and patients with endometrial benign lesions, and to explore the correlation with the differentiation and stage of endometrial carcinoma. Methods: The clinical and pathological data of 92 patients with endometrial carcinoma and 92 patients with endometrial hyperplasia without atypia were retrospectively analyzed in our hospital from January 2015 to March 2019. Results: The plasma levels of fibrinogen, D-dimer, cholesterol and platelet in endometrial carcinoma patients were significantly higher than those in endometrial hyperplasia without atypia (P < 0.05). Moreover, the plasma levels of fibrinogen and D-dimer were increasing with the increase of the differentiation and stage of endometrial carcinoma (P < 0.05). However, the plasma levels of the activated partial thrombopiastin time and the high density lipoprotein in endometrial carcinoma patients were significantly lower than those in endometrial hyperplasia without atypia (P < 0.05). Conclusion: The high level of blood lipid can be regarded as the early-warning index in the endometrial carcinoma risk group. And the abnormal blood coagulation function can be regarded as the important index to evaluate the differentiation and stage of endometrial carcinoma. And, it can provide the basis to prevent occurrence, advancing and antithrombotic therapy of endometrial carcinoma.