上皮性卵巢癌中血小板计数与聚集功能的变化及临床意义

盛红娜; 马学功; 王颖梅; 田文艳; 齐政; 薛凤霞

doi:10.3969/j.issn.1000-8179.2013.10.005

上皮性卵巢癌中血小板计数与聚集功能的变化及临床意义

Function of thrombocytosis and platelet aggregation in epithelial ovarian cancer

摘要

摘要:
目的探讨上皮性卵巢癌（epithelial ovarian cancer, EOC）中血小板聚集功能与计数的变化及其对卵巢癌早期诊断、病情监测和预后评估的临床意义。
方法选取天津医科大学总医院妇科2010年1月至2012年6月收治的61例上皮性卵巢癌患者（EOC组）, 57例卵巢良性肿瘤患者（良性肿瘤组）和80例健康查体患者（健康对照组）, 应用血小板聚集测量仪以二磷酸腺苷（ADP）为诱导剂, 比浊法检测血小板最大聚集率（maximum aggregation rate, MAR）及聚集曲线坡度（Platelet Aggregation Slope, PtS）, 全血细胞自动检测分析仪检测血小板计数及血红蛋白浓度, 并与卵巢癌临床病理因素进行相关性分析。
结果 24.59% EOC患者伴有血小板增多症, EOC组平均血小板计数及MAR显著高于良性肿瘤组和健康对照组（P < 0.05）; EOC组PtS显著高于健康对照组（P < 0.05）。EOC患者血小板增多及MAR水平升高与组织学高分级、FIGO分期晚期、术后残余灶≥1 cm及术前CA125升高显著相关（P < 0.05）, 与病理类型无关（P>0.05）。PtS与EOC患者临床病理特征无明显相关性（P>0.05）。
结论卵巢癌患者外周血血小板数量与聚集功能均明显增强, 并且血小板计数增多及MAR水平升高与组织学分级、FIGO分期、术后残余灶以及CA125水平等卵巢癌不良预后因素密切相关。

Abstract:
Objective This study aimed to investigate the incidence of thrombocytosis, platelet aggregation rate, and their correlation with the diagnosis and prognosis of epithelial ovarian cancer (EOC).
Methods The maximum platelet aggregation (MAR), PtS, platelet count, and hemoglobin were determined in 61 patients with EOC, 57 patients with benign tumor, and 80 normal persons as controls using a CHRONO-PAR platelet aggregation analyzer (ADP-induced turbidimetry) and whole-blood analyzer, respectively.
Results A total of 24.59% EOC patients presented thrombocytosis. The mean platelet count, MAR, and PtS were significantly higher in the EOC group than in the control group (P < 0.05). Thrombocytosis and higher MAR were identified to be associated with higher tumor grade, more advanced stage, residue tumor size > 1 cm, and higher CA-125 level in EOC patients (P < 0.05). No significant correlation was observed between Pts and clinicopathological features of EOC.
Conclusion Thrombocytosis accompanied by higher platelet aggregation rates was associated with negative prognostic factors and suggested more aggressive tumor biology in EOC.

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